[Child abuse: its knowledge, attention and diffusion in three pediatric hospitals in Mexico].

Science.gov (United States)

Loredo-Abdalá, Arturo; Villanueva-Clift, Héctor; Aguilar-Ceniceros, Angélica María; Casas-Muñoz, Abigail

Child abuse (CA) was observed in Mexico since the early 60's through isolated publications from clinical cases and where manifestations of physical injury or sexual abuse predominated. Since the 90's, the Clinic for Integral Care of the Abused Child was established at the National Institute of Pediatrics (CAINM-INP, for its Spanish acronym), which actions were addressed to the care, teaching and research on this topic. This approach was replicated in two hospital centers in the country: the Clinic for Integral Care of the Abused Children at Children's Specialty Care Hospital of Chihuahua and the Pediatric Service of the General Hospital of Mexicali. The main objective of this work was to present to the medical community, paramedics, and other professionals who interact with the pediatric population and society, the efforts that have been made in Mexico to address this legal, medical, and social pathology in a logical manner, and always aimed at protecting victims and their families. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Best nursing practices in diabetes education for the hospitalized child: an integrative review

Directory of Open Access Journals (Sweden)

Luíza de Oliveira Messias Ortiz

2017-12-01

Full Text Available The incidence of Diabetes Mellitus type 1 (DM1 has increased in the last years, with a consequent growth of child hospitalizations due to diabetic prime decompensation, with growing need of an educational process. Thus, our objective was to identify in the literature the best nursing practices in diabetes education for hospitalized children with DM1 and their families. We conducted an integrative review with the descriptors: Diabetic Ketoacidosis, Diabetes Education, Nursing and Child, Hospitalized, and the free search in reference journals and similar articles. We selected four studies, and we identified three categories: Family Involvement and Empowerment in the Diabetes Educational Process; Performance of the Multi-professional Team; Definition and Content of the Educational Process. We concluded that the educational process should include the family, it should be conducted by a multi-professional team and based on scientific evidence. We identified few studies, showing the need for more studies in the field.

Relationship between parent knowledge of child sleep, and child sleep practices and problems: A pilot study in a children's hospital cohort.

Science.gov (United States)

McDowall, Philippa S; Elder, Dawn E; Campbell, Angela J

2017-08-01

To describe parent reports of sleep practices, and examine associations with parent knowledge of child sleep, and whether children's sleep practices differ between parents who underestimated, overestimated or accurately estimated children's sleep needs. Parents of children aged 2-12 years (n = 115) attending hospital inpatient or day wards were approached and asked to report child sleep routines, sleep problems, parent education, household income and parent knowledge of child sleep via questionnaire. Younger age was associated with earlier bedtimes and wake times, shorter sleep latencies, longer sleep durations and greater sleep problems (P child sleep reported earlier weekday and weekend bedtimes (r s  ≥ 0.26) and wake times (r s  ≥ 0.21) and greater consistency between their child's weekend and weekday sleep routines (P child's sleep needs: parents who underestimated reported later weekday bedtimes (on average, 46 min), and longer sleep latencies (17 min); parents who overestimated reported longer sleep latencies (22 min). These findings remained significant when controlling for child age (P Child Health Division (The Royal Australasian College of Physicians).

A Service evaluation of a hospital child death review process to elucidate understanding of contributory factors to child mortality and inform practice in the English National Health Service.

Science.gov (United States)

Magnus, Daniel S; Schindler, Margrid B; Marlow, Robin D; Fraser, James I

2018-03-16

To describe a novel approach to hospital mortality meetings to elucidate understanding of contributory factors to child death and inform practice in the National Health Service. All child deaths were separately reviewed at a meeting attended by professionals across the healthcare pathway, and an assessment was made of contributory factors to death across domains intrinsic to the child, family and environment, parenting capacity and service delivery. Data were analysed from a centrally held database of records. All child deaths in a tertiary children's hospital between 1 April 2010 and 1 April 2013. Descriptive data summarising contributory factors to child deaths. 95 deaths were reviewed. In 85% cases, factors intrinsic to the child provided complete explanation for death. In 11% cases, factors in the family and environment and, in 5% cases, factors in parenting capacity, contributed to patient vulnerability. In 33% cases, factors in service provision contributed to patient vulnerability and in two patients provided complete explanation for death. 26% deaths were classified as potentially preventable and in those cases factors in service provision were more commonly identified than factors across other domains (OR: 4.89; 95% CI 1.26 to 18.9). Hospital child death review meetings attended by professionals involved in patient management across the healthcare pathway inform understanding of events leading to a child's death. Using a bioecological approach to scrutinise contributory factors the multidisciplinary team concluded most deaths occurred as a consequence of underlying illness. Although factors relating to service provision were commonly identified, they rarely provided a complete explanation for death. Efforts to reduce child mortality should be driven by an understanding of modifiable risk factors. Systematic data collection arising from a standardised approach to hospital reviews should be the basis for national mortality review processes and database

[Art therapy and the promotion of child development in a hospitalization context].

Science.gov (United States)

Valladares, Ana Cláudia Afonso; da Silva, Mariana Teixeira

2011-09-01

This study aimed to evaluate and compare the development of hospitalized children before and after art therapy interventions. Qualitative case studies were undertaken in this descriptive-exploratory research, based on the developmental evaluation of the children. The study participants were five children between seven and ten years old, in the Hospital of Tropical Illnesses (HDT) in the city of Goiânia, state of Goiás, Brazil, in 2006. Results showed that art therapy interventions efficiently promoted children's development. Art therapy is a resource for positively channeling the variables of hospitalized children's development and for neutralizing affective factors that naturally appear, as well as for exposing the child's healthier potentials, which sometimes receive little stimulus in the context of hospitalization.

Medical social work practice in child protection in China: A multiple case study in Shanghai hospitals.

Science.gov (United States)

Zhao, Fang; Hämäläinen, Juha; Chen, Yu-Ting

2017-01-01

With the rapid development of the child welfare system in China over recent years, medical social work has been increasingly involved in providing child protection services in several hospitals in Shanghai. Focusing on five cases in this paper, the exploratory study aims to present a critical overview of current practices and effects of medical social work for child protection, based on a critical analysis of the multidimensional role of social work practitioners engaged in the provision of child protection services as well as potential challenges. Implications and suggestions for future improvements of China's child protection system are also discussed.

Inpatient child mortality by travel time to hospital in a rural area of Tanzania.

Science.gov (United States)

Manongi, Rachel; Mtei, Frank; Mtove, George; Nadjm, Behzad; Muro, Florida; Alegana, Victor; Noor, Abdisalan M; Todd, Jim; Reyburn, Hugh

2014-05-01

To investigate the association, if any, between child mortality and distance to the nearest hospital. The study was based on data from a 1-year study of the cause of illness in febrile paediatric admissions to a district hospital in north-east Tanzania. All villages in the catchment population were geolocated, and travel times were estimated from availability of local transport. Using bands of travel time to hospital, we compared admission rates, inpatient case fatality rates and child mortality rates in the catchment population using inpatient deaths as the numerator. Three thousand hundred and eleven children under the age of 5 years were included of whom 4.6% died; 2307 were admitted from time between admission and death. Assuming uniform mortality in the catchment population, the predicted number of deaths not benefiting from hospital admission prior to death increased by 21.4% per hour of travel time to hospital. If the same admission and death rates that were found at <3 h from the hospital applied to the whole catchment population and if hospital care conferred a 30% survival benefit compared to home care, then 10.3% of childhood deaths due to febrile illness in the catchment population would have been averted. The mortality impact of poor access to hospital care in areas of high paediatric mortality is likely to be substantial although uncertainty over the mortality benefit of inpatient care is the largest constraint in making an accurate estimate. © 2014 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Hospitalization for mental illness among parents after the death of a child

DEFF Research Database (Denmark)

Li, Jiong; Laursen, Thomas Munk; Precht, Dorthe Hansen

2005-01-01

Background The loss of a child is considered one of the most stressful events in the life of a parent. We hypothesized that parental bereavement increases the risk of hospital admission for a psychiatric disorder, especially for affective disorders. Methods We studied a cohort of 1,082,503 person...

Brincar no hospital: estratégia de enfrentamento da hospitalização infantil Playing in the hospital: coping strategy in child hospitalization

Directory of Open Access Journals (Sweden)

Alessandra Brunoro Motta

2004-04-01

Full Text Available Estudos indicam que a hospitalização pode afetar o desenvolvimento da criança, interferindo na qualidade de vida. Para lidar com essa situação, o brincar tem funcionado como estratégia de enfrentamento. Procurando-se avaliar a importância dada ao brincar pela criança e caracterizar atividades lúdicas possíveis no hospital, 28 crianças hospitalizadas com câncer (6-12 anos, em Vitória/ES, foram entrevistadas e responderam a um instrumento especialmente elaborado (AEH - Avaliação das Estratégias de Enfrentamento da Hospitalização - Conjunto B: Brincar no hospital, contendo 20 desenhos de brinquedos e brincadeiras, classificados em jogos de Exercícios, Simbólicos, de Acoplagem, de Regras e Atividades Diversas. 78,6% das crianças relataram que gostariam de brincar no hospital, o que é justificado principalmente pela sua função lúdica, na companhia de outras crianças internadas. Não houve diferenças significativas nas escolhas entre as categorias de brincadeiras. O instrumento mostrou que o brincar pode ser um recurso adequado para a adaptação da criança hospitalizada, permitindo personalizar a intervenção.Studies have shown that the hospitalization can affect a child development interfering with his/her quality of life. In order to deal with this situation, the act of playing has worked as a coping strategy. With the purpose to assess of the importance children give to play and to characterize possible playful activities in the hospital, 28 children hospitalized with cancer (6-12 years in Vitória, ES, were interviewed and took part on an instrument specially developed (AEH Evaluation of the Coping Strategies of the Hospitalization - group B: Playing in the hospital, consisting of 20 drawings of toys and games classified in games of Exercises, Symbolic Game, Game of Connection, Game of Rules and a variety of Activities. 78,6% of the children said that they would like playing in the hospital, which is justified mainly

A review of infant and young child feeding practice in hospital and ...

African Journals Online (AJOL)

Objectives: To describe infant and young child feeding practices at home and in hospital in KwaZulu-Natal Midlands, South .... Table 1 reflects the timing as well as the content of information ... frequency of meat consumption in the home was not determined. .... households do not have access to internet, the majority has a.

A 2-Year-Old Child's Memory of Hospitalization during Early Infancy

Science.gov (United States)

Solter, Aletha

2008-01-01

A child who had had surgery at 5 months of age, and who had been treated at the time for post-traumatic symptoms (reported in a previous paper by the author), was interviewed 2 years later and almost 3 years later to test for possible verbal recall of his hospitalization. He appeared to have some memories of the experience at 29 months of age, and…

The Impact of a Management Protocol on the Outcomes of Child Abuse in Hospitalized Children in Hong Kong

Science.gov (United States)

Lee, Anselm C. W.; Li, C. H.; So, K. T.

2006-01-01

Objective: To study the outcomes of children hospitalized for suspected child abuse before and after the implementation of a management protocol in a hospital in Hong Kong. Study period: Two 2-year periods before (1994-1995) and after (2002-2003) the implementation of the protocol in 1998. Methods: This is a retrospective hospital chart review in…

Child Maltreatment; Types and effects: Series of six cases from a university hospital in Oman

Directory of Open Access Journals (Sweden)

Muna Al-Saadoon

2012-02-01

Full Text Available Child maltreatment (CM is common worldwide, and can take many forms. It may even endanger the child’s life, especially when younger children are the victims. CM affects the child’s quality of life and consequently leads to long term issues to be dealt with by the child, family and community. This case series discusses six children who have been subjected to CM, and diagnosed by the child protection team of the departments of Child Health and Behavioural Medicine at Sultan Qaboos University Hospital (SQUH, Oman. The aim of this case series is to increase the level of awareness of CM among Oman’s medical professionals and to highlight the difficulties encountered in diagnosing and providing optimal care for these children. Although treatment is provided in Oman’s health care system, it is clear that there are gaps in the existing system which affect the quality of child protection services provided to the children and their families.

Bedroom air quality and vacuuming frequency are associated with repeat child asthma hospital admissions.

Science.gov (United States)

Vicendese, Don; Dharmage, Shyamali C; Tang, Mimi L K; Olenko, Andriy; Allen, Katrina J; Abramson, Michael J; Erbas, Bircan

2015-09-01

Indoor environment factors have been associated with risk of asthma exacerbations in children but little is known about their role on asthma hospital readmissions. As children in Western societies continually spend more time indoors, understanding the influence of these factors on asthma exacerbation is important. We examined the role of indoor environmental and lifestyle characteristics on child asthma readmissions. A hospital-based case-control study recruited 22 children readmitted for asthma and 22 controls not readmitted for asthma. Logistic regression models were used to examine the association between aeroallergens and fungi in the bedroom and indoor lifestyle characteristics factors for asthma readmissions. To determine the best possible set of predictors among a large set of risk factors, we used random forests (RF) techniques. Higher levels of airborne Cladosporium and yeast in the child's bedroom increased risk of readmission (OR = 1.68, 95% CI 1.04-2.72 and OR = 1.52, 95% CI 0.99-2.34, respectively). Carpeted floors in the bedroom and synthetic doonas were also associated with increase in asthma readmissions (OR = 4.07, 95% CI 1.03-16.06 and OR = 14.6, 95% CI 1.26-169.4, respectively). In the home, frequent vacuuming using bagged cleaners increased risk of asthma readmission OR = 15.7 (95% CI 2.82-87.2). Factors in the child's bedroom play an important role in increasing the risk of asthma hospital readmissions. These findings have major clinical implications as the identified potential risk factors may be modifiable. Further epidemiological studies with larger samples are necessary to evaluate these associations further.

Management of physical child abuse in South Africa: literature review and children's hospital data analysis.

Science.gov (United States)

Janssen, T L; van Dijk, M; Al Malki, I; van As, A B

2013-11-01

The reason for this review is the lack of data on the management of physical abused children in Africa. The primary goal of the first part is to outline the management of physical child abuse in (South) Africa and provide suggestions for other governments in Africa on which to base their management of physical child abuse, at both governmental and hospital management level. The main aim of the second part is to outline the extent of the problem as seen at the Red Cross Memorial Children's Hospital (RCH) in Cape Town. The National Library of Medicine's PubMed database was searched for articles specifically about the management of physical child abuse. Hospital data were analysed in two phases: one addressed various types of assault in order to assess the number of patients admitted to the trauma unit of RCH between 1991 and 2009, and the other to identify all children with suspected non-accidental injury (NAI) presenting to the trauma unit at RCH from January 2008 until December 2010. Information on physical abuse of children in Africa in the English scientific literature remains disappointing with only two articles focusing on its management. RCH data for the period 1991-2009 recorded a total number of 6415 children hospitalised with injuries following assault, who accounted for 4.2% of all trauma admissions. Types of abuse included assault with a blunt or sharp instrument, rape/sexual assault and human bite wounds. Over the last 2 decades, there has been a minor decline in the number of cases of severe abuse requiring admission; admissions for other injuries have remained stable. More detailed analysis of hospital data for 2008-2010, found that boys were far more commonly assaulted than girls (70.5% vs 29.5%). Physical abuse appeared to be the most common cause of abuse; 89.9% of all boys and 60.5% of all girls presented after physical abuse. In order to eradicate child abuse, awareness of it as to be promoted in the community at large. Because the types of child

The effectiveness of the solidary care ahead of events that follow the chronicle illness process of the hospitalized child

Directory of Open Access Journals (Sweden)

Alexandra Maria Alves

2006-08-01

Full Text Available Article of research that objectified to identify how the nurses carrie through the solidary care front to the alterations in the evolution of the hospitalized child that lead to the chronicle illness process. The methodology is qualitative through the exploratory- description method. The subjects had been nine assisstencial nurses who act in pediatric units of a great hospital of Curitiba-PR wich is reference in the pediatric area in all Brazil. For the collection of the information we used the half-structuralized interview. To accomplish the analysis of the depositions we followed the content analysis proposal by Bardin (1991. The ethical rules had been followed in agreement to the Resolution 196/96. All the subjects had signed the term of content of written informed consent. After the transcription of the interviews that had been recorded, we initiate the categorization. Three Units of Context and six Units of Meaning had been apprehended.The Units of Context include the perception of the chronicle illness process of the hospitalized child by the nurse; the perception of the nursing actions of solidary care by the family and, pointing characteristics that interpose the solidary care. For the analysis of the depositions it was possible to perceive that the lack of familiar structure is visible, therefore the child remains long time in the hospital, modifying its daily routine, affecting the family and changing its routine, that is, coexisting with the chronicle illness process imposes alterations in the existing space and temporality of the child. The family and child need support supplied by the nurse in solidary care. The solidary care is perceived by the bond, interest, contact, dialogue, support, the presence, the listening, for the empathy, reliable transmission and hope. It can be established with multiprofessional work, preparation of the team, knowledge, availability, respect for the other. The solidary care is a process, an event that

Sleep of Parents Living With a Child Receiving Hospital-Based Home Care: A Phenomenographical Study.

Science.gov (United States)

Angelhoff, Charlotte; Edéll-Gustafsson, Ulla; Mörelius, Evalotte

2015-01-01

Caring for an ill child at home gives the family the chance to be together in a familiar environment. However, this involves several nocturnal sleep disturbances, such as frequent awakenings and bad sleep quality, which may affect parents' ability to take care of the child and themselves. The aim of this study was to describe parents' perceptions of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care (HBHC) services. This is a phenomenographical study with an inductive, exploratory design. Fifteen parents (11 mothers and 4 fathers) with children enrolled in HBHC services were interviewed. Data were analyzed to discover content-related categories describing differences in ways parents experienced sleep when caring for their children receiving HBHC. Four descriptive categories were detected: sleep influences mood and mood influences sleep; support influences safeness and safeness influences sleep; the child's needs influence routines and routines influence sleep; and "me time" influences sleep. Sleep does not affect only the parents' well-being but also the child's care. Symptoms of stress may limit the parents' capacity to meet the child's needs. Support, me time, and physical activity were perceived as essential sources for recovery and sleep. It is important for nurses to acknowledge parental sleep in the child's nursing care plan and help the parents perform self-care to promote sleep and maintain life, health, and well-being.

An IBCLC in the Maternity Ward of a Mother and Child Hospital: A Pre- and Post-Intervention Study

Directory of Open Access Journals (Sweden)

Antonella Chiurco

2015-08-01

Full Text Available Published evidence on the impact of the integration of International Board Certified Lactation Consultants (IBCLCs for breastfeeding promotion is growing, but still relatively limited. Our study aims at evaluating the effects of adding an IBCLC for breastfeeding support in a mother and child hospital environment. We conducted a prospective study in the maternity ward of our maternal and child health Institute, recruiting 402 mothers of healthy term newborns soon after birth. The 18-month intervention of the IBCLC (Phase II was preceded (Phase I by data collection on breastfeeding rates and factors related to breastfeeding, both at hospital discharge and two weeks later. Data collection was replicated just before the end of the intervention (Phase III. In Phase III, a significantly higher percentage of mothers: (a received help to breastfeed, and also received correct information on breastfeeding and community support, (b started breastfeeding within two hours from delivery, (c reported a good experience with the hospital staff. Moreover, the frequency of sore and/or cracked nipples was significantly lower in Phase III. However, no difference was found in exclusive breastfeeding rates at hospital discharge or at two weeks after birth.

Knowledge and perceptions of HIV/AIDS and mother to child transmission among antenatal mothers at Nnamdi Azikiwe University Teaching hospital, Nnewi.

Science.gov (United States)

Igwegbe, A O; Ilika, A L

2005-12-01

Knowledge of HIV/AIDS by pregnant mothers is very important in the prevention of mother to child transmission. This study evaluates the knowledge and perceptions of HIV/AIDS and mother to child transmission among pregnant women attending antenatal clinic at a University Teaching Hospital. Pre-tested questionnaires were interviewer administered to 312 pregnant women randomly selected at the antenatal clinic of the Nnamdi Azikiwe University Teaching Hospital Nnewi. The level of awareness of HIV/AIDS among antenatal mothers was very high (99%) and the main sources of information were radio (44.7%), television (38.8%), and print media (34.0%). Though majority (94.2%) was aware HIV infection can coexist with pregnancy, only 76.9% were aware of mother to child transmission. Transplacental (46.1%), breastfeeding (31.7%), and vaginal delivery (16.3%) were the commonly identified routes of vertical transmission. Surprisingly, eighteen respondents (5.8%) indicated that caesarean section is a possible route of vertical transmission. Though the percentage of HIV/AIDS knowledge is high, the level of knowledge and perceptions of mother to child transmission is inadequate. This suggests the need to scale up health education about mother to child transmission in our health facilities.

Hospitalization of abused and neglected children.

Science.gov (United States)

Marshall, W N

1997-03-01

To describe the use of inpatient hospitalization for abused and neglected children living in a metropolitan area. Retrospective record review of abused and neglected children admitted in 1992 and 1993 to hospitals with 87% of metropolitan area pediatric admissions; comparison of these data with population, crisis nursery, and child protective services data. Thirty-four abused and neglected children were admitted to hospital, representing 0.3% (34/11,066; 95% confidence interval, 0%-1.2%) of pediatric admissions and 0.2% (34/19,950; 95% confidence interval, 0%-0.6%) of child protective services reports. This represents a rate of hospitalization for child abuse of 10 children (95% confidence interval, 0-46) per 100,000 child population per year. Seven hundred fifteen children were admitted to the crisis nursery by child protective services. Of those admitted to the hospital, 12 needed intensive care, 5 of whom died. Only 3 of 34 hospital-admitted children had private health insurance; 19 of 34 were younger than 1 year. Inpatient hospitalization for abuse represented a small fraction of total pediatric admissions and of child protective services reports. Comprehensive medical care for most abused children and medical education about child abuse must occur in outpatient settings.

Impact of rotavirus vaccination on child mortality, morbidity, and rotavirus-related hospitalizations in Bolivia.

Science.gov (United States)

Inchauste, Lucia; Patzi, Maritza; Halvorsen, Kjetil; Solano, Susana; Montesano, Raul; Iñiguez, Volga

2017-08-01

The public health impact of rotavirus vaccination in countries with high child mortality rates remains to be established. The RV1 rotavirus vaccine was introduced in Bolivia in August 2008. This study describes the trends in deaths, hospitalizations, and healthcare visits due to acute gastroenteritis (AGE) and in rotavirus-related hospitalizations, among children rotavirus-related AGE was assessed using data from the active surveillance hospitals. Compared with the 2001-2008 pre-vaccine baseline, the mean number of rotavirus-related hospitalizations was reduced by 40.8% (95% confidence interval (CI) 21.7-66.4%) among children rotavirus disease. Over the post-vaccine period, changes in rotavirus epidemiology were observed, manifested by variations in seasonality and by a shift in the mean age of those with rotavirus infection. The significant decrease in main AGE-related health indicators in children rotavirus vaccine provides evidence of a substantial public health impact of rotavirus vaccination in Bolivia, as a measure for protecting children against AGE. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Mental health problems among female staff in a provincial maternal and child health hospital: an investigation of 647 individuals].

Science.gov (United States)

He, W J; Xia, J H; Lv, X; Li, L M

2018-02-20

Objective: To investigate the current status of depression and anxiety among female staff in a maternal and child health hospital, and to provide a basis for developing related prevention and intervention measures and promoting the mental health of female staff. Methods: The female staff from a provincial maternal and child health hospital completed a psycho-health questionnaire survey on Internet from June to October, 2016. The questionnaires used in the survey consisted of Patient Health Questionnaire (PHQ-9) , Generalized Anxiety Disorder Scale (GAD-7) , and Symptom Checklist-90 (SCL-90) . The distribution features of mental health problems such as depression and anxiety were analyzed according to the results: of the questionnaire survey. Results Of all female staff surveyed, 42.04% showed depression symptoms, 28.90% showed anxiety symptoms, and 26.12% showed comorbid symptoms of depression and anxiety. Moderate or severe depression (anxiety) was mainly distributed among the female staff with comorbid symptoms (90.63% and 97.01%, respectively) . There were significant differences in the distribution of moderate or severe anxiety symptoms between the medical staff and nursing staff (χ(2)= 5.81, P =0.05) and between those with intermediate and junior professional titles (χ(2)=7.99, P =0.018) . As for SCL-90 results, the total score, total average score, and scores on factors of somatization, compulsion, interpersonal sensitivity, depression, and anxiety in the female staff with comorbid symptoms, moderate or severe depression, and moderate or severe anxiety were significantly higher than the national norm ( P staff with comorbid symptoms than in the female staff with a single symptom and asymptomatic female staff (both P staff in the maternal and child health hospital, mainly characterized by comorbid symptoms of moderate or severe depression and anxiety. Comorbidity is accompanied by mental health problems such as interpersonal sensitivity, obsessive compulsion

[Validity of the Child Psychiatric Hospital Teacher Questionnaire for the assessment of ADHD. Teacher's version].

Science.gov (United States)

Ulloa, R E; Narváez, M R; Arroyo, E; del Bosque, J; de la Peña, F

2009-01-01

Teacher's rating scales for the evaluation of attention deficit and superactivity disorder (TDAH) and conduct disorders have been shown to be useful and valid tools. The Child Psychiatric Hospital Teacher Questionnaire (CPHTQ) of the Hospital Psiquiátrico Infantil Dr. Juan N. Navarro was designed for the assessment of ADHD symptoms, externalizing symptoms and school functioning difficulties of children and adolescents. Internal consistency, criterion validity, construct validity and sensitivity of the scale to changes in symptom severity were evaluated in this study. The scale was administered to 282 teachers of children and adolescents aged 5 to 17 years who came to a unit specialized in child psychiatry. The validity analysis of the instrument showed that the internal consistency measured by Cronbach's alpha was 0.94. The factorial analysis yielded 5 factors accounting for 59.1% of the variance: hyperactivity and conduct symptoms, predatory, conduct disorder, inattentive, poor functioning and motor disturbances. The CPHTQ scores on the scale showed positive correlation with the Clinical Global impression (CGI) scale in the patients' response to drug treatment. The CPHTQ shows adequate validity characteristics that demonstrate its utility in the evaluation of patients with ADHD and its comorbidity with other behavior disorders.

Child abuse and neglect as seen in General Hospital, Kuala Lumpur--a two year study.

Science.gov (United States)

Kassim, M S; George, R; Kassim, K; Begum, M; Cherian, M P; Tajudin, A K; Chandran, V; Anan, A; Reddy, R; Singh, J

1989-06-01

Eighty-six children diagnosed as child abuse and/or neglect were admitted to the Paediatric wards of the General Hospital, Kuala Lumpur during 1985 and 1986. Of these cases, 62 were of physical abuse, six of sexual abuse, one case of both physical and sexual abuse and 17 of neglect. There were 25 boys and 61 girls. Thirty-four of these children were Malays, 16 Chinese, 26 Indians, three mixed and seven illegal immigrants. Twenty-one were below the age of one year, 24 from one to four years, 25 from five to nine years and 16 were ten years and above. The abusers were mainly close members of the family. Of these children, 24 were sent back to their parents and 11 to their relatives home. Twenty-seven were taken into care by the Ministry of Social Welfare and the remaining seven children who were illegal immigrants, were deported with their parents. Only one child was successfully fostered. Eleven children were taken away from the hospital by their parents or guardians without the knowledge of the health staff. There were five deaths in the series.

Methodological challenges in following up patients of a hospital child protection team: is there a recruitment bias?

Directory of Open Access Journals (Sweden)

Lips Ulrich

2010-11-01

Full Text Available Abstract Background The aims of this study are to describe the methodological challenges in recruiting a follow-up sample of children referred to an interdisciplinary hospital child protection team (CPT and to compare participating versus non-participating groups on several demographic variables and maltreatment characteristics. Methods Of the 319 in- and outpatients referred to the CPT at University Children's Hospital Zurich from 2005–2006 a sample of 180 children was drawn to contact for a follow-up. The children and their parents were asked to participate in a face-to-face interview at the hospital; in 42 cases the children and parents consented to do so. Alternatively, the parents could take part in a telephone interview (n = 39. Non-participation resulted because no contact or adequate communication in German, French, or English could be established (n = 49 or because the parents or children refused to participate (n = 50. Results Participants and non-participants did not differ significantly in mean child age at follow-up, gender, family status, place of residence, certainty and type of maltreatment, and type of perpetrator. However, the child's nationality had a significant impact: Percentages of foreign nationals were higher in the fully participating group (45%; n = 19 and the non-contactable group (53%; n = 26 and significantly lower in the refusal (26%; n = 10 and the telephone interview group (18%; n = 9. Although a high percentage of families had moved in the few years since the CPT intervention (32%; n = 57, the percentage of moves was not significantly higher in non-participants compared to participants. Conclusions Further research is needed to support these results in different national backgrounds and to test for biases in variables not included – especially socioeconomic status. This includes gathering more detailed information on non-participants, while respecting ethical boundaries. Overall, the fact that only child

Clinical Commentary by Barbara Segal, a Consultant Child and Adolescent Psychotherapist Working in University College London Hospitals

Science.gov (United States)

Segal, Barbara

2010-01-01

This moving clinical account describes the psychotherapeutic work of a child psychotherapist undertaken in a hospital room with 13-year-old Maya, after the sudden onset of a terrifying and serious illness, Guillain-Barre syndrome, leaving her with paralysis and extreme weakness. The first session takes place almost three weeks after Maya's…

Using Routinely Collected Hospital Data for Child Maltreatment Surveillance: Issues, Methods and Patterns

Directory of Open Access Journals (Sweden)

Scott Debbie A

2011-01-01

maltreatment cases. Conclusion This study has demonstrated that hospital data could provide valuable information for routine monitoring and surveillance of child maltreatment, even in the absence of population-based linked data sources. With national and international calls for a public health response to child maltreatment, better understanding of, investment in and utilisation of our core national routinely collected data sources will enhance the evidence-base needed to support an appropriate response to children at risk.

Predictive factors of mother-child communication patterns in the mothers referred to Khorramabad Shahid Madani hospital in 2012

Directory of Open Access Journals (Sweden)

khatereh Anbari

2014-03-01

Full Text Available Background : The quality of mother-child relationship play an important role in personality shaping, social functioning and mental health of children in the future . This study was designed to evaluate the prognostic factors of mother - child relationship patterns.   Materials and Methods: In this cross sectional study 110 mothers admitted to children's hospital of Khorramabad selected by consecutive sampling method. Data gathering tool was Mother - Child Relationship Evaluation (MCRE questionnaire. At first the view points of the mothers about four communication patterns including: over protection, child rejection, overneglignce and child acceptance were examined, then according to each pattern cut off, the type of communication pattern was determined. Fisher's exact test and linear regression were used for data analysis.   Results: The mean age of participants was 28.6±6.46. Communication pattern in 66.4% of the mothers was over protection and 19.1% of them had overneglence pattern. Also communication pattern in 12.8% of the participants was child acceptance and 1.8% followed from child rejectoin communication pattern. A significant statistical relation was seen between age, education level, marital status, mothers residence and pregnancy status with the pattern of their relationship (P <0.05. In linear regression analysis, most important factors in predicting the communication pattern were single parent and unplanned pregnancy.   Conclusion: Raising awareness of mothers through workshops can increase proper child skills and led to the development of social skills and reducing child behavior problems in the future.

Everyone's business: developing an integrated model of care to respond to child abuse in a pediatric hospital setting.

Science.gov (United States)

Connolly, Sarah

2012-01-01

In pediatric hospitals, social work plays a central role in the prevention, identification, and management of child abuse. Children who are suspected of having been abused or neglected require an evaluation of their psychosocial situation. As an integral member of the health care team, the social worker is well placed to undertake comprehensive psychosocial assessments including information on the child's development, parental capacity, family, and community supports. Current practice approaches have seen a shift away from a narrow, "expert" approach to child protection. This article describes the development of an integrated model of social work service delivery to better respond to vulnerable and at-risk children in a pediatric hospital setting. Developing a new model of service required strategic planning, consultation, and endorsement from senior hospital management. The new model aimed to ensure a high quality, responsive social work service to children at risk of physical abuse, neglect, or cumulative harm. The change necessitated understanding of current research evidence, development of best practice guidelines, and effective communication with staff and external stakeholders. Policy development, implementation of practice guidelines, staff training, data collection, and service evaluation are described. The role of social work management and leadership were central in creating change. Visionary leadership is widely regarded as key to successful organizational change. The management approach included consultation with staff, building commitment to the need for change, addressing staff concerns, and providing a vision of enhanced client outcomes as a result of the change process. This article provides a candid overview of challenges and barriers to change. Change strategies described are easily transferable to other social work settings. Copyright © Taylor & Francis Group, LLC

Pediatric out-of-hospital deaths following hospital discharge: a ...

African Journals Online (AJOL)

Background: Out-of-hospital death among children living in resource poor settings occurs frequently. Little is known about the location and circumstances of child death following a hospital discharge. Objectives: This study aimed to understand the context surrounding out-of-hospital deaths and the barriers to accessing ...

["FESZEK": A program based on cognitive behavioral therapy in Vadaskert Child and Adolescent Psychiatry Hospital and Outpatient Clinic].

Science.gov (United States)

Kis, Dóra Sarolta; Miklós, Martina; Füz, Angelika; Farkas, Margit; Balázs, Judit

2017-01-01

Attention-deficit/hyperactivity disorder (ADHD) is a common child psychiatric disorder, which occurs in approximately 4-6% of school-aged children. The symptoms of ADHD cause difficulties in academic performance, during leisure activities and affect family-, and peer relations as well. The most effective treatment for managing ADHD is the combination of non-pharmacological and pharmacological interventions. The aim of this paper is to introduce the "Fészek" program - which takes place in Vadaskert Child and Adolescent Psychiatry Hospital and Outpatient Clinic - where children with the diagnosis of ADHD or showing the symptoms of ADHD go through the diagnostic procedure and participate in a cognitive behavioral therapy program.

Child dental fear and behavior: The role of environmental factors in a hospital cohort

Directory of Open Access Journals (Sweden)

B S Suprabha

2011-01-01

Full Text Available Introduction: Information on the origin of dental fear and uncooperative behavior in a child patient is important for behavior management strategy. The effects of environmental factors have been comparatively less studied, especially in an Indian scenario. Objectives: To find the association of (1 age, gender, family characteristics, previous medical, and dental experiences with dental fear and behavior (2 dental fear with dental behavior. Materials and Methods: A cross-sectional questionnaire study involving 125 children aged between 7 and 14 years undergoing dental treatment under local anesthesia. The parent completed a questionnaire on family situation, medical history, and past dental experiences of the child. Child′s dental fear was recorded using Children′s Fear Survey Schedule-Dental Subscale and behavior was rated using Frankl Behaviour Rating Scale. Statistical Analysis: Data were analyzed using chi square test and binary logistic regression analysis. Results: Unpleasant experience in dental clinic and age of the child significantly influenced dental behavior. Visited pediatrician in the past one year, prior history of hospital admission, previous visit to dentist, experience at the first dental visit, and age of the child were contributing factors for dental fear. There was also significant association between dental fear levels and behavior. Conclusions: In 7 to 14 year olds, dental fear influences dental behavior, but the factors affecting them are not the same. Although dental fear decreases and dental behavior improves with age, experiences at the previous dental visits seem to influence both dental fear and behavior. Past medical experiences are likely to influence dental fear but not dental behavior.

A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

DEFF Research Database (Denmark)

Mollerup, Pernille Maria; Gamborg, Michael Orland; Trier, Cæcilie

2017-01-01

BACKGROUND: Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. METHODS: In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS......) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children's Obesity Clinics' Treatment protocol. Height, weight, and WC were measured at all consultations...... was invested per child per year. CONCLUSION: BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility....

[Understanding a hospitalized, school-aged child's stress in the PICU: the application of picture books in nursing care].

Science.gov (United States)

Wang, Pei-Ju; Feng, Jui-Ying

2013-06-01

Hospitalization in the pediatric intensive care unit (PICU) can be a very stressful and sometimes traumatic experience for school-aged children due to illness, painful procedures, unfamiliar environment, and separation from family. We incorporated picture books into PICU nursing care to explore the stress response in a school-aged child with compartment syndrome who was hospitalized in the PICU. Observation, interview and communication with the patient were used to assess her psychological reactions and emotional and behavioral responses to stress related to hospitalization and medical treatment. Autonomy and control were provided and strengthened by giving the patient choices and purposive life plans. Picture books were used to establish rapport and help the patient express her feelings, needs, and desires for parental love and company. This case report highlights the importance of nurses' awareness of children's stresses and needs during hospitalization in the PICU as well as the value of picture books or other age-appropriate tools for this patient population.

The Child Opportunity Index and Disparities in Pediatric Asthma Hospitalizations Across One Ohio Metropolitan Area, 2011-2013.

Science.gov (United States)

Beck, Andrew F; Huang, Bin; Wheeler, Kathryn; Lawson, Nikki R; Kahn, Robert S; Riley, Carley L

2017-11-01

To determine whether the Child Opportunity Index (COI), a nationally available measure of relative educational, health/environmental, and social/economic opportunity across census tracts within metropolitan areas, is associated with population- and patient-level asthma morbidity. This population-based retrospective cohort study was conducted between 2011 and 2013 in a southwest Ohio county. Participants included all children aged 1-16 years with hospitalizations or emergency department visits for asthma or wheezing at a major pediatric hospital. Patients were identified using discharge diagnosis codes and geocoded to their home census tract. The primary population-level outcome was census tract asthma hospitalization rate. The primary patient-level outcome was rehospitalization within 12 months of the index hospitalization. Census tract opportunity was characterized using the COI and its educational, health/environmental, and social/economic domains. Across 222 in-county census tracts, there were 2539 geocoded hospitalizations. The median asthma-related hospitalization rate was 5.0 per 1000 children per year (IQR, 1.9-8.9). Median hospitalization rates in very low, low, moderate, high, and very high opportunity tracts were 9.1, 7.6, 4.6, 2.1, and 1.8 per 1000, respectively (P asthma morbidity. The details provided by the COI may inform interventions aimed at increasing opportunity and reducing morbidity across regions. Copyright © 2017 Elsevier Inc. All rights reserved.

Child malnutrition – from Hospital to clinical practice – the experience of Tanzania and Uganda

Directory of Open Access Journals (Sweden)

Alexandra Vasconcelos

2016-12-01

Full Text Available In recent years, there has been a global effort to tackle the problem of child malnutrition that is still the underlying cause of death of at least 3.1 million children annually. Uganda and Tanzania are among the 22 countries with higher prevalence of child malnutrition. However, these two countries are true examples of how it is possible to reduce this scourge through simple, low-cost strategies. In 2010 I had the opportunity to learn and understand childhood malnutrition through a postgraduate course in Tanzania and Uganda – the East African Short Course in Tropical Medicine from London School of Hygiene and Tropical Medicine (LSHTM. Beginning with a review of concepts and definitions of childhood malnutrition and the links between development and nutrition, this article moves on to summarise a learning experience from Uganda and Tanzania related to the progress and effectiveness of ‘hospital-based” and ‘community-specific’ interventions.

Physical Child-Abuse in Tehran, Iran

Directory of Open Access Journals (Sweden)

Ali Akbar Sayyari

2001-12-01

Full Text Available Objective: Child-abuse (physical, mental and sexual is considered as one of the important problems faced by persons specialized in behavioral Sciences and Forensic Medicine, physicians and pediatricians. This cross-sectional study was conducted to determine the status of physical child-abuse in Tehran. Materials & Methods: Forty-five pediatric residents, trained for this purpose, conducted this ten-day study in three teaching hospitals (Children's Medical Center, Bahrami Hospital, Hazrat Ali-Asghar Hospital. A questionnaire on physical child-abuse, designed and proposed by the WHO, was completed for 3019 children (male=1578, 52.3% female=1441, 47.7% less than 18 years of age, who attended the emergency department of the above hospitals. The children and their parents were interviewed and physical examination was performed for the children. Results: A total of 347 children (male=14.5%, female =9.6%, which is 12.2% of the total number of children studied, were physically abused. Injuries were mostly present on the face, upper extremities, back and lower extremities, among which 12.8% of the cases were severe and 87.2% were moderate in intensity. Fathers and mothers were responsible for 51.2% and 34.1% of the cases of child-abuse respectively. Among the persons responsible for causing child-abuse, 34.1% had themselves been physically abused during their childhood period and 26.4% had physically abused children before. Hyperactivity, bed-wetting and an unwanted child were among the most common causes of child-abuse. Conclusion: Factors precipitating child-abuse included: large numbers of children in the family drug addiction of one of the family members, and acute or severe psychological stress during the past 6 months. Using the Chi-square test, a significant relationship (P value=0.00l was found to exist between physical child-abuse and demographic factors such as age, sex, site of residence, history of divorce or separation of the parents and

The influence of family accommodation on pediatric hospital experience in Canada.

Science.gov (United States)

Franck, Linda S; Ferguson, Deron; Fryda, Sarah; Rubin, Nicole

2017-08-15

The goals of our study were to describe the types of family accommodation for parents of hospitalized children and to examine their influence on the pediatric hospital experience. This multi-site cohort survey included 10 hospitals in Ontario Province, Canada. Participants were parents of inpatient children (n = 1240). Main outcome measures included ratings of three parent-reported measures of hospital experience: overall hospital experience; willingness to recommend the hospital to family or friends; and how much the accommodation type helped parent stay involved in their child's hospital care. Parents most often stayed in the child's room (74.7%), their own home (12.3%), hotel (4.0%) or a Ronald McDonald House (3.0%). Accommodation varied based on hospital, parent and child factors. Length of stay and the child's health status were significant predictors for overall hospital experience and recommending the hospital to family or friends, but accommodation type was not. Families who stayed at a Ronald McDonald House reported greater involvement in their child's care compared with other accommodation types (odds ratio: 1.54-20.73 for contrasted accommodation types). Use of different overnight accommodations for families of hospitalized pediatric patients in Canada is similar to a previous report of U.S. family hospital accommodations. In contrast to the previous U.S. findings, Canadian hospital experience scores were lower and accommodation type was not a significant predictor of overall hospital experience or willingness to recommend the hospital. In Canada, as in the U.S., families who stayed at a Ronald McDonald House reported that this accommodation type significantly improved their ability to be involved in their child's care.

Clustering of acute respiratory infection hospitalizations in childcare facilities

DEFF Research Database (Denmark)

Kamper-Jørgensen, Mads; Benn, Christine Stabell; Simonsen, Jacob

2010-01-01

To estimate how risk of acute respiratory infection (ARI) hospitalization in children attending childcare facilities with a recently (within 1 month) hospitalized child is affected by gender, age and other characteristics.......To estimate how risk of acute respiratory infection (ARI) hospitalization in children attending childcare facilities with a recently (within 1 month) hospitalized child is affected by gender, age and other characteristics....

A comparison of the 'cost per child treated' at a primary care-based sedation referral service, compared to a general anaesthetic in hospital.

Science.gov (United States)

Jameson, K; Averley, P A; Shackley, P; Steele, J

2007-09-22

To compare the cost-effectiveness of dental sedation techniques used in the treatment of children, focusing on hospital-based dental general anaesthetic (DGA) and advanced conscious sedation in a controlled primary care environment. Data on fees, costs and treatment pathways were obtained from a primary care clinic specialising in advanced sedation techniques. For the hospital-based DGA cohort, data were gathered from hospital trusts in the same area. Comparison was via an average cost per child treated and subsequent sensitivity analysis. Analysing records spanning one year, the average cost per child treated via advanced conscious sedation was pound245.47. As some treatments fail (3.5% of cases attempted), and the technique is not deemed suitable for all patients (4-5%), DGA is still required and has been factored into this cost. DGA has an average cost per case treated of pound359.91, 46.6% more expensive than advanced conscious sedation. These cost savings were robust to plausible variation in all parameters. The costs of advanced conscious sedation techniques, applied in a controlled primary care environment, are substantially lower than the equivalent costs of hospital-based DGA, informing the debate about the optimum way of managing this patient group.

[Child abuse in Tlaxcala: a case-control study].

Science.gov (United States)

Herrada-Huidobro, A; Nazar-Beutelspacher, A; Cassaball-Núñez, M; Vega-Ramos, R; Nava-Cruz, C B

1992-01-01

A longitudinal, retrospective and descriptive study about child abuse was carried out in the Hospitals of the Tlaxcala Secretariat of Health, Mexico. The information was obtained from hospitalized children's charts between January first and November 30, 1991. The charts included were those belonging to zero to 14 year old children with injuries, poisoning, and II-III degrees of malnutrition. Four child-abuse criteria were established: physical, sexual, non organic malnutrition and mixed (physical and non organic malnutrition). Two control groups were defined. Different patterns were observed between accidental and non accidental injuries, malnutrition and poisoning among the case and the control groups. The study provides useful information for the integral diagnosis of child abuse in hospitalized children.

Using drawings to understand the child's experience of child-centred care on admission to a paediatric high dependency unit.

Science.gov (United States)

Foster, Mandie; Whitehead, Lisa

2018-01-01

Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.

Asthma - child - discharge

Science.gov (United States)

Pediatric asthma - discharge; Wheezing - discharge; Reactive airway disease - discharge ... Your child has asthma , which causes the airways of the lungs to swell and narrow. In the hospital, the doctors and nurses helped ...

In hospital with a hearing impaired child - How parents experience communication between nurses and their child

Science.gov (United States)

Brooks, Seraina; Eckerli-Wäspi, Irene; Händler Schuster, Daniela

2018-04-01

Background: In daily communication, children with hearing impairment are restricted and dependent on their parents’ help. In case of a hospitalisation, the risk of insufficient information and resulting traumatisation for those children is high. The aim of this study is the investigation of the communicative needs of the children concerned in order to avoid negative consequences of a hospitalisation and of inappropriate communication by nursing staff. Aim: This study explores how parents of a child with hearing impairment experience the communication between the nursing staff and their hospitalised child. Method: The study was conducted together with an advisory centre for hearing-impaired children, where most of the parents could be recruited. Narrative, semi-structured interviews were conducted. The transcribed interviews were analysed according to the method of interpretative phenomenology. Results: The parents expressed their wish for affectionate verbal and nonverbal love and care for their child. They often experienced the nursing staff having little time, that there was no continuity and that the communicative needs of the child were not recognised. Since the parents did not think the nursing staff were capable of communicating with the child and because they wanted to protect him or her, they adopted a mediating role. Conclusions: Besides the sensitisation of the nursing staff, time resources, continuity, professional knowledge and benevolence in the nursing care of a child with hearing impairment play a fundamental role.

Alojamiento conjunto madre-hijo y lactancia humana exclusiva Joined mother-child hospital lodging and exclusive human lactation

Directory of Open Access Journals (Sweden)

SAMUEL FLORES-HUERTA

1997-03-01

Full Text Available Objetivo. Conocer la influencia del alojamiento conjunto (AC madre-hijo, en la frecuencia de lactancia humana exclusiva (LHE, desde el nacimiento hasta los cuatro meses de vida. Material y métodos. Estudio de cohortes no aleatorizado realizado en la clínica de lactancia del Hospital "Luis Castelazo Ayala", del Instituto Mexicano del Seguro Social, de enero de 1993 a octubre de 1994, en el que participaron 178 binomios madre-hijo (BMH sanos con gestación de término. El grupo con alojamiento conjunto (AC se integró con 90 BMH, y la madre recibió asesoría para lactar; 88 se atendieron en forma separada, sin asesoría para lactar. Se realizó análisis estadístico de los datos para apreciar frecuencia y asociaciones de las variables. Resultados. La alimentación se registró como LHE, fórmula o ambas. Los grupos con y sin AC se estratificaron por la forma de nacimiento, parto o cesárea. Con X² de Mantel-Haenszel y de rango logarítmico se aceptaron diferencias con pObjective. To determine the influence of joined mother-child hospital lodging (JL on the frequency of exclusive human lactation (EHL from birth to four months of age. Material and methods. Non-randomized cohort study performed at the lactation clinic of the "Luis Castelazo Ayala" Hospital of the Mexican Social Security Institute from January 1993 to October 1994 which included 178 healthy mother-child pairs (MCP with term pregnancy. The jointly lodged group (JL consisted of 90 MCP in which mothers received assessment for lactation; 88 MCP were lodged separately and no assessment was provided. Results were statistically analyzed to determine frequency and variable associations. Results. Feeding was recorded as either EHL, powdered milk or both. Groups with or without JL were stratified by form of birth, either labor or Cesarean section. With the Mantel-Haenszel X² and logarithmic range, differences were significant with p<0.05. During the study, global lactation was similar

Implementation of prevention of mother-to-child transmission of HIV programme through private hospitals of Delhi--policy implications.

Science.gov (United States)

Gupta, A K; Garg, C R; Joshi, B C; Rawat, N; Dabla, V; Gupta, A

2015-01-01

In India, programme for prevention of mother-to-child transmission (PMTCT) of HIV is primarily implemented through public health system. State AIDS Control Societies (SACSs) encourage private hospitals to set up integrated counselling and testing centres (ICTCs). However, private hospitals of Delhi did not set up ICTCs. Consequently, there is no information on PMTCT interventions in private hospitals of Delhi. This study was undertaken by Delhi SACS during March 2013 through September 2013 to assess status of implementation of PMTCT programme in various private hospitals of Delhi to assist programme managers in framing national policy to facilitate uniform implementation of National PMTCT guidelines. Out of total 575 private hospitals registered with Government of Delhi, 336 (58.4%) catering to pregnant women were identified. About 100 private hospitals with facility of antenatal care, vaginal/caesarean delivery and postnatal care and minimum 10 indoor beds were selected for study. Study sample comprised of large corporate hospitals (≥100 beds; n = 29), medium-sized hospitals (25 to women tested, 52 (0.14%) were detected HIV-positive. However, against National Policy, HIV testing was done without pre/post-test counselling/or consent of women, no PMTCT protocol existed, delivery of HIV-positive women was not undertaken and no efforts were made to link HIV-positive women to antiretroviral treatment. Major intervention observed was medical termination of pregnancy, which indicates lack of awareness in private hospitals about available interventions under national programme. The role of private hospitals in management of HIV in pregnant women must be recognized and mainstreamed in HIV control efforts. There is an urgent need for capacity building of private health care providers to improve standards of practice. National AIDS Control Organization may consider establishing linkages or adopting model developed by some countries with generalized epidemic for delivering

A survey of attitudes, knowledge and practice of dentists in London towards child protection. Are children receiving dental treatment at the Eastman Dental Hospital likely to be on the child protection register?

Science.gov (United States)

Al-Habsi, S A; Roberts, G J; Attari, N; Parekh, S

2009-02-28

To investigate the attitudes, knowledge and practices of general dental practitioners (GDPs), specialists and consultants in paediatric dentistry in London, towards child protection. Additionally, to determine if children attending paediatric dental casualty at the Eastman Dental Hospital (EDH) and those who need treatment of caries under general anaesthesia (GA) are on the child protection register (CPR). The survey was conducted by postal questionnaires with 14 closed questions. A total of 228 dentists were invited to participate in the study. Children who attended EDH and required treatment under GA or at paediatric dental casualty were checked against the CPR. The respond rate was 46% (105/228). Overall 15% (16/105) of dentists had seen at least one patient with suspected child abuse in the last six months, but only 7% (7/105) referred or reported cases to child protection services. Reasons for dentists not referring included: fear of impact on practice (10%; 11/105); fear of violence to child (66%; 69/105); fear of litigation (28%; 29/105); fear of family violence against them (26%; 27/105); fear of consequences to the child (56%; 59/105); lack of knowledge regarding the procedures for referral (68%; 71/105); and lack of certainty about the diagnosis (86%; 90/105). Of the 220 children attending for dental GA and casualty from October 2004 to March 2005, one child was found to be on the CPR. More information and training is required to raise awareness of the potential importance of the role of dentists in child protection. Improved communication between dental and medical departments is important for safeguarding children.

Going to the Hospital

Science.gov (United States)

... and therapists will show you how to use pieces of equipment, like crutches, if you need them. Some hospitals have child life specialists. Their job is to make sure kids in the hospital understand what's going on around them and help them feel more ...

Where do parents sleep best when children are hospitalized? A pilot comparison study.

Science.gov (United States)

Franck, Linda; Wray, Jo; Gay, Caryl; Dearmun, Annette K; Alsberge, Isaline; Lee, Kathryn A

2014-01-01

This pilot study compared the sleep quality and quantity of parents who slept at their hospitalized child's bedside with parents who slept at the hospital's onsite Ronald McDonald House® (RMH). Wrist actigraphy and questionnaires were used to estimate parent sleep quality and quantity. Parents who slept at their hospitalized child's bedside (n = 27) experienced more sleep disruption (wake after sleep onset) and reported poorer sleep quality and feeling less rested than parents who slept at RMH (n = 11). Bedside accommodation was associated with poorer parent sleep even when controlling for the covariates of child age and parent gender. Nearby family accommodations, such as RMH, may facilitate parent-child proximity during a child's hospitalization while also providing parents with opportunities for essential sleep.

OHSU web site readers have access to distinctive information. How to e-mail a child in the hospital; where to find a midwife.

Science.gov (United States)

Botvin, Judith D

2005-01-01

Oregon Health & Science University (OHSU), Portland, Ore., posts a web site which generously covers the various aspects of this complex organization. Visitors to www.osuhealth.com, can find a midwife, send an email to a child in the hospital, and learn about the benefits of living in Oregon.

Outcome of short-term hospitalization for children with severe asthma.

Science.gov (United States)

Weinstein, A G; Faust, D S; McKee, L; Padman, R

1992-07-01

This study presents results of a family-centered, short-term residential program in which medical, behavioral, and treatment assessments were provided to the child with severe asthma and the family. After a median stay of 15 days, forty-four consecutively admitted children with severe asthma achieved a 93% reduction in hospital days (median, 7 hospital days for the year before treatment versus median 0 hospital days per patient per year at 20 1/2-month follow-up; p less than 0.001) and an 81% reduction in emergency care (median, 4 visits for the year previously versus median, 0.4 visits per patient per year at follow-up; p less than 0.01). There was also a significant reduction in corticosteroid bursts and improvement in FEV1. Unique to this program was mandatory family participation focusing on the child's and family's adaptation to severe asthma and development of family-specific interventions to promote compliance with the treatment regimen. Child and family functioning was assessed at admission and follow-up. Hospital use at follow-up was greater for children from dysfunctional families. Families demonstrating difficulties in disciplining the child with asthma required more hospital days both before admission and at follow-up. Short-term hospitalization for children with severe asthma is associated with significant improvement in pulmonary morbidity when the family of the child is included in assessment and treatment.

Child and Adolescent Inpatient Unit in General Hospital “Tzaneio”

Directory of Open Access Journals (Sweden)

E. Tseva

2017-01-01

Full Text Available The Child and Adolescent Psychiatry Inpatient Service offers comprehensive diagnostic evaluation and treatment of children and adolescents (typical age ranges from 3-16 years old with a variety of emotional and behavioral problems including mood disorders, anxiety disorders, psychotic disorders, severe disruptive behavior, and suicide attempts. Treatment Team. The inpatient treatment team includes psychiatrists, psychologists, registered nurses, special education teacher, social worker, speech and occupational therapists. In addition, pediatricians from a full range of medical subspecialties are available for consultations. The multi-disciplinary staff emphasizes a family-oriented approach and parents and care-givers are encouraged to be active participants in the treatment team throughout a child’s stay. Treatment Program. The program offers developmentally appropriate therapeutic activities in a closely supervised environment. Extensive opportunities for observation, assessment, and intervention are possible in this intensive setting. Specialized assessments including neuropsychological testing, speech and language testing, and occupational therapy assessments are all available. Treatment plans typically include a combination of individual psychotherapy, behavior management, family counseling and medications. Staff members develop an individualized treatment plan emphasizing safety for each patient during the hospital stay. The plan is closely coordinated with families, outpatient providers, and resource programs to coordinate aftercare plans and facilitate a smooth transition to home.

Child protection medical service demonstration centers in approaching child abuse and neglect in Taiwan.

Science.gov (United States)

Chang, Yu-Ching; Huang, Jing-Long; Hsia, Shao-Hsuan; Lin, Kuang-Lin; Lee, En-Pei; Chou, I-Jun; Hsin, Yi-Chen; Lo, Fu-Song; Wu, Chang-Teng; Chiu, Cheng-Hsun; Wu, Han-Ping

2016-11-01

Child abuse includes all forms of physical and emotional ill treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child's health, development, or dignity. In Taiwan, the Child Protection Medical Service Demonstration Center (CPMSDC) was established to protect children from abuse and neglect. We further analyzed and compared the trends and clinical characteristics of cases reported by CPMSDC to evaluate the function of CPMSDC in approaching child abuse and neglect in Taiwan. We prospectively recorded children with reported child abuse and neglect in a CPMSDC in a tertiary medical center from 2014 to 2015. Furthermore, we analyzed and compared age, gender, scene, identifying settings, time of visits, injury type, injury severity, hospital admission, hospitalization duration, and outcomes based on the different types of abuse and the different settings in which the abuse or neglect were identified. Of 361 child abuse cases (mean age 4.8 ± 5.36 years), the incidence was highest in 1- to 6-year-old children (n = 198, 54.85%). Physical abuse and neglect were predominant in males, while sexual abuse was predominant in females (P Neglect was most common (n = 279, 75.85%), followed by physical (n = 56, 15.51%) and sexual abuse (n = 26, 7.2%). The most common identifying setting was the emergency department (n = 320, 88.64%), with neglect being most commonly reported. Head, neck, and facial injuries were more common in physically abused children than in neglected and sexual abused children (P neglect (P abuse, and to increase the rate of registry. Cases of physical abuse had a higher Injury Severity Score, longer duration of hospitalization, and more injuries of head, face, and neck compared with other types of abuse. The reported rate of neglect was highly elevated after the CPMSDC established during the study period. Recognition of neglect is not easy, but the consequent injury, especially

Child maltreatment hospitalisations in Hong Kong: incidence rate and seasonal pattern.

Science.gov (United States)

Ip, Patrick; Ho, Frederick Ka-Wing; Chan, Ko Ling; Yip, Paul Siu-Fai; Lau, Joseph Tak-Fai; Wong, Wilfred Hing-Sang; Chow, Chun-Bong; Jiang, Fan

2016-12-01

We investigated the incidence and seasonal patterns of child maltreatment hospitalisations in Hong Kong. A retrospective study of subjects aged under 19 years with a primary diagnosis of child maltreatment admitted to hospitals in Hong Kong from 2001 to 2010. Data were retrieved from the centralised database of all 42 public hospitals in the Hospital Authority. Child maltreatment incidence rate. A consistent seasonal pattern was found for non-sexual maltreatment in children aged 6-18 years (pmaltreatment or among children under 6 years. The seasonal pattern of child maltreatment coincided with the two school examination periods. The annual child maltreatment hospitalisation rate in Hong Kong in 2010 was 73.4 per 100 000 children under 19 years, more than double that in 2001. A peculiar seasonal pattern and an alarming increasing trend in child maltreatment hospitalisation were observed in Hong Kong, which we speculated to be related to school examination stress and increasing socioeconomic disparity. Our findings highlighted differences in the trends of child maltreatment between Hong Kong and the West. Professionals and policymakers should be made aware of these trends and develop effective strategies to tackle child maltreatment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Child responsible personnel in adult mental health services.

Science.gov (United States)

Lauritzen, Camilla; Reedtz, Charlotte

2016-01-01

Children who have parents with mental health problems are a vulnerable group. Intervening early to support parents with a mental illness can contribute to improve outcomes for children. Rigging the adult mental health system in such a manner that child responsible personnel are designated in wards is a strategy to systematically address the needs of families. It has since 2010 been mandatory for Norwegian hospitals to appoint such personnel in all hospital wards. The current study aimed to investigate the appointment of child responsible personnel in the adult mental health services in a regional hospital with local clinics. Additionally, to describe the characteristics of child responsible staff in terms of gender and educational background, their competence, clinical practice and knowledge about parental mental illness. A final aim was to study whether or not the clinics had established collaboration with other services concerning follow-up for the children of parents with mental illness. Participants in this study are the staff at psychiatric clinics in a large university hospital in Norway. Practitioners were asked to answer a questionnaire prior to the initial process of implementing the new legislation in 2010 (N = 219). After a three-year period of implementing routines to adopt the new law in the clinic, the same survey was sent out to the staff in 2013 (N = 185) to monitor if changes were taking place. To study if the changes were sustained within the clinics, we conducted a two-year follow up in 2015 (N = 108). The results indicated that the systematic work to change clinical practice in the participating hospital had made a difference. Routines to follow up children's patients after the new legislation had to some extent been implemented. The child responsible personnel had more knowledge and awareness about the consequences of parental mental illness for children. The results of this study suggested that the systems change of establishing child

Facilitators and barriers to screening for child abuse in the emergency department

Directory of Open Access Journals (Sweden)

Louwers Eveline CFM

2012-10-01

Full Text Available Abstract Background To identify facilitators of, and barriers to, screening for child abuse in emergency departments (ED through interviews with ED staff, members of the hospital Board, and related experts. Methods This qualitative study is based on semi-structured interviews with 27 professionals from seven Dutch hospitals (i.e. seven pediatricians, two surgeons, six ED nurses, six ED managers and six hospital Board members. The resulting list of facilitators/barriers was subsequently discussed with five experts in child abuse and one implementation expert. The results are ordered using the Child Abuse Framework of the Dutch Health Care Inspectorate that legally requires screening for child abuse. Results Lack of knowledge of child abuse, communication with parents in the case of suspected abuse, and lack of time for development of policy and cases are barriers for ED staff to screen for child abuse. For Board members, lack of means and time, and a high turnover of ED staff are impediments to improving their child abuse policy. Screening can be promoted by training ED staff to better recognize child abuse, improving communication skills, appointing an attendant specifically for child abuse, explicit support of the screening policy by management, and by national implementation of an approved protocol and validated screening instrument. Conclusions ED staff are motivated to work according to the Dutch Health Care Inspectorate requirements but experiences many barriers, particularly communication with parents of children suspected of being abused. Introduction of a national child abuse protocol can improve screening on child abuse at EDs.

Parents' experience of hospitalization: different strategies for feeling secure.

Science.gov (United States)

Kristensson-Hallström, I; Elander, G

1997-01-01

Twenty parents of boys (ages 2-14 years) hospitalized for hypospadias repair in a pediatric surgery department in Sweden, were interviewed concerning their experience when their child was hospitalized. A qualitative analysis of the interviews indicated that the most important issue to the parents was finding security at the hospital. Parents manifested one of three different strategies that enabled them to feel secure at the hospital; (a) relinquishing the care of their children to the nursing staff; (b) obtaining a measure of control over their children's care; and (c) relying on knowing their child best. The parental strategy adopted to feel secure was found to correspond with the way parents experienced the hospitalization. Differences were found in their children's experiences of pain and the alleviation of the pain during the hospitalization.

Being hospitalized with a newly diagnosed chronic illness--a phenomenological study of children's lifeworld in the hospital.

Science.gov (United States)

Ekra, Else Mari Ruberg; Gjengedal, Eva

2012-08-17

The impact of a hospital environment on children has rarely been investigated. Recently, however, the perspective of hospitalized children has been taken into account. Being hospitalized and facing an illness represent a dramatic change in a child's daily life, and the quality of the environment may influence the child's experiences. The aim of this study was to investigate the experiences of children being hospitalized with newly diagnosed type 1 diabetes and to obtain an increased understanding of the environmental influences on the children's lifeworld. The study used a hermeneutic phenomenological approach. The design is a combination of observation of the participant, interviews, and photographs. Nine children, aged between 7 and 12 years, participated in the study. The data were collected between October 2008 and February 2010 and analysed in accordance with thematic analysis as described by van Manen. The children experienced change through recognition and adaptation. They perceived the environment as strange but still comfortable because of the "child-friendly" atmosphere, close contact with their relatives, and access to private space. The children were gradually able to adapt to their new life; they perceived their illness through bodily changes and developed practical skills and understanding. The findings underscored the necessity for an emphasis on the mutual relationship between the body and its environment. Bodily changes that occur during illness may lead to changes in one's perception of the environment. Children seem to be particularly affected when the body appears alien and the hospital environment is unfamiliar. A well-adapted environment, active involvement, and the incorporation of new habits are significant elements of gradually returning to a more familiar life. However, the child's new life requires alertness to the body's signals and acclimation to a demanding diabetes treatment regime. All these factors remind children of their body

Being hospitalized with a newly diagnosed chronic illness—A phenomenological study of children's lifeworld in the hospital

Directory of Open Access Journals (Sweden)

Else Mari Ruberg Ekra

2012-08-01

Full Text Available The impact of a hospital environment on children has rarely been investigated. Recently, however, the perspective of hospitalized children has been taken into account. Being hospitalized and facing an illness represent a dramatic change in a child's daily life, and the quality of the environment may influence the child's experiences. The aim of this study was to investigate the experiences of children being hospitalized with newly diagnosed type 1 diabetes and to obtain an increased understanding of the environmental influences on the children's lifeworld. The study used a hermeneutic phenomenological approach. The design is a combination of observation of the participant, interviews, and photographs. Nine children, aged between 7 and 12 years, participated in the study. The data were collected between October 2008 and February 2010 and analysed in accordance with thematic analysis as described by van Manen. The children experienced change through recognition and adaptation. They perceived the environment as strange but still comfortable because of the “child-friendly” atmosphere, close contact with their relatives, and access to private space. The children were gradually able to adapt to their new life; they perceived their illness through bodily changes and developed practical skills and understanding. The findings underscored the necessity for an emphasis on the mutual relationship between the body and its environment. Bodily changes that occur during illness may lead to changes in one's perception of the environment. Children seem to be particularly affected when the body appears alien and the hospital environment is unfamiliar. A well-adapted environment, active involvement, and the incorporation of new habits are significant elements of gradually returning to a more familiar life. However, the child's new life requires alertness to the body's signals and acclimation to a demanding diabetes treatment regime. All these factors remind

Being hospitalized with a newly diagnosed chronic illness—A phenomenological study of children's lifeworld in the hospital

Science.gov (United States)

Gjengedal, Eva

2012-01-01

The impact of a hospital environment on children has rarely been investigated. Recently, however, the perspective of hospitalized children has been taken into account. Being hospitalized and facing an illness represent a dramatic change in a child's daily life, and the quality of the environment may influence the child's experiences. The aim of this study was to investigate the experiences of children being hospitalized with newly diagnosed type 1 diabetes and to obtain an increased understanding of the environmental influences on the children's lifeworld. The study used a hermeneutic phenomenological approach. The design is a combination of observation of the participant, interviews, and photographs. Nine children, aged between 7 and 12 years, participated in the study. The data were collected between October 2008 and February 2010 and analysed in accordance with thematic analysis as described by van Manen. The children experienced change through recognition and adaptation. They perceived the environment as strange but still comfortable because of the “child-friendly” atmosphere, close contact with their relatives, and access to private space. The children were gradually able to adapt to their new life; they perceived their illness through bodily changes and developed practical skills and understanding. The findings underscored the necessity for an emphasis on the mutual relationship between the body and its environment. Bodily changes that occur during illness may lead to changes in one's perception of the environment. Children seem to be particularly affected when the body appears alien and the hospital environment is unfamiliar. A well-adapted environment, active involvement, and the incorporation of new habits are significant elements of gradually returning to a more familiar life. However, the child's new life requires alertness to the body's signals and acclimation to a demanding diabetes treatment regime. All these factors remind children of their body

Hospital-based home care for children with cancer

DEFF Research Database (Denmark)

Hansson, Eva Helena; Kjaergaard, H; Schmiegelow, K

2012-01-01

, as it decreased the strain on the family and the ill child, maintained normality and an ordinary everyday life and fulfilled the need for safety and security. According to family members of children with cancer, hospital-based home care support enhanced their quality of life during the child's cancer trajectory......The study aims to describe the experiences of a hospital-based home care programme in the families of children with cancer. Fourteen parents, representing 10 families, were interviewed about their experiences of a hospital-based home care programme during a 4-month period in 2009 at a university...... hospital in Denmark. Five children participated in all or part of the interview. The interviews were transcribed verbatim and analysed using qualitative content analysis. The findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment...

Lack of knowledge about mother-to-child HIV transmission prevention in pregnant women at Tijuana General Hospital, Baja California, Mexico.

Science.gov (United States)

Becka, Chandra M; Chacón-Cruz, Enrique; Araneta, Maria Rosario; Viani, Rolando M

2015-01-01

The objective of this study was to identify determinants of human immunodeficiency virus (HIV) knowledge regarding mother-to-child transmission (MTCT) among pregnant women at Tijuana General Hospital, Baja California, Mexico. Between March and November 2003, patients from the prenatal care (n = 1294) and labor and delivery (L&D) units (n = 495) participated in a cross-sectional study to measure HIV knowledge. Less than one-third (30%) knew that HIV could be transmitted to a child during delivery, and 36% knew that HIV could be transmitted by breast-feeding. Only 27% knew that an MTCT could be prevented. Prenatal patients were more likely to know that MTCT was preventable (prenatal: 31% versus L&D 25%; P = .02). Logistic regression indicated that prenatal patients (odds ratio = 1.49, confidence interval 1.07-2.07) were more likely to know that HIV could be transmitted through breast-feeding. Overall, both groups had poor knowledge regarding MTCT of HIV. © The Author(s) 2014.

Comparison of anti-retroviral therapy treatment strategies in prevention of mother-to-child transmission in a teaching hospital in Ethiopia.

Science.gov (United States)

Kumela, Kabaye; Amenu, Demisew; Chelkeba, Legese

2015-01-01

More than 90% of Human immunodeficiency virus (HIV) infection in children is acquired due to mother-to-child transmission, which is spreading during pregnancy, delivery or breastfeeding. To determine the effectiveness of highly active antiretroviral and short course antiretroviral regimens in prevention of mother-to-child transmission of HIV and associated factors Jimma University Specialized Hospital (JUSH). A hospital based retrospective cohort study was conducted on HIV infected pregnant mothers who gave birth and had follow up at anti-retroviral therapy (ART) clinic for at least 6 months during a time period paired with their infants. The primary and secondary outcomes were rate of infant infection by HIV at 6 weeks and 6 months respectively. The Chi-square was used for the comparison of categorical data multivariate logistic regression model was used to identify the determinants of early mother-to-child transmission of HIV at 6 weeks. Cox proportional hazard model was used to analyze factors that affect the 6 month HIV free survival of infants born to HIV infected mothers. A total of 180 mother infant pairs were considered for the final analysis, 90(50%) mothers received single dose nevirapine (sdNVP) designated as regimen-3, 67 (37.2%) mothers were on different types of ARV regimens commonly AZT + 3TC + NVP (regimen-1), while the rest 23 (12.8%) mothers were on short course dual regimen AZT + 3TC + sdNVP (regimen-2). Early mother-to-child transmission rate at 6 weeks for regimens 1, 2 and 3 were 5.9% (4/67), 8.6% (2/23), and 15.5% (14/90) respectively. The late cumulative mother-to-child transmission rate of HIV at 6 months regardless of regimen type was 15.5% (28/180). Postnatal transmission at 6 months was 28.5% (8/28) of infected children. Factors that were found to be associated with high risk of early mother-to-child transmission of HIV include duration of ARV regimen shorter than 2 months during pregnancy (OR=4.3, 95%CI =1.38-13.46), base line CD4 less

How Much Will My Child's Operation Cost? Availability of Consumer Prices From US Hospitals for a Common Pediatric Orthopaedic Surgical Procedure.

Science.gov (United States)

Racimo, Allison R; Talathi, Nakul S; Zelenski, Nicole A; Wells, Lawrence; Shah, Apurva S

2018-05-02

Price transparency allows patients to make value-based health care decisions and is particularly important for individuals who are uninsured or enrolled in high-deductible health care plans. The availability of consumer prices for children undergoing orthopaedic surgery has not been previously investigated. We aimed to determine the availability of price estimates from hospitals in the United States for an archetypal pediatric orthopaedic surgical procedure (closed reduction and percutaneous pinning of a distal radius fracture) and identify variations in price estimates across hospitals. This prospective investigation utilized a scripted telephone call to obtain price estimates from 50 "top-ranked hospitals" for pediatric orthopaedics and 1 "non-top-ranked hospital" from each state and the District of Columbia. Price estimates were requested using a standardized script, in which an investigator posed as the mother of a child with a displaced distal radius fracture that needed closed reduction and pinning. Price estimates (complete or partial) were recorded for each hospital. The number of calls and the duration of time required to obtain the pricing information was also recorded. Variation was assessed, and hospitals were compared on the basis of ranking, teaching status, and region. Less than half (44%) of the 101 hospitals provided a complete price estimate. The mean price estimate for top-ranked hospitals ($17,813; range, $2742 to $49,063) was 50% higher than the price estimate for non-top-ranked hospitals ($11,866; range, $3623 to $22,967) (P=0.020). Differences in price estimates were attributable to differences in hospital fees (P=0.003), not surgeon fees. Top-ranked hospitals required more calls than non-top-ranked hospitals (4.4±2.9 vs. 2.8±2.3 calls, P=0.003). A longer duration of time was required to obtain price estimates from top-ranked hospitals than from non-top-ranked hospitals (8.2±9.4 vs. 4.1±5.1 d, P=0.024). Price estimates for pediatric

Parental experiences of a developmentally focused care program for infants and children during prolonged hospitalization.

Science.gov (United States)

So, Stephanie; Rogers, Alaine; Patterson, Catherine; Drew, Wendy; Maxwell, Julia; Darch, Jane; Hoyle, Carolyn; Patterson, Sarah; Pollock-BarZiv, Stacey

2014-06-01

This study investigates parental experiences and perceptions of the care received during their child's prolonged hospitalization. It relates this care to the Beanstalk Program (BP), a develop-mentally focused care program provided to these families within an acute care hospital setting. A total of 20 parents (of children hospitalized between 1-15 months) completed the Measures of Processes of Care (MPOC-20) with additional questions regarding the BP. Scores rate the extent of the health-care provider's behaviour as perceived by the family, ranging from 'to a great extent' (7) to 'never' (1). Parents rated Respectful and Supportive Care (6.33) as highest, while Providing General Information (5.65) was rated lowest. Eleven parents participated in a follow-up, qualitative, semi-structured interview. Interview data generated key themes: (a) parents strive for positive and normal experiences for their child within the hospital environment; (b) parents value the focus on child development in the midst of their child's complex medical care; and (c) appropriate developmentally focused education helps parents shift from feeling overwhelmed with a medically ill child to instilling feelings of confidence and empowerment to care for their child and transition home. These results emphasize the importance of enhancing child development for hospitalized infants and young children through programs such as the BP. © The Author(s) 2013.

Parent & Child Perceptions of Child Health after Sibling Death.

Science.gov (United States)

Roche, Rosa M; Brooten, Dorothy; Youngblut, JoAnne M

Understanding children's health after a sibling's death and what factors may affect it is important for treatment and clinical care. This study compared children's and their parents' perceptions of children's health and identified relationships of children's age, gender, race/ethnicity, anxiety, and depression and sibling's cause of death to these perceptions at 2 and 4 months after sibling death. 64 children and 48 parents rated the child's health "now" and "now vs before" the sibling's death in an ICU or ER or at home shortly after withdrawal of life-prolonging technology. Children completed the Child Depression Inventory and Spence Children's Anxiety Scale. Sibling cause of death was collected from hospital records. At 2 and 4 months, 45% to 54% of mothers' and 53% to 84% of fathers' ratings of their child's health "now" were higher than their children's ratings. Child health ratings were lower for: children with greater depression; fathers whose children reported greater anxiety; mothers whose child died of a chronic condition. Children's ratings of their health "now vs before" their sibling's death did not differ significantly from mothers' or fathers' ratings at 2 or 4 months. Black fathers were more likely to rate the child's health better "now vs before" the death; there were no significant differences by child gender and cause of death in child's health "now vs before" the death. Children's responses to a sibling's death may not be visually apparent or become known by asking parents. Parents often perceive their children as healthier than children perceive themselves at 2 and 4 months after sibling death, so talking with children separately is important. Children's perceptions of their health may be influenced by depression, fathers' perceptions by children's anxiety, and mother's perceptions by the cause of sibling death.

Child and adolescent abuse recorded at a national referral hospital, 2006-2011

OpenAIRE

Escalante-Romero, Lorena; Facultad de Medicina, Universidad de San Martin de Porres. Lima, Perú. Interno de Medicina.; Huamaní, Charles; Oficina General de Informática y Sistemas, Instituto Nacional de Salud. Lima, Perú. Médico cirujano.; Serpa, Hilda; Departamento de Investigación, Docencia y Atención en Salud Mental, Instituto Nacional de Salud del Niño. Lima, Perú. médico psiquiatra.; Urbano-Durand, Carlos; Departamento de Atención y Servicios al Paciente, Instituto Nacional de Salud del Niño. Lima, Perú. médico pediatra.; Farfán-Meza, Gaudy; Facultad de Medicina, Universidad de San Martin de Porres. Lima, Perú. Interno de Medicina.; Ferrer-Salas, Carolina; Facultad de Medicina, Universidad de San Martin de Porres. Lima, Perú. Interno de Medicina.; Granados-Chávez, Gilda; Facultad de Medicina, Universidad de San Martin de Porres. Lima, Perú. Interno de Medicina.

2014-01-01

Objectives. To describe the records of child and adolescent abuse of the Instituto Nacional de Salud del Niño (INSN) from January 2006 to September 2011, characterizing the victim and perpetrator. Materials and methods. A secondary sources analysis was performed, based on the domestic violence and child abuse records, from froms administered by Child Abuse and Adolescent Health Unit (MAMIS) at the INSN. The records include data of the victim, offender and characteristics of the aggression...

Invisible child maltreatment and long-term social harm

DEFF Research Database (Denmark)

Christoffersen, Mogens

Research questions Research on child maltreatment has suggested that children exposed to abuse and neglect exhibit various social, cognitive and emotional developmental problems. The paper explores long-term consequences and addresses the following questions: how many is exposed to child...... and hospital wards. While 5.6 percent of the birth cohort experienced physical abuse only 1.1 percent of a birth cohort was known to the local authorities, and only 0.1 percent of a birth cohort registered at a hospital ward. Less than half of child maltreatment known to the local authorities was reduced...... is associated with a reduced risk of PTSD symptoms even when experienced poor parenting with the destructiveness of physical abuse, sexual assault, psychological maltreatment and physical neglect. ADHD symptoms turn out to be associated with later PTSD also when accounted for poor parenting and other risk...

Child related background factors affecting compliance with induction of anaesthesia.

Science.gov (United States)

Proczkowska-Björklund, Marie; Svedin, Carl Göran

2004-03-01

Factors such as age, sex, behaviour problems, fears, earlier traumatic hospital events and reactions to vaccination were assessed together with behaviour observed before premedication in order to evaluate their importance in predicting response to the anaesthetic process. The anaesthetic process was divided into four endpoints; compliance when given premedication, sedation, compliance during needle insertion or when an anaesthetic mask was put in place and behaviour when put to sleep. A total of 102 children who were undergoing day-stay surgery and overnight stay surgery were video-filmed during premedication and anaesthetic induction. Before premedication the children and parents answered questionnaires about behaviour [Preschool Behaviour Check List (PBCL)] and fears [Fears Survey Schedule for Children-Revised (FSSC-R)]. The films were analysed to assess behaviour before and after premedication and during induction of anaesthesia. A semistructured interview was conducted with the parents during the time the children were asleep. There was a significantly higher odds ratio for noncompliant behaviour during premedication if the child placed itself in the parent's lap or near the parent or had previously experienced traumatic hospital events. The odds ratio for not being sedated by premedication was higher if compliance was low when premedication was given or the child had experienced a traumatic hospital event in the past. A high odds ratio for noncompliant behaviour during venous access or placement of an anaesthetic mask was seen if the child was not sedated or the child had had a negative reaction when vaccinated. The odds ratio for falling asleep in an anxious or upset state was higher if the child had shown noncompliant behaviour during premedication, had not been sedated or had shown noncompliant behaviour during venous access or facemask placement. The overall most important factor that predicts noncompliant behaviour and a distressed state in the child

The role of a child life specialist in a pediatric radiology department

International Nuclear Information System (INIS)

McGee, Kristen

2003-01-01

Child life programming is predominantly developed in inpatient areas throughout major pediatric hospitals. However, the trend toward outpatient services has increased the need for facilities to develop child life positions to assist in the teaching demands of patients and families coming in for routine hospital visits. Since radiology is often the first experience for families, but not the last, it is essential to involve them in a positive experience. Imaging facilities serving pediatric patients are currently developing or considering child life programs. A certified child life specialist (CCLS) is committed to developing programming that enhances the child's understanding and involvement in their medical experience. This paper provides an outline of the responsibilities and areas of expertise of the CCLS in a pediatric radiology department. The reviewed program is based on, but not limited, to fluoroscopy. (orig.)

Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

Science.gov (United States)

Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F

2012-01-01

To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.

Child Sexual Abuse and Exploitation: Guest Editor’s Introduction

OpenAIRE

Michael Salter

2015-01-01

One of the most unnerving aspects of child sexual abuse is that it is constantly manifesting in unexpected ways. The current Royal Commission into Institutional Responses to Child Sexual Abuse has collected testimony of abuse in churches, schools, out-of-home care, hospitals and religious communities, demonstrating the breadth of institutional arrangements whose structures and cultures have facilitated child sexual abuse. Cases of serious and prolonged sexual abuse in family contexts have bee...

The effect of educational interventions with siblings of hospitalized children.

Science.gov (United States)

Gursky, Barbara

2007-10-01

Research has demonstrated that siblings of chronically ill children can experience significant emotional and behavior changes; however, few studies have looked at the specific impact of pediatric hospitalization on the nonhospitalized child. Studies also indicate that children who receive age-appropriate information are better equipped to handle the stress and anxiety often associated with hospitalization.This study explored whether siblings of hospitalized children who received educational interventions had lower anxiety levels compared to siblings who did not receive interventions. A pretest-posttest experimental design was used with 50 subjects, ages 6-17 years, recruited from a children's hospital within a university medical center. Subjects were matched according to age, sex, and race, with 25 siblings each in the experimental and control groups. Siblings assigned to the experimental group received interventions from a standardized educational intervention protocol developed by the researcher. Interventions focused on teaching the sibling about hospitalization, illness or injury, and treatment for the patient, based on cognitive stages of development. All interventions were conducted by child life specialists on staff at the hospital with extensive training and experience in preparation and procedural teaching. Results shows that siblings who received educational interventions had significantly lower anxiety levels after interventions, compared to siblings who did not receive interventions. These findings have significant impact on children's health care and supporting family needs when a child is hospitalized.

Factors associated with multidisciplinary case conference outcomes in children admitted to a regional hospital in Hong Kong with suspected child abuse: a retrospective case series with internal comparison.

Science.gov (United States)

Lo, W C; Fung, G Pg; Cheung, P Ch

2017-10-01

In all cases of suspected child abuse, accurate risk assessment is vital to guide further management. This study examined the relationship between risk factors in a risk assessment matrix and child abuse case conference outcomes. Records of all children hospitalised at United Christian Hospital in Hong Kong for suspected child abuse from January 2012 to December 2014 were reviewed. Outcomes of the hospital abuse work-up as concluded in the Multi-Disciplinary Case Conference were categorised as 'established', 'high risk', or 'not established'. All cases of 'established' and 'high risk' were included in the positive case conference outcome group and all cases of 'not established' formed the comparison group. On the other hand, using the Risk Assessment Matrix developed by the California State University, Fresno in 1990, each case was allotted a matrix score of low, intermediate, or high risk in each of 15 matrix domains, and an aggregate matrix score was derived. The effect of individual matrix domain on case conference outcome was analysed. Receiver operating characteristic curve analysis was used to examine the relationship between case conference outcome and aggregate matrix score. In this study, 265 children suspected of being abused were included, with 198 in the positive case conference outcome group and 67 in the comparison group. Three matrix domains (severity and frequency of abuse, location of injuries, and strength of family support systems) were significantly associated with case conference outcome. An aggregate cut-off score of 23 yielded a sensitivity of 91.4% and specificity of 38.2% in relation to outcome of abuse categorisation. Risk assessment should be performed when handling suspected child abuse cases. A high aggregate score should arouse suspicion in all disciplines managing child abuse cases.

Child Social Exclusion Risk and Child Health Outcomes in Australia.

Directory of Open Access Journals (Sweden)

Itismita Mohanty

Full Text Available This paper studies the relationship between the risk of child social exclusion, as measured by the Child Social Exclusion (CSE index and its individual domains, and child health outcomes at the small area level in Australia. The CSE index is Australia's only national small-area index of the risk of child social exclusion. It includes five domains that capture different components of social exclusion: socio-economic background, education, connectedness, housing and health services.The paper used data from the National Centre for Social and Economic Modelling (NATSEM, University of Canberra for the CSE Index and its domains and two key Australian Institute of Health and Welfare (AIHW data sources for the health outcome measures: the National Hospital Morbidity Database and the National Mortality Database.The results show positive associations between rates of both of the negative health outcomes: potentially preventable hospitalisations (PPH and avoidable deaths, and the overall risk of child social exclusion as well as with the index domains. This analysis at the small-area level can be used to identify and study areas with unexpectedly good or bad health outcomes relative to their estimated risk of child social exclusion. We show that children's health outcomes are worse in remote parts of Australia than what would be expected solely based on the CSE index.The results of this study suggest that developing composite indices of the risk of child social exclusion can provide valuable guidance for local interventions and programs aimed at improving children's health outcomes. They also indicate the importance of taking a small-area approach when conducting geographic modelling of disadvantage.

Child life services.

Science.gov (United States)

Wilson, Jerriann M

2006-10-01

Child life programs have become standard in most large pediatric centers and even on some smaller pediatric inpatient units to address the psychosocial concerns that accompany hospitalization and other health care experiences. The child life specialist focuses on the strengths and sense of well-being of children while promoting their optimal development and minimizing the adverse effects of children's experiences in health care or other potentially stressful settings. Using play and psychological preparation as primary tools, child life interventions facilitate coping and adjustment at times and under circumstances that might prove overwhelming otherwise. Play and age-appropriate communication may be used to (1) promote optimal development, (2) present information, (3) plan and rehearse useful coping strategies for medical events or procedures, (4) work through feelings about past or impending experiences, and (5) establish therapeutic relationships with children and parents to support family involvement in each child's care, with continuity across the care continuum. The benefits of this collaborative work with the family and health care team are not limited to the health care setting; it may also optimize reintegration into schools and the community.

NEW ASPECTS OF CHILD CARE*

African Journals Online (AJOL)

In the social field of child care the Children Act of 1948 marked a major ... Better methods for the prevention of ... t the hospital for Sick Children, Great Ormond Street, there is an ... With modern drugs to control infection and with more children ...

Successful treatment of Reye's syndrome in a child (сase report

Directory of Open Access Journals (Sweden)

Tsymbalista O.L.

2016-03-01

Full Text Available A 6-year-old child with Reye's syndrome was successfully treated in the Department of Pediatric Anaesthesiology and Intensive Care of the Ivano-Frankivsk Regional Children's Clinical Hospital. At admission to the hospital the child's condition was critical due to cerebral vascular insufficiency (semicoma, psychomotor agitation, endogenous intoxication syndrome, severe anemic syndrome (Hb — 78g/l, and coagulopathy. Due to the progression of type II respiratory failure, hepatic failure, hemorrhagic and anemic syndromes, and cerebral deficit tracheal intubation for the purpose of controlled ventilation was performed. In order to correct anemia, hypoproteinemia and hemorrhagic syndrome washed erythrocytes, a 10% albumin solution and fresh frozen plasma were transfused. Therapeutic bronchoscopy was performed due to the progression of the expectorant component secondary to ventilator!associated pneumonia. Nonspecific detoxification therapy with discrete plasmapheresis was used. On the 3rd day of treatment tracheal extubation was performed, on the 10th day the child was transferred to the gastroenterology department. On the 13th day of hospital stay in the gastroenterology department and on the 24th day of admission the child was discharged home in satisfactory condition.

HOME CARE OF THE SICK CHILD *

African Journals Online (AJOL)

is separated from his mother was high-lighted by the work· ... disturbance, reaching sometimes far into later life. Although ... of child care, together with the trend towards smaller families, .... balance between hospital and domiciliary practice; for.

BCG Vaccination at Birth and Rate of Hospitalization for Infection Until 15 Months of Age in Danish Children

DEFF Research Database (Denmark)

Stensballe, Lone Graff; Ravn, Henrik; Birk, Nina Marie

2018-01-01

Background: The bacillus Calmette-Guérin (BCG) vaccine against tuberculosis might reduce the non-tuberculosis-related child mortality rate in low-income settings. We tested the hypothesis that BCG vaccination at birth would reduce early childhood hospitalization for infection in Denmark, a high...... analysis, we observed 588 hospitalizations for infection (mean, 0.28 hospitalization per child) among the 2129 children allocated to receive the BCG vaccine and 595 hospitalizations for infection (mean, 0.28 hospitalization per child) among the 2133 children allocated to the control group (hazard ratio [HR...... months in Danish children. In future studies, the role of maternal BCG-vaccination, premature birth, and cesarean delivery needs further exploration....

Factors associated with HIV infection among children born to mothers on the prevention of mother to child transmission programme at Chitungwiza Hospital, Zimbabwe, 2008.

Science.gov (United States)

Ngwende, Stella; Gombe, Notion T; Midzi, Stanley; Tshimanga, Mufuta; Shambira, Gerald; Chadambuka, Addmore

2013-12-14

Zimbabwe is one of the five countries worst affected by the HIV/AIDS pandemic with HIV infection contributing increasingly to childhood morbidity and mortality. Among the children born to HIV positive mothers participating in the PMTCT programme, 25% tested positive to HIV. We investigated factors associated with HIV infection among children born to mothers on the PMTCT programme. A 1:1 unmatched case-control study was conducted at Chitungwiza Hospital, Zimbabwe, 2008. A case was defined as a child who tested HIV positive, born to a mother who had been on PMTCT programme. A control was a HIV negative child born to a mother who had been on PMTCT programme. An interviewer-administered questionnaire was used to collect data on demographic characteristics, risk factors associated with HIV infection and immunization status. A total of 120 mothers were interviewed. Independent risk factors associated with HIV infection among children included maternal CD4 count of less than 200 during pregnancy [aOR = 7.1, 95% CI (2.6-17)], mixed feeding [aOR = 29, 95% CI (4.2-208)], being hospitalized since birth [aOR = 2.9, 95% CI (1.2-4.8)] whilst being exclusively breast fed for less than 6 months [aOR = 0.1 (95% CI 0.03-0.4)] was protective. HIV infection among children increased if the mother's CD4 count was ≤200 cells/μL and if the child was exposed to mixed feeding. Breastfeeding exclusively for less than six months was protective. We recommended exclusive breast feeding period for the first six months and stop breast feeding after 6 months if affordable, sustainable and safe.

Child abuse in Bangladesh

Directory of Open Access Journals (Sweden)

Farzana Islam

2015-01-01

Full Text Available In Bangladesh, a large number of children are deprived of their basic human rights due to unacceptable health, nutrition, education as well as social conditions. In addition, children are exposed to severe forms of sexual, physical and mental abuses at home, in the work place, in institutions and other public places. The nature and extent of violence against children irrespective of age, sex and class has been increasing day by day. These include physical torture, rape, homicide and sometimes heinous attacks with acid. Children are also victims of child labor and trafficking, both of which are treated as the most severe form of child exploitation and child abuse in the world today. This review article is aimed to focus on the present situation of various forms of child abuses in our country. Data collection is based on secondary sources of information from Dhaka Medical College Hospital, One Stop Crisis Center (OCC,UNICEF, Ministry of Home Affairs, Ministry of Women and Children Affairs, several Dhaka based organizations and news paper clipping. Ibrahim Med. Coll. J. 2015; 9(1: 18-21

Presentation of an unusual metallic foreign body in a child

Directory of Open Access Journals (Sweden)

Ravikiran Vernekar

2018-01-01

Full Text Available Ingestion of foreign object is a common problem with children. These foreign bodies (FBs can be in the respiratory tract of the aerodigestive tract. A 14-month-old male child presented to the emergency department of our hospital at 6.30 pm with irritability and continuous crying. On radiology, we found that the metallic body in the shape of a cycle was lodged in the upper esophagus. We decided to remove the FB endoscopically using an esophagoscope. We used meticulous and gentle manipulation around the edge of the metallic FB and did over a sufficient amount of time so as to dislodge the body from the impacted esophageal mucosa without causing any trauma or bleeding from the adjacent site. The child was placed under overnight observation in the hospital. The stay in the hospital was uneventful, and the child was discharged the next day. We would like to present this case due to unusual shape and nature of the FB and the difficulty encountered in clinical management of the patient.

iCHRCloud: Web & Mobile based Child Health Imprints for Smart Healthcare.

Science.gov (United States)

Singh, Harpreet; Mallaiah, Raghuram; Yadav, Gautam; Verma, Nitin; Sawhney, Ashu; Brahmachari, Samir K

2017-11-29

Reducing child mortality with quality care is the prime-most concern of all nations. Thus in current IT era, our healthcare industry needs to focus on adapting information technology in healthcare services. Barring few preliminary attempts to digitalize basic hospital administrative and clinical functions, even today in India, child health and vaccination records are still maintained as paper-based records. Also, error in manually plotting the parameters in growth charts results in missed opportunities for early detection of growth disorders in children. To address these concerns, we present India's first hospital linked, affordable automated vaccination and real-time child's growth monitoring cloud based application- Integrated Child Health Record cloud (iCHRcloud). This application is based on HL7 protocol enabling integration with hospital's HIS/EMR system. It provides Java (Enterprise Service Bus and Hibernate) based web portal for doctors and mobile application for parents, enhancing doctor-parent engagement. It leverages highchart to automate chart preparation and provides access of data via Push Notification (GCM and APNS) to parents on iOS and Android mobile platforms. iCHRcloud has also been recognized as one of the best innovative solution in three nationwide challenges, 2016 in India. iCHRcloud offers a seamless, secure (256 bit HTTPS) and sustainable solution to reduce child mortality. Detail analysis on preliminary data of 16,490 child health records highlight the diversified need of various demographic regions. Thus, primary lesson would be to implement better validation strategies to fulfill the customize requisites of entire population. This paper presents first glimpse of data and power of the analytics in policy framework.

Child abuse consultations initiated by child protective services: the role of expert opinions.

Science.gov (United States)

McGuire, Lindsay; Martin, Kimberly D; Leventhal, John M

2011-01-01

To describe consultations provided by child abuse pediatricians for cases referred by child protective services (CPS); compare the opinions of the likelihood of child maltreatment of the initial physician, CPS, and the child abuse pediatrician; and examine predictors of the experts' opinions. Cases were referred by CPS for consultations between March 1, 1998, and June 30, 2005, to 2 child abuse pediatricians at Yale-New Haven Children's Hospital. We abstracted demographic and clinical information and the opinions of the initial physician, CPS, and the child abuse expert, each coded using a 5-point scale from definite maltreatment to definite benign cause (eg, accident). Of 187 cases, 50.3% occurred in children younger than 1 year of age. Children's most serious injuries were fractures (50.8%), burns (16.6%), and bruises/abrasions (15.0%). The child abuse experts' opinions were 47.6% definite or probable maltreatment, 8.6% uncertain, and 43.9% definite or probable benign. Of the 119 cases with opinions from all 3 assessors, the expert agreed with the physician in 57.1% of cases (κ = 0.34) and with CPS in 64.7% (κ = 0.42). The best predictor of the expert's opinion that the injury was due to maltreatment was agreement between the physician and CPS that maltreatment had occurred. Levels of agreement were fair to poor between the child abuse expert and either the physician or CPS. Child abuse experts' opinions have important value in selected cases to confirm previous assessments by the physician and/or CPS, or to change the opinion of the case. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Breastfeeding and the mother–child relationship: A case study of Ebonyi State University Teaching Hospital, Abakaliki

Directory of Open Access Journals (Sweden)

Uche M. Okeh

2010-04-01

Objectives: This study was aimed at determining the relationships that exist between a mother and child and various breastfeeding habits. Method: The primary method of data collection was the design and use of a comprehensive questionnaire, which was distributed to women at the post-natal unit of the Gynaecology Department of Ebonyi State University Teaching Hospital in Abakaliki, Nigeria (EBSUTHAI. These women were civil servants, traders, students and housewives. A simple random sampling procedure of data collection was adopted in selecting the sample of 190 women. A chi-square method of analysis was used to test for independence of association. A 5% level of significance was considered. Results: At a 5% level of significance, a significant relationship existed between the category/occupation of mothers and the time intervals at which mothers breastfed their children (χ2cal= 20.53. Given the same level, exclusive breastfeeding was found to be dependent on a woman’s occupation (χ2cal= 8.49; however, at the same significance level, analysis showed that there was a significant relationship between a mother’s decision to feed her child breast milk as well as semi-solid food and those who chose to breastfeed exclusively (χ2cal= 12.168. No significant relationship (χ2cal= 3.14 was found in determining whether children who are fed breast milk only are more intelligent than children who are fed semi-solid food as well. Conclusion: Mothers were expected to breastfeed their children at will because the time intervals at which they should breastfeed were not fixed. It seems that breastfeeding does not determine the intelligence of a child. Although it is generally recommended that mothers should practise exclusive breastfeeding, the findings of this study suggested that mothers should be equally recommended to alternate between feeding their children both semi-solid food and breast milk and breast milk exclusively, because a significant relationship exists between a

The Effect of Child Access Prevention Laws on Non-Fatal Gun Injuries

OpenAIRE

Jeff DeSimone; Sara Markowitz

2005-01-01

Many states have passed child access prevention (CAP) laws, which hold the gun owner responsible if a child gains access to a gun that is not securely stored. Previous CAP law research has focused exclusively on gun-related deaths even though most gun injuries are not fatal. We use annual hospital discharge data from 1988-2001 to investigate whether CAP laws decrease non-fatal gun injuries. Results from Poisson regressions that control for various hospital, county and state characteristics, i...

The importance of laboratory re-evaluation in cases of suspected child abuse - A case report.

Science.gov (United States)

Woydt, L; König, C; Bernhard, M K; Nickel, P; Dreßler, J; Ondruschka, B

2017-09-01

In order to accurately diagnose child abuse or neglect, a physician needs to be familiar with diseases and medical conditions that can simulate maltreatment. Unrecognized cases of abuse may lead to insufficient child protection, whereas, on the other hand, over-diagnosis could be the cause of various problems for the family and their potentially accused members. Regarding child abuse, numerous cases of false diagnoses with undetected causes of bleeding are described in the scientific literature, but, specifically concerning leukemia in childhood, only very few case reports exist. Here, for the first time, we report a case of a 2-year-old boy who got hospitalized twice because of suspicious injuries and psychosocial conspicuities, in a family situation known for repeated endangerment of the child's well-being. After his first hospitalization with injuries typical for child abuse, but without paraclinical abnormalities, medical inspections were arranged periodically. The child was hospitalized with signs of repeated child abuse again five months later. During second admission, an acute lymphoblastic leukemia was revealed by intermittent laboratory examination, ordered due to new bruises with changes in morphology, identifiable as petechial hemorrhages. This case elucidates the discussion of known cases of leukemia in childhood associated with suspected child abuse in order to provide an overview of possible diseases mimicking maltreatment. To arrange necessary supportive examinations, a skillful interaction between pediatrician and forensic pathologist is crucial in the differentiation between accidental and non-accidental injury. Copyright © 2017 Elsevier B.V. All rights reserved.

Postpartum depression among mothers as seen in hospitals in ...

African Journals Online (AJOL)

Introduction: Postpartum depression is an uncommon and frequently undocumented issue that impacts negatively on maternal and child health. Methods: The study was carried out among mothers who attended postpartum clinics from two teaching hospitals and three private hospitals all in Enugu metropolis.

Prolonged postoperative desaturation in a child with Down syndrome and atrial septal defect

Directory of Open Access Journals (Sweden)

Renu Sinha

2011-01-01

Full Text Available We report prolonged desaturation in a child with Down syndrome (DS and atrial septal defect due to undiagnosed interstitial lung disease. An 18-month-old child with DS was scheduled for bilateral lens aspiration for cataract. The child had atrial septal defect and hypothyroidism. He also had delayed milestones and hypotonia with episodes of recurrent respiratory tract infection necessitating repeated hospitalization. Preoperative evaluation was unremarkable. General anaesthesia and controlled ventilation using proseal laryngeal mask airway was instituted. He had uneventful intraoperative period. In the postoperative period, the child had desaturation 1 hour after surgery on discontinuation of oxygen supplementation by face mask, which improved with oxygen therapy. Supplemental oxygen via face mask was continued and weaned off over several days. On further evaluation, the child was diagnosed as having interstitial lung disease. He improved and discharged from the hospital 15 days after the surgery with room air saturation of 90%.

High mortality in HIV-infected children diagnosed in hospital underscores need for faster diagnostic turnaround time in prevention of mother-to-child transmission of HIV (PMTCT) programs.

Science.gov (United States)

Wagner, Anjuli; Slyker, Jennifer; Langat, Agnes; Inwani, Irene; Adhiambo, Judith; Benki-Nugent, Sarah; Tapia, Ken; Njuguna, Irene; Wamalwa, Dalton; John-Stewart, Grace

2015-02-15

Despite expanded programs for prevention of mother-to-child HIV transmission (PMTCT), HIV-infected infants may not be diagnosed until they are ill. Comparing HIV prevalence and outcomes in infants diagnosed in PMTCT programs to those in hospital settings may improve pediatric HIV diagnosis strategies. HIV-exposed infants turnaround time for tests were compared between PMTCT programs and hospital sites. Among the enrolled cohort, baseline characteristics, survival, and timing of antiretroviral therapy (ART) initiation were compared between infants diagnosed in PMTCT programs versus hospital. Among 1,923 HIV-exposed infants, HIV prevalence was higher among infants tested in hospital than PMTCT early infant diagnosis (EID) sites (41% vs. 11%, p 3 times as likely to die (HR = 3.1, 95% CI = 1.3-7.6). Among HIV-exposed infants, hospital-based testing was more likely to detect an HIV-infected infant than PMTCT testing. Because young symptomatic infants diagnosed with HIV during hospitalization have very high mortality, every effort should be made to diagnose HIV infections before symptom onset. Systems to expedite turnaround time at PMTCT EID sites and to routinize inpatient pediatric HIV testing are necessary to improve pediatric HIV outcomes.

Distinguishing neglect from abuse and accident: analysis of the case files of a hospital child protection team in Israel.

Science.gov (United States)

Davidson-Arad, Bilha; Benbenishty, Rami; Chen, Wendy; Glasser, Saralee; Zur, Shmuel; Lerner-Geva, Liat

2010-11-01

The study compares the characteristics of children assessed as neglected, physically abused, or accident victims by a hospital child protection team (CPT) and identifies the information on which the CPT based its assessments. The comparison is based on content analysis of records of 414 children examined by the CPT in a major hospital in Israel between 1991 and 2006, of whom 130 (31.4%) were neglected, 54 (13.0%) were physically abused, and 230 (55.6%) were accident victims. Findings of three hierarchical logistic regressions show that the children classified as neglected had the most early development problems, but were the least likely to have received psychological treatment, and that that their families were the most likely to be receiving state financial support and to have had prior contact with the social services. They also show that the CPT had received the least information indicative of maltreatment about these children from the community and that their medical and physical examinations aroused the least suspicion. Finally, they show that the impressions the hospital staff and CPT had of the parents during the hospital visit had greater power to distinguish between the groups than the children's characteristics or the parents' socio-demographic background. The findings attest to the ability of the CPT to differentiate between neglect victims and physical abuse or accident victims. With this, they also point to ambiguities in the classification process that should be addressed by further research and training and to the need for detailed and thorough documentation of the information and observations on which the CPT's assessments are based. © 2010 Blackwell Publishing Ltd.

Hospitality: transformative service to children, families, and communities.

Science.gov (United States)

Melton, Gary B

2014-11-01

Hospitality is an ancient moral practice that was deeply embedded in early Judaism, Christianity, and Islam. Hospitality requires acceptance of, service to, and respect for people who lack a place in the community. The contemporary importance of this practice reflects the social disconnection and economic disadvantage of many young parents and the high frequency of separation of young people, including many young parents, from their communities. Such social deterioration substantially increases the risk of child maltreatment. Building on the proposals of the U.S. Advisory Board on Child Abuse and Neglect, Strong Communities for Children demonstrated the effectiveness of community building in reducing such risk. It further suggested the importance of both relying on and learning from hospitable people in strengthening support for children and their parents. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Knowledge about osteoporosis in women of child bearing age (15-49 years) attending fauji foundation hospital rawalpindi

International Nuclear Information System (INIS)

Wazir, A.; Ali, F.

2016-01-01

Objective: The objective of this study was to assess the knowledge on symptoms, risk factors, preventive measures and treatment options for regarding osteoporosis in healthy women of child bearing age (15-49 years) accompanying patients, in Fauji Foundation Hospital (FFH) Rawalpindi. Study Design: Cross sectional survey. Place and Duration of Study: The study was conducted in FFH Rawalpindi from February 2015 to October 2015. Material and Methods: A cross sectional survey was conducted using a validated questionnaire i.e. OKAT (Osteoporosis Knowledge Assessment Tool) from 385 women attending OPDs of Fauji Foundation Hospital Rawalpindi, for a period of Feb-August 2015. The data was analyzed using SPSS (version 21). Mean knowledge scores were calculated and compared with socio demographic variables. Results: Total knowledge score mean was 8 (total max score achieved 14). Mean scores were found for knowledge regarding symptoms 0.85 (total score 2), and treatment options were 0.82 (total score 2) for the disease. Comparison of knowledge scores between respondents of different age, residential status (p<=0.009), and educational status (p<=0.056) was found statistically significant. Conclusion: Women lacked knowledge regarding osteoporosis, especially older uneducated ones, belonging to lower socioeconomic class residing in villages. Community based educational interventional programs targeting this population can help reduce the knowledge gap and contribute towards disease prevention. (author)

Death of a Child at Home or in Hospital: Experiences of Greek Mothers.

Science.gov (United States)

Papadatou, Danai; And Others

1996-01-01

Investigates experiences of Greek mothers who cared for a child dying of cancer. Highlighted some needs during the terminal period. Fifteen mothers were interviewed and both quantitative and qualitative procedures were used to analyze findings. Family networks played a significant role in supporting mother-child units, especially when death…

Magical attachment: Children in magical relations with hospital clowns

Directory of Open Access Journals (Sweden)

Lotta Linge

2012-02-01

Full Text Available The aim of the present study was to achieve a theoretical understanding of several different-age children's experiences of magic relations with hospital clowns in the context of medical care, and to do so using psychological theory and a child perspective. The method used was qualitative and focused on nine children. The results showed that age was important to consider in better understanding how the children experienced the relation with the hospital clowns, how they described the magical aspects of the encounter and how they viewed the importance of clown encounters to their own well-being. The present theoretical interpretation characterized the encounter with hospital clowns as a magical safe area, an intermediate area between fantasy and reality. The discussion presented a line of reasoning concerning a magical attachment between the child and the hospital clowns, stating that this attachment: a comprised a temporary relation; b gave anonymity; c entailed reversed roles; and d created an emotional experience of boundary-transcending opportunities.

[Child health care and its development in Vrsac].

Science.gov (United States)

Sljapić, Ziva; Sljapić-Roganović, Miljana

2002-01-01

Documents concerning history of medicine during the Turkish reign (1552-1716) are very rare. However, there is evidence of plague epidemic in 18th century and colera epidemic in the 19th century. The first medical institutions: The German Communal Hospital, The Serbian Hospital and the Pharmacy were founded in the second half of the 18th century. In the year 1803, children were vaccinated against variola. The first Serbian book about child care--"Cadoljub" was written by Dr. Gavrilo Pekarović (1812-1851) during his studies of medicine in Budapest. In 1927 the city founded a dispensary for the newborn. The Polyclinic for schoolchildren was established as a part of the Health Center in 1934. After World War II, Children's Department was opened in the Health Center, later on it was turned into Mother and Child Center. At the beginning of 1955, a provisional children's ward with 18 beds was established in the former sanatorium, whereas till the end of the year it had 49 beds. In May 1965, it was moved into a new hospital building. After integration of Hospital and the Health Center into a Medical Center in 1967, a department for children was founded and it consisted of the emergency center and a hospital. Parents counseling, dispensary for children and dispensary for schoolchildren were founded in August 1971.

Anxiety and depression in mothers and fathers of a chronically ill child

NARCIS (Netherlands)

van Oers, H. A.; Haverman, L.; Limperg, P. F.; van Dijk-Lokkart, E. M.; Maurice-Stam, H.; Grootenhuis, M. A.

2014-01-01

We aimed to determine the levels of anxiety and depression in mothers and fathers of a chronically ill child (0-18 years) and to study which parental and child variables are associated with anxiety and depression. In a cross-sectional design, anxiety and depression were assessed with the Hospital

Knowledge, attitude and practice towards child adoption amongst women attending infertility clinics in Lagos State, Nigeria

Directory of Open Access Journals (Sweden)

Adenike O. Omosun

2011-10-01

Full Text Available Background: Child adoption is a recommended alternative form of infertility management. Infertility is of public health importance in Nigeria and many other developing nations. This is a result of its high prevalence and especially because of its serious social implications as the African society places a passionate premium on procreation in any family setting. Objectives: The aim of this study was to determine the knowledge, attitude and practice of child adoption amongst women attending infertility clinics in teaching hospitals in Lagos State and to determine the factors that influence their attitude and practice towards it. Method: A cross-sectional descriptive design was used. Data were collected by using a structured questionnaire which was interviewer-administered. The study was conducted in the two teaching hospitals in Lagos State (LUTH [Lagos University Teaching Hospital] and LASUTH [Lagos State University Teaching Hospital] from amongst 350 women attending the gynaecological clinics. All the patients under management for infertility at the gynaecology clinics during the period of the study were interviewed. Results: Many respondents (85.7% had heard of child adoption and 59.3% of them knew the correct meaning of the term. More than half of the respondents (68.3% said that they could love an adopted child but less than half of them (33.7% were willing to consider adoption. Only 13.9% has ever adopted a child. The major reason given for their unwillingness to adopt was their desire to have their own biological child. Factors that were favourable towards child adoption were Igbo tribe identity, an age above 40 years, duration of infertility above 15 years, and knowing the correct meaning of child adoption. Conclusion: There is a poor attitude to adoption even amongst infertile couples. Interventions need to be implemented to educate the public on child adoption, to improve their attitude towards adoption and to make it more acceptable.

Pediatric Hospital: The Paradigms of Play in Brazil.

Science.gov (United States)

de Macedo, Lino; da Silva, Gláucia Faria; Setúbal, Sandra Mutarelli

2015-01-29

The role of play in Brazilian children's hospitals is highlighted, as well as the perspective of humanization in Brazil. Some aspects of our culture are crucial to understanding the importance of play considering our society. Sabara Children's Hospital ("Hospital Infantil Sabará") in Brazil is used particularly to discuss humanization. To understand the issue of play in Brazil, it is important to discuss hospitals in their social context, their history, current roles in children's care, humanization history and child development, according to the approaches of Piaget and Winnicott that are used in our culture.

A period prevalence study of being a parent in a secure psychiatric hospital and a description of the parents, the children and the impact of admission on parent-child contact.

Science.gov (United States)

Argent, Sarah Elizabeth; Riddleston, Laura; Warr, Jodie; Tippetts, Hannah; Meredith, Zoe; Taylor, Pamela Jane

2018-02-01

Most secure psychiatric hospital patients are of childbearing age, but their parental status is minimally researched. The aim of the study is to describe the parent patients in one regional secure hospital and explore post-admission child-parent contact. A 9-year records survey of a complete secure hospital admissions cohort was conducted. Nearly half of the cohort of 165 patients (46%) were parents. Parent patients were less likely than childless patients to have diagnostic co-morbidity or to have received childhood mental health care but were more likely to have committed a homicide/life-threatening index offence with family or friend victims. Men, whether fathers or not, and childless women were unlikely ever to have harmed a child, but it was more likely than not that mother patients had. Records indicated minimal discussion about childlessness. Ninety-four (60%) of the 157 children involved were under 18 years on parental admission. Adult children who had been living with the parent patient before the parent's admission invariably maintained contact with them afterwards, but nearly half (48%) of such under 18-year-olds lost all contact. The only characteristic related to such loss was the index offence victim having been a nuclear family member. As the discrepancy in whether or not parent patients and their children continued contact with each other after the parent's admission seemed to depend mainly on the child's age and his or her resultant freedom to choose, acquisition of accurate data about affected children's perspective on visiting seems essential. Given that parent patients had experienced relative stability in interpersonal relationships and had rarely had childhood disorders, parenting support in conjunction with treatment seems appropriate. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

A qualitative study of sleep quality in children and their resident parents when in hospital.

Science.gov (United States)

Stickland, Alice; Clayton, Esther; Sankey, Ruth; Hill, Catherine M

2016-06-01

Poor sleep quality impairs immune responses and pain tolerance, both key to recovery from acute illness. Hospitalised children and their co-sleeping parents also risk emotional lability and impaired coping skills when sleep-deprived. We aimed to study the experiences of children and parents during hospital admissions. Semi-structured interviews were conducted with parents within a week of their child's discharge. Questions explored parent and child sleep quality, factors contributing to this, perceived impact on day-time functioning and suggested improvements to ward sleep environment. Southampton Children's Hospital, UK. 17 co-sleeping parents of 16 children aged 3-12 years completed interviews. Children admitted for surgical procedures and those with established sleep disorders or nocturnal seizures were excluded. Constant comparative methods identified themes within the data using a grounded theory approach. Parents reported that they, and to a lesser extent their children, experienced reduced sleep quality. Noise and light as well as ward schedules were identified as key factors disrupting sleep. Parents reported that lack of sleep caused difficulties with their own emotional regulation and that of their child, affecting daytime parent-child relationships. Furthermore, they reported a negative impact of sleep deprivation on decision-making about their child's medical care. Parents identified poor sleep in hospital as a significant additional burden to their child's hospital admission. Importantly, they identified potential improvements to the ward sleep environment. Intervention studies that target modifiable, child-centred alterations to night-time ward culture are recommended, focusing on measurable child and parental outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Facilitating Employee Recruitment and Retention through On-Site Child Day Care.

Science.gov (United States)

Lombardo, Kathy A.

An early childhood educator at a 360-bed community general hospital implemented a licensed on-site child care program for children between 6 weeks and 10 years of age in order to improve employee recruitment and retention by assisting employees with appropriate child care arrangements. A parent questionnaire was used to assess the degree to which…

Elektronisk patientjournal kan bidrage til at rejse mistanke om battered child-syndrom

DEFF Research Database (Denmark)

Christensen, Mikkel Holm

2013-01-01

Child abuse is a very serious offence and is often underdiagnosed. This case report shows how the use of electronic medical records from different hospitals aided in diagnosing a case of battered child in a 16-month-old girl with an unusual acromion fracture. This illustrates the need for thorough...

Child care in Vrsac and its development

OpenAIRE

Šljapić Živa; Šljapić-Roganović Miljana

2002-01-01

Documents concerning history of medicine during the Turkish reign (1552-1716) are very rare. However, there is evidence of plague epidemic in 18th century and cholera epidemic in the 19th century. The first medical institutions: The German Communal Hospital, The Serbian Hospital and the Pharmacy were founded in the second half of the 18th century. In the year 1803, children were vaccinated against variola. The first Serbian book about child care – "Čadoljub" was written by Dr. Gavrilo Pekarov...

The dignity of the child in a psychiatric hospital

Directory of Open Access Journals (Sweden)

Błażej Kmieciak

2012-12-01

Full Text Available The right to respect the dignity of children using medical services in psychiatric units is regulated among other by the Patients’ Rights act and the Patients’ Rights Ombudsman act, Physician and Dentist Professions Act and the Medical Ethics Code. Although since 1994 the Mental Health Protection Act has existed, some information appears about the violation of the dignity of the child in psychiatric hospitals. Material and methods: Analysis of the information obtained from different sources (the media, the Internet, from patients and/or their legal guardians, peror Psychiatric Hospital Patients’ Ombudsman allowed to draw up a list of repeated situations in psychiatric units for children and adolescents where the dignity of the juvenile/minor patient may be violated. Results: The most frequently reported issues are: reduction of the minor/juvenile patients’ access to “privileges” (such as direct contacts with colleagues, lack of privacy (such as controls in toilets and bathrooms, irregularities during the use of direct coercion, lack of regular access to a mobile phone, the Internet, stereo equipment, lack of juvenile/minor patients’ consent for treatment (including the double permission, engaging the patients to cleaning work, and medical staff’s interventions of educational and corrective character (the patients perceive this as the use of penalties. Discussion: It was found out that the reaction of a minor/juvenile psychiatric unit patient or her/his carers to the detachment from her/his surroundings, favourite activities or things, and educational interventions are related to precise determination of diagnostic and therapeutic procedures and rules prevalent in the group, privileges, consequences, and application of behavioural effects in the form of negative reinforcements (so-called penalties and positive reinforcements (rewards. A strong response to infringement of the rules may be perceived by the patients as a violation of

Brincar no hospital: subsídios para o cuidado de enfermagem Playing in hospital: subsidy to the nursing care

Directory of Open Access Journals (Sweden)

Maria Cândida de Carvalho Furtado

1999-12-01

Full Text Available Brincar é uma das atividades essenciais para o desenvolvimento físico, emocional e social da criança. Apesar da reconhecida importância desta atividade, durante o processo de hospitalização ela é pouco valorizada, conseqüentemente não se encontra entre as ações terapêuticas previstas. O objetivo deste trabalho é discutir princípios teóricos e práticos para subsidiar a utilização do brincar/brinquedo na assistência às crianças hospitalizadas. A coleta de dados empíricos foi realizada através da observação participante de 11 crianças internadas numa unidade pediátrica de um hospital de ensino do interior do Estado de São Paulo. Identificamos que o ato de brincar tem repercussões na criança, enfermeira e hospital. Para a criança não bloqueia o desenvolvimento; ajuda-a na compreensão do que ocorre consigo e a liberar temores, tensões, ansiedade e frustração; promove satisfação, diversão e espontaneidade e possibilita que converta experiências que deveria suportar passivamente em desempenho ativo. Para a enfermeira é um instrumento de intervenção e uma forma de comunicação, possibilitando detectar a singularidade de cada criança. Quanto ao hospital, altera a visão corrente de que é apenas espaço de dor e sofrimento.Playing is one of the essencial activities for the fisical, emocional and social development to the child. Although the recognized importance of this activity, during the hospitalization process it is little value, so it is not find out between the foreseen therapeutic actions that are preview. The goal of this paper is discuss the theoric and pratic principles to subsidize the utilization of play in the aid to the hospitalization children. The empiric data collection was realized through the participant observation of 11 children who were intern in a pediatric unit of a teaching hospital of State of Seto Paulo upcountry. We identifie that the act to play has repercussions in the child

Welcome to Naval Hospital Jacksonville

Science.gov (United States)

. Transparency in Medicine See How We're Doing Compare Military Health System Hospitals and Clinics TRICARE Online | ICE | OWA | Suicide Prevention Lifeline | 1-800-USA-NAVY | Navy Medicine | Military Health Child Street, Jacksonville, Florida 32214 This is an official U.S. Navy website. This is a Department of

The Baby-friendly Hospital Initiative and Qatar, 2016

Directory of Open Access Journals (Sweden)

Mohamad A. Chehab, MBBCh

2018-06-01

Full Text Available Breastfeeding instills countless benefits that extend beyond the infant and child to the entire nation. One of the global targets set by the WHO to improve maternal, infant, and young child nutrition is to increase the rate of exclusive breast-feeding “in the first 6 months” up to at least 50% by 2025.3 Thus, as a global endeavor to promote and sustain breastfeeding, the WHO and UNICEF launched the Baby-friendly Hospital Initiative (BFHI 1 year after the Innocenti Declaration of 1990. Regarding the State of Qatar, there was a 34% rate of early initiation of breastfeeding “within the first hour of birth” and a 29% rate of exclusive breastfeeding between 2010 and 2015. In Qatar during 2016, many obstacles in achieving the aforementioned global target remained. In addition, there are still no hospitals with a BFHI accreditation. Keywords: Baby-friendly Hospital Initiative, Breastfeeding, Maternal health, Qatar

Hospital-based child protection teams that care for parents who abuse or neglect their children recognize the need for multidisciplinary collaborative practice involving perinatal care and mental health professionals: a questionnaire survey conducted in Japan

Directory of Open Access Journals (Sweden)

Okato A

2018-02-01

Full Text Available Ayumi Okato,1 Tasuku Hashimoto,1 Mami Tanaka,2 Masumi Tachibana,1 Akira Machizawa,3 Jun Okayama,4 Mamiko Endo,5 Masayoshi Senda,6,7 Naoki Saito,5,7 Masaomi Iyo1 1Department of Psychiatry, Graduate School of Medicine, Chiba University, 2Division of Clinical Study on Juvenile Delinquency, Center for Forensic Mental Health, Chiba University, 3Department of Psychiatry, Chiba University Hospital, 4Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 5Department of Pediatrics, Graduate School of Medicine, Chiba University, 6Department of Pediatrics, Asahi General Hospital, 7Division of Clinical Forensic Medicine, Education and Research Center of Legal Medicine, Chiba University, Chiba, Japan Background: Child abuse and/or neglect is a serious issue, and in many cases, parents are the perpetrators. Hospital-based child protection teams (CPTs play pivotal roles in the management of not only abused and/or neglected children but also of their parents; this is generally conducted through multidisciplinary practice. The aim of this study is to survey hospital-based CPT members to determine the professions they perceive to be most applicable to participation in CPTs. Participants and methods: The participants were members of CPTs affiliated with hospitals that had pediatric emergency departments and which were located in Chiba Prefecture; specifically, 114 CPT members from 23 hospitals responded to this survey. The two main questionnaire items concerned are as follows: 1 each respondent’s evaluation of conducting assessments, providing support, and implementing multidisciplinary collaborative practice in the treatment of abusive and negligent parents, and 2 each CPT member’s opinion on the professions that are most important for CPT activities. An exploratory factor analysis (EFA was performed to explore the factor structure of the data, and a correlation analysis was performed using the result obtained. Results: The EFA

[The treatment needs of migrant children according to child and adolescent psychiatrists from medical clinics and in private practice].

Science.gov (United States)

Siefen, Georg; Kirkcaldy, Bruce; Adam, Hubertus; Schepker, Renate

2015-03-01

How does the German child and adolescent psychiatry system respond to the increasing number of migrant children and adolescents? Senior doctors from German child and adolescent psychiatric hospitals (Association of Medical Hospital Directors in Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Germany, BAG) completed a specially constructed questionnaire about the treatment needs of migrant children, while a «random, representative» sample of child and adolescent psychiatrists in private practice (German Professional Association for Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, BKJPP) was administered a slightly modified version. The 100 psychiatrists in private practice represented only about one-eighth of their group, whereas the 55 medical directors comprised a representative sample. One-third of the hospitals has treatments tailored to the specific needs of migrants. In both settings, however, competent interpreters were rarely found, despite the treatment problems arising from the understanding the illness by the parents, language problems, and the clinical knowledge of the patient. Cultural diversity is perceived as enriching. The migration background and the sex of child and adolescent psychiatrists influence the treatment of migrants. Facilitating the process of «cultural opening» in child and adolescent psychiatry involves enacting concrete steps, such as the funding of interpreter costs.

Maternal thyroid dysfunction and risk of seizure in the child

DEFF Research Database (Denmark)

Andersen, Stine Linding; Laurberg, Peter; Wu, Chunsen

2013-01-01

Thyroid hormones are essential for brain development, and maternal thyroid disease may affect child neurocognitive development. Some types of seizures may also depend upon early exposure of the developing central nervous system, and we hypothesized that maternal thyroid dysfunction could increase...... the risk of seizure in the child. In a Danish population-based study we included 1,699,693 liveborn singletons, and from the Danish National Hospital Register we obtained information on maternal diagnosis of hyper- or hypothyroidism and neonatal seizure, febrile seizure, and epilepsy in the child. Maternal...... diagnosis of thyroid dysfunction before or after birth of the child was registered in two percent of the singleton births. In adjusted analyses, maternal hyperthyroidism and hypothyroidism first time diagnosed after birth of the child were associated with a significant increased risk of epilepsy...

Pediatric Hospital: The Paradigms of Play in Brazil

Directory of Open Access Journals (Sweden)

Lino de Macedo

2015-01-01

Full Text Available The role of play in Brazilian children’s hospitals is highlighted, as well as the perspective of humanization in Brazil. Some aspects of our culture are crucial to understanding the importance of play considering our society. Sabara Children’s Hospital (“Hospital Infantil Sabará” in Brazil is used particularly to discuss humanization. To understand the issue of play in Brazil, it is important to discuss hospitals in their social context, their history, current roles in children’s care, humanization history and child development, according to the approaches of Piaget and Winnicott that are used in our culture.

Planning an outing from hospital for ventilator-dependent children.

Science.gov (United States)

Gilgoff, I S; Helgren, J

1992-10-01

Returning ventilator-dependent children to the home environment has become a well-accepted occurrence. The success of a home program depends on careful pre-discharge planning in order to ensure the child's medical safety, and adequate preparation to ensure the child's and family's adjustment to an active community life after discharge. To achieve this, involvement in community activities must begin while the child is still in hospital. As part of a complete rehabilitation program, nine ventilator-dependent children were taken on an inpatient outing to Disneyland. The planning and goals of the outing are described.

The relationship between mothers' coping patterns and children's anxiety about their hospitalization as reflected in drawings.

Science.gov (United States)

Burns-Nader, Sherwood; Hernandez-Reif, Maria; Porter, Maggie

2014-03-01

This study explored the relationships between hospitalized children's anxiety level, mothers' use of coping strategies, and mothers' satisfaction with the hospital experience. Twenty-four hospitalized children and their mothers participated in this study. Children were asked to draw a person in the hospital, which was then coded as a projective measure of anxiety; mothers were asked to complete questionnaires on their coping behaviors and their satisfaction with their child's hospital experience. The use of more coping strategies by the mothers was related to less anxiety in the children. In addition, the more coping strategies the mothers used, the higher they reported their satisfaction. The findings suggest the importance of providing resources aimed at increasing maternal coping and satisfaction with the quality of care of a child's hospitalization in order to minimize the negative effects of the hospitalization on the children.

Voyage through Childhood into the Adult World: A Guide to Child Development. Lifeways Series. Second Edition.

Science.gov (United States)

Frommer, Eva A.

Originally written for students at St. Thomas' Hospital in London, this guide to child development offers an overview of child development for parents, teachers, and all adults concerned with raising children. Many of the book's ideas come from direct work with children and draw on Rudolf Steiner's approach to child development. The book's…

[The status of music therapy in inpatient child and adolescent psychiatry].

Science.gov (United States)

Stegemann, Thomas; Mauch, Christine; Stein, Vera; Romer, Georg

2008-07-01

Although music therapy is very common in child and adolescent psychiatry, no data are available that describe the working conditions for music therapists or the situation with regard to coverage of the patient population. A cross-sectional questionnaire study in all German hospitals of child and adolescent psychiatry with inpatient treatment programmes (n = 134) collected data on the structure and content of the respective music therapy treatment offered. 63.4% of the hospitals provide music therapy as a method of inpatient psychotherapy (77.7% response rate). This article focuses on the duties, setting, and clientele in music therapy, the available equipment and instruments, and the formation and methodological spectrum of music therapists. In summary, we conclude that music therapists working in child and adolescent psychiatry are well trained and experienced. To strengthen the professional identity of music therapists and to evaluate the efficacy of music therapy further research is needed and professional representation and proofs of efficacy must be emphasized.

Profile of Under-Five Malnourished Children Admitted in a Tertiary Care Teaching Hospital in Pune, India

Directory of Open Access Journals (Sweden)

Dhrubajyoti J Debnath

2014-01-01

Full Text Available Background: Malnutrition is a major public health problem in a developing country like India. Keeping this in mind a study was carried out to find the proportion of under-five children suffering from malnutrition among the under-five hospitalized children and to study co-morbid illnesses and epidemiological factors associated with malnutrition. Methods: This was a hospital-based cross sectional study carried out in the pediatric ward of a tertiary care teaching hospital in Pune, India. All under-five children suffering from malnutrition were studied over a period of 1 month. Results: Total number of under five children diagnosed as malnourished were 47 (39.83%. Moderate and severe/very severe malnutrition was statistically significantly higher in a girl child. The proportion of moderate and severe/very severe malnutrition was higher in low birth weight babies, children who were incompletely immunized for age. Faulty infant feeding practice was observed in 28 (59.6% children. Some of the co-morbid illnesses contributing to morbidity in the malnourished child were acute diarrheal diseases, acute respiratory infection, anemia, and septicemia. Conclusion: A large proportion of hospitalized children were malnourished. Girl child suffered from moderate to severe forms of malnutrition as compared to male child and this was the only statistically significant association. This may be due to neglect of girl child.

Childrens Hospital Integrated Patient Electronic Record System Continuation (CHIPERS)

Science.gov (United States)

2015-12-01

child might...lytes  and  glucose.     **  Time  zero  is  the  first  point  at  which  anyone  considers  that  a   child ...culture  of  their  hospital,  namely  the  hierarchy  of  medicine  and  a   stigma  for  nurses  calling  

Predictors of Intention of Reporting Child Abuse among Emergency Nurses.

Science.gov (United States)

Lee, Hye-Mi; Kim, Ji-Soo

The current study investigates predictors of intention of reporting child abuse among emergency nurses in Korea. A descriptive cross-sectional design was used. Data were collected from 200 emergency nurses in eight general hospitals in Korea through a questionnaire that asked about their general characteristics, knowledge about child abuse, perceived behavioral control, experiences of child abuse cases and reporting, and attitude toward child abuse. Multiple regression analysis indicated that attitude toward child abuse was the most influential predictor of the intention of reporting child abuse among Korea's emergency nurses. Knowledge about child abuse, and perceived behavioral control were also significant influencing predictors of reporting intention. These variables explained 22.1% of the variances in the intention of reporting child abuse among emergency nurses. Reporting child abuse has not yet been established as a professional responsibility among Korea's emergency nurses. Increasing the level of awareness of the characteristics of child abuse and encouraging communication among nurses about the responsibility to report suspected child abuse will increase nurses' confidence to report. Training for reporting child abuse should be implemented in the near future to improve emergency nurses' understanding of child abuse. A support program is also needed to help emergency nurses build confidence in reporting child abuse as a professional responsibility. Copyright © 2017 Elsevier Inc. All rights reserved.

Parenting a child at home with hypoplastic left heart syndrome: experiences of commitment, of stress, and of love.

Science.gov (United States)

Cantwell-Bartl, Annie M; Tibballs, James

2017-09-01

To evaluate the experiences of parenting a child with hypoplastic left heart syndrome after the child has been discharged home from hospital. A study of the parents' experiences using face-to-face interviews and psychometric measures with parents whose child had survived stage surgery. Parents were interviewed within the home environment or within the hospital if that was their choice. A total of 29 parents (16 mothers and 13 fathers) of surviving children. Intervention A semi-structured face-to-face interview plus psychometric tests (parent demographics, Maslach Burnout Inventory, Impact on Family Scale, and the Psychological Check List - Civilian). Measurements and main results The parents' experience in supporting a child with hypoplastic left heart syndrome is one of stress, of commitment, and of love. Although parents experienced joy in their child, they were also subjected to anxiety with four parents test positive to post-traumatic stress disorder and hypervigilance while monitoring their child's condition. Parents lived with many difficulties, and demands.

Chronic Hepatitis C-Related Cirrhosis Hospitalization Cost Analysis in Bulgaria

Directory of Open Access Journals (Sweden)

Maria Dimitrova

2017-08-01

Full Text Available ObjectiveHCV infection is a leading cause of chronic liver disease with long-term complications—extensive fibrosis, cirrhosis, and hepatocellular carcinoma. The objective of this study is to perform cost analysis of therapy of patients with chronic HCV-related cirrhosis hospitalized in the University Hospital “Queen Joanna-ISUL” for 3-year period (2012–2014.MethodsIt is a prospective, real life observational study of 297 patients with chronic HCV infection and cirrhosis monitored in the University Hospital “Queen Joanna-ISUL” for 3-year period. Data on demographic, clinical characteristics, and health-care resources utilization (hospitalizations, highly specialized interventions, and pharmacotherapy were collected. Micro-costing approach was applied to evaluate the total direct medical costs. The points of view are that of the National Health Insurance Fund (NHIF, hospital and the patients. Collected cost data are from the NHIF and hospitals tariffs, patients, and from the positive dug list for medicines prices. Descriptive statistics, chi-squared test, Kruskal–Wallis, and Friedman tests were used for statistical processing.Results76% of patients were male. 93% were diagnosed in grade Child-Pugh A and B. 97% reported complications, and almost all developed esophageal varices. During the 3 years observational period, patients did not change the critical clinical values for Child-Pugh status and therefore the group was considered as homogenous. 847 hospitalizations were recorded for 3 years period with average length of stay 17 days. The mortality rate of 6.90% was extremely high. The total direct medical costs for the observed cohort of patients for 3-year period accounted for 1,290,533 BGN (€659,839 with an average cost per patient 4,577 BGN (€2,340. Statistically significant correlation was observed between the total cost per patient from the different payers’ perspective and the Child-Pugh cirrhosis score

Child neurology residency: system implications of new training models.

Science.gov (United States)

Heiser, Karen

2012-02-01

From limitations on residents' duty hours, to ways in which outcomes are measured, changes to graduate medical education are sweeping the nation. In this issue of the journal, Gilbert and Greenwood present thoughtful, if somewhat disparate, opinions on ways to improve the educational experience of child neurology trainees. As the Designated Institutional Officer of a large children's hospital, I have focused my commentary on "the big picture." That is, what systemwide impact can changes in child neurology trainees' education have.

Safer Beginnings: Perinatal Child-Parent Psychotherapy for Newborns and Mothers Exposed to Domestic Violence

Science.gov (United States)

Lieberman, Alicia F.; Diaz, Manuela A.; Van Horn, Patricia

2009-01-01

Pregnancy is a time of heightened risk for domestic violence and of increased vulnerability to traumatic events. In this article, the authors explain how the experience of domestic violence during pregnancy threatens the newborn's healthy development as well as the parent-child relationship. San Francisco General Hospital's Perinatal Child-Parent…

Parents' perceptions during the transition to home for their child with a congenital heart defect: How can we support families of children with hypoplastic left heart syndrome?

Science.gov (United States)

March, Sarita

2017-07-01

The aim of the study was to explore the literature related to transitions in healthcare between the hospital and home that caregivers experience with a child who has a congenital heart defect (CHD), specifically related to hypoplastic left heart syndrome (HLHS). A systematic literature review was conducted searching OVID Medline, CINAHL, and PubMed to discover the caregivers' perceptions on their transitions between hospital care and home care of their child with a CHD. Articles included those with focus on the transitions of caregivers between hospital and home care for children with CHD. Excluded articles were studies focused on adolescents, transition to adult healthcare, mortality results, other diseases associated with CHDs, comparison of CHD treatments, feasibility studies, differences in care between hospitals, home monitoring, and comparison of videoconference and telephone home communication. Ten articles were selected. Many parents voiced their concerns with feeding their child, learning medical skills and knowledge, reported a disrupted relationship between parents and their child, and identified stress and anxiety associated with taking care of a child with a CHD. There were limited studies on caregivers' transitions with a child with HLHS, but there also was limited focus on the caregivers' experiences with transitions between hospital and home care for their child with any CHD. Research on the transition experience between hospital care and home care for caregivers of children born with a CHD, and a specific focus on HLHS from the caregivers' viewpoint, would provide insight into the perspective of caregivers during the numerous transitions. © 2017 Wiley Periodicals, Inc.

Neglect Contributing to Tertiary Hospitalization in Childhood Asthma.

Science.gov (United States)

Boxer, Gary H.; And Others

1988-01-01

The study examined the extent to which child neglect and family dysfunction have contributed to the need for hospitalization of asthmatic children. Using a measure of global functioning, psychologic morbidity is associated with medical neglect. (Author/DB)

Validation of the Child HCAHPS survey to measure pediatric inpatient experience of care in Flanders.

Science.gov (United States)

Bruyneel, Luk; Coeckelberghs, Ellen; Buyse, Gunnar; Casteels, Kristina; Lommers, Barbara; Vandersmissen, Jo; Van Eldere, Johan; Van Geet, Chris; Vanhaecht, Kris

2017-07-01

The recently developed Child HCAHPS provides a standard to measure US hospitals' performance on pediatric inpatient experiences of care. We field-tested Child HCAHPS in Belgium to instigate international comparison. In the development stage, forward/backward translation was conducted and patients assessed content validity index as excellent. The draft Flemish Child HCAHPS included 63 items: 38 items for five topics hypothesized to be similar to those proposed in the US (communication with parent, communication with child, attention to safety and comfort, hospital environment, and global rating), 10 screeners, a 14-item demographic and descriptive section, and one open-ended item. A 6-week pilot test was subsequently performed in three pediatric wards (general ward, hematology and oncology ward, infant and toddler ward) at a JCI-accredited university hospital. An overall response rate of 90.99% (303/333) was achieved and was consistent across wards. Confirmatory factor analysis largely confirmed the configuration of the proposed composites. Composite and single-item measures related well to patients' global rating of the hospital. Interpretation of different patient experiences across types of wards merits further investigation. Child HCAHPS provides an opportunity for systematic and cross-national assessment of pediatric inpatient experiences. Sharing and implementing international best practices are the next logical step. What is Known: • Patient experience surveys are increasingly used to reflect on the quality, safety, and centeredness of patient care. • While adult inpatient experience surveys are routinely used across countries around the world, the measurement of pediatric inpatient experiences is a young field of research that is essential to reflect on family-centered care. What is New: • We demonstrate that the US-developed Child HCAHPS provides an opportunity for international benchmarking of pediatric inpatient experiences with care through parents

Children staying in hospital: a research on psychological stress of caregivers

Directory of Open Access Journals (Sweden)

Commodari Elena

2010-05-01

Full Text Available Abstract Background Having a child hospitalized is a stressful event for parents. Previous studies have found increased stress in families with children affected by different kinds of pathologies, and analyzed disease related objective variables producing stress. However, most of these studies recruited caregivers of children with chronic or serious illnesses, and focused on evaluation of objective environmental stressors and did not consider subjective "perception" of stress. The aim of this study was to investigate perception of acute stress in caregivers taking care of children without serious physical damage that were hospitalized for short periods. Moreover, some variables, such as recreational and school services offered to children, influencing perception of cognitive, physiological and behavioral state relating to the sensation of "being stressed" were analyzed. Methods This study was realized with a sample of caregivers of children hospitalized for mild acute diseases. Research was conducted using two standardized tests, PSM (Psychological Stress Measure and STAI (State Trait Anxiety Inventory, whose characteristics of reliability and validity had been successfully established. Results Present data showed that caregivers of hospitalized children perceived high levels of stress and anxiety. Perception of stress was influenced by the degree of kindred with patients, length of hospitalization, and, notably, participation in some of the activities offered to children, mainly school services. Discussion Findings showed that child hospitalization is a stressful event for caregivers, even if hospitalization is for middle and transient pathologies. Perception of stress was influenced by length of hospitalization, and by degree of kindred. Findings even suggest that some services offered to children can modulate caregivers' perception of stress and impact of hospitalization. Caregivers whose children used school services describe themselves as

Newborn Parent Based Intervention to Increase Child Safety Seat Use

Directory of Open Access Journals (Sweden)

Xiangxiang Liu

2016-08-01

Full Text Available This paper intends to assess the effect of a maternity department intervention on improvement of knowledge and use of child safety seats (CSS among newborn parents. An intervention study included three groups (one education plus free CSS intervention group, one education only group, and one control group. The participants were parents of newborns in the maternity department of two hospitals. Both of the intervention groups received a folded pamphlet of child passenger safety, a height chart and standardized safety education during their hospital stay after giving birth. The education plus free CSS intervention group received an additional free CSS and professional installation training at hospital discharge. The control group received a pamphlet with educational information about nutrition and food safety. Three months after enrollment, a telephone follow-up was conducted among participants in the three groups. Data on child passenger safety knowledge, risky driving behaviors, and use of CSS were evaluated before and after the intervention. A total of 132 newborn parents were enrolled in the study; of those, 52 (39.4% were assigned into the education plus free CSS intervention group, 44 (33.3% were in the education intervention only group, and 36 (27.3% were in the control group. No significant differences existed in demographics among the three groups. There was a significant difference in newborn parents’ child passenger safety knowledge and behaviors in the three groups before and after the intervention. In addition, the CSS use increased significantly in the education plus free CSS group after the intervention compared to parents in the education only or control groups. Education on safety, combined with a free CSS and professional installation training, were effective at increasing newborn parents’ knowledge and use of CSS. Future studies with larger sample sizes and longer follow-up are needed to determine a long-term effect of the

Newborn Parent Based Intervention to Increase Child Safety Seat Use

Science.gov (United States)

Liu, Xiangxiang; Yang, Jingzhen; Cheng, Fuyuan; Li, Liping

2016-01-01

This paper intends to assess the effect of a maternity department intervention on improvement of knowledge and use of child safety seats (CSS) among newborn parents. An intervention study included three groups (one education plus free CSS intervention group, one education only group, and one control group). The participants were parents of newborns in the maternity department of two hospitals. Both of the intervention groups received a folded pamphlet of child passenger safety, a height chart and standardized safety education during their hospital stay after giving birth. The education plus free CSS intervention group received an additional free CSS and professional installation training at hospital discharge. The control group received a pamphlet with educational information about nutrition and food safety. Three months after enrollment, a telephone follow-up was conducted among participants in the three groups. Data on child passenger safety knowledge, risky driving behaviors, and use of CSS were evaluated before and after the intervention. A total of 132 newborn parents were enrolled in the study; of those, 52 (39.4%) were assigned into the education plus free CSS intervention group, 44 (33.3%) were in the education intervention only group, and 36 (27.3%) were in the control group. No significant differences existed in demographics among the three groups. There was a significant difference in newborn parents’ child passenger safety knowledge and behaviors in the three groups before and after the intervention. In addition, the CSS use increased significantly in the education plus free CSS group after the intervention compared to parents in the education only or control groups. Education on safety, combined with a free CSS and professional installation training, were effective at increasing newborn parents’ knowledge and use of CSS. Future studies with larger sample sizes and longer follow-up are needed to determine a long-term effect of the intervention. PMID

Child deaths at National District Hospital, Free State: one a month is ...

African Journals Online (AJOL)

H Brits

implemented by the NDoH decreased child mortality (MDG 4) at National District ... deaths, gastroenteritis, health strategies, HIV, malnutrition, Millennium Development Goal 4 ... specific indicators.2 The most important initiatives introduced by.

Bourdieu at the bedside: briefing parents in a pediatric hospital.

Science.gov (United States)

LeGrow, Karen; Hodnett, Ellen; Stremler, Robyn; McKeever, Patricia; Cohen, Eyal

2014-12-01

The philosophy of family-centered care (FCC) promotes partnerships between families and staff to plan, deliver, and evaluate services for children and has been officially adopted by a majority of pediatric hospitals throughout North America. However, studies indicated that many parents have continued to be dissatisfied with their decision-making roles in their child's care. This is particularly salient for parents of children with chronic ongoing complex health problems. These children are dependent upon medical technology and require frequent hospitalizations during which parents must contribute to difficult decisions regarding their child's care. Given this clinical issue, an alternative theoretical perspective was explored to redress this problem. Pierre Bourdieu's theoretical concepts of field, capital, and habitus were used to analyze the hierarchical relationships in pediatric acute care hospitals and to design a briefing intervention aimed at improving parents' satisfaction with decision making in that health care setting. © 2014 John Wiley & Sons Ltd.

Community Based Distribution of Child Spacing Methods at ...

African Journals Online (AJOL)

uses volunteer CBD agents. Mrs. E.F. Pelekamoyo. Service Delivery Officer. National Family Welfare Council of Malawi. Private Bag 308. Lilongwe 3. Malawi. Community Based Distribution of. Child Spacing Methods ... than us at the Hospital; male motivators by talking to their male counterparts help them to accept that their ...

The potential migration effect of rural hospital closures

DEFF Research Database (Denmark)

Sørensen, Jens Fyhn Lykke

2008-01-01

to out-migration, although the hypothetical way of questioning leaves uncertainty about the actual scale of out-migration. Child families appear to be the most likely out-migrants. Elderly people may be hardest hit by a hospital closure, being most reliant on health care and least inclined to move away.......Rural hospital closures are high on the current health care agenda in Denmark. One raised concern is that rural hospital closures may further decrease population numbers in rural areas, as closures may induce some residents to move away from affected areas, i.e. closer to health care services...

Influence of older primiparity on childbirth, parenting stress, and mother-child interaction.

Science.gov (United States)

Sonobe, Mami; Usui, Masami; Hiroi, Kayoko; Asai, Hiromi; Hiramatsu, Mayumi; Nekoda, Yasutoshi; Hirose, Taiko

2016-04-01

Delivery at 35 years and above has increased in Japan. While there is much research concerning obstetrical risk and delivery at advanced age, little research addresses child-rearing after birth. This study seeks to identify how older primiparas' characteristics of child-rearing, parenting stress, and mother-child interaction differ from those of younger mothers. Participants were primipara women aged 35 years and above and primiparas aged 20-29 years; all delivered in the hospital. Questionnaires were distributed during hospitalization after birth and during home visits at 3 months, 1 year, and 2 years post-partum. Mother-child interactions during home visits were assessed using the Nursing Child Assessment Teaching Scale (NCATS). The older group included 13 primiparas, and the control group included seven primiparas at the study's end. Some older primiparas used fertility treatment and cesarean section, but primiparas in their 20s used neither. There were no significant differences in terms of depression, psychological health, size of networks, and number of daytime or night-time feedings. Statistically significant differences were as follows. Older primiparas experienced more social isolation and overall stress, and their children exhibited greater hypersensitivity/lack of adaptability at 3 months. Older mothers were more likely to report little effort by their children to please them at 1 and 2 years after birth. Under observation, older primiparas received higher NCATS caregiver scores, but children of primiparas in their 20s received higher child scores. Mothers and child-care specialists should recognize that older primiparas interact more favorably with their children, but have more parenting stress. © 2016 Japan Academy of Nursing Science.

Local macroeconomic trends and hospital admissions for child abuse, 2000-2009.

Science.gov (United States)

Wood, Joanne N; Medina, Sheyla P; Feudtner, Chris; Luan, Xianqun; Localio, Russell; Fieldston, Evan S; Rubin, David M

2012-08-01

To examine the relationship between local macroeconomic indicators and physical abuse admission rates to pediatric hospitals over time. Retrospective study of children admitted to 38 hospitals in the Pediatric Hospital Information System database. Hospital data were linked to unemployment, mortgage delinquency, and foreclosure data for the associated metropolitan statistical areas. Primary outcomes were admission rates for (1) physical abuse in children <6 years old, (2) non-birth, non-motor vehicle crash-related traumatic brain injury (TBI) in infants <1 year old (which carry high risk for abuse), and (3) all-cause injuries. Poisson fixed-effects regression estimated trends in admission rates and associations between those rates and trends in unemployment, mortgage delinquency, and foreclosure. Between 2000 and 2009, rates of physical abuse and high-risk TBI admissions increased by 0.79% and 3.1% per year, respectively (P ≤ .02), whereas all-cause injury rates declined by 0.80% per year (P < .001). Abuse and high-risk TBI admission rates were associated with the current mortgage delinquency rate and with the change in delinquency and foreclosure rates from the previous year (P ≤ .03). Neither abuse nor high-risk TBI rates were associated with the current unemployment rate. The all-cause injury rate was negatively associated with unemployment, delinquency, and foreclosure rates (P ≤ .007). Multicenter hospital data show an increase in pediatric admissions for physical abuse and high-risk TBI during a time of declining all-cause injury rate. Abuse and high-risk TBI admission rates increased in relationship to local mortgage delinquency and foreclosure trends.

The Effectiveness of Parent-Child Play Therapy on Decreasing Depression Symptoms in Children with Cancer, Decreasing Perceived Stress on Their Mothers and Improving Parent-Child Relationship

Directory of Open Access Journals (Sweden)

رویا سادات علویان

2017-01-01

Full Text Available Present study, aimed to assess the effect of parent-child play therapy on decreasing depression symptoms in children with cancer, decreasing perceived stress of their mothers and improving the parent-child relationship. A total of 14 children diagnosed with cancer were selected, among the patients of Dr. Sheikh Hospital in the city of Mashhad, and randomly assigned into two groups of intervention and control. Mothers completed the Perceived Stress Scale (PSS and the Parent-Child Relationship Scale (PCRS, the children completed the Child Depression Inventory (CDI, both in pre-test and post-test. Eight sessions of parent-child play therapy were adminstered separately for every pair of mother-child from intervention group. Data were analyzed by using analysis of covariance. Compared to the control group, CDI scores of intervention group reduced significantly from pre to post test. Also scores of PCRS increased significantly for the intervention group. PSS Scores of intervention groups was not significantly different from control group. As a result, parent-child play therapy can be effective in reducing depression symptoms of children with cancer, and improving the parent-child relationship; while, it was not effective for reducing mothers' level of perceived stress.

[Status of music therapy in inpatient pediatrics and child and adolescent psychiatry].

Science.gov (United States)

Evers, S

1998-04-01

In order to study the present situation of music therapy in hospitals of pediatrics and of child and adolescent psychiatry in the FRG, a postal survey at these hospitals was performed. The personnel situation, methods of music therapy and indications for music therapy were examined. The data are analysed according to the kind and the size of hospital; they are compared to results obtained in a survey at out-patient pediatrics and to a similar survey from the year 1990.

Social Networking Family of Caregivers during Hospitalization of Children.

Science.gov (United States)

Menezes, Marina; Moré, Carmen Leontina Ojeda Ocampo; Barros, Luísa

2016-06-01

To identify and analyze the significant networks of family, social and hospital support described by the family caregivers of hospitalized children 5-12 years during the hospital stay. Descriptive study, exploratory and qualitative study conducted with 20 caregivers of children hospitalized in a hospital in a city in southern Brazil, through semi-structured interviews and significant social networks maps, tailored to the hospital setting. Data analysis showed that the most active social network was comprised of families through emotional support, material aid and services. Relations with hospital health care team and the hospital context were cited as providing support to the caregivers of the hospitalized child. The identification of social networks in the child's hospitalization course enables equip professionals working in the institution aiming at better targeting of actions and care for the family and hospitalized children. Identificar e analisar as redes significativas de suporte familiar, social e hospitalar descritas pelos familiares acompanhantes de crianças hospitalizadas de 5 a 12 anos, durante o período de internação. Estudo descritivo, exploratório e de cunho qualitativo realizado com 20 acompanhantes de crianças hospitalizadas em uma unidade hospitalar em uma cidade do Sul do Brasil, por meio de entrevistas semiestruturadas e dos Mapas de Redes sociais significativas, adaptado para o contexto hospitalar. A análise dos dados demonstrou que a rede social mais atuante foi composta por familiares, através de apoio emocional, ajuda material e de serviços. As relações com a equipe de saúde do hospital e com o contexto hospitalar foram citadas como capazes de fornecer apoio ao acompanhante da criança internada. a identificação das redes sociais no curso da hospitalização da criança possibilita instrumentalizar os profissionais que atuam na instituição objetivando um melhor direcionamento de ações e cuidados destinados à família e a

Parents’ experience confronting child burning situation

Directory of Open Access Journals (Sweden)

Valdira Vieira de Oliveira

2015-05-01

Full Text Available Objective: to understand experiences of parents in a child burning situation during the hospitalization process. Methods: phenomenological research in view of Martin Heidegger, held with seven assisting parents at a pediatrics unit of a general hospital in Montes Claros. The information was obtained by phenomenological interview, containing the question guide: “What does it mean to you being with a son who is suffering with burns?”. Results: during the experience, parents revealed anguish, fear, helplessness, concerns and expectations of “being-in-the-world”. Conclusion: respect, understanding and care from the health team were fundamental for the adaptation and the confrontation demanded by the consequent suffering of the event.

Young traffic victims' long-term health-related quality of life : Child self-reports and parental reports

NARCIS (Netherlands)

Sturms, LM; van der Sluis, CK; Groothoff, JW; ten Duis, HJ; Eisma, WH

Objectives: To describe the long-term health-related quality of life (HRQOL) reported by young traffic injury victims and to assess the child-parent agreement on the child's HRQOL. Design: Cohort study with a mean follow-up of 2.4 years. Setting: Traumatology department in a university hospital in

The perception of nurses regarding educational practices for children with diabetes in hospital care

Directory of Open Access Journals (Sweden)

Viviane Peixoto dos Santos Pennafort

Full Text Available The aim of this study was to describe the perception of nurses regarding educational practices conducted with children with diabetes in a hospital unit. It is a descriptive qualitative study, conducted in an inpatient unit of a public hospital in Fortaleza, state of Ceará, Brazil, between January and February of 2013, with six nurses. Data were collected by means of semi-structured interviews and submitted to content analysis, from which two categories emerged: role of nurses and staff in caring for the child with diabetes: the necessary intersection; and health education directed at the child with diabetes and family members in the hospital context. Nursing professionals acknowledged educational activities as part of an interdisciplinary care strategy which must occur since the moment the child is admitted. However, they displayed a reductionist view, centered on insulin therapy and changes of habit, which indicates the need for more creative approaches, capable of enhancing learning aspects and minimizing the gaps which prevent the disease from being managed appropriately.

Identification of ICD Codes Suggestive of Child Maltreatment

Science.gov (United States)

Schnitzer, Patricia G.; Slusher, Paula L.; Kruse, Robin L.; Tarleton, Molly M.

2011-01-01

Objective: In order to be reimbursed for the care they provide, hospitals in the United States are required to use a standard system to code all discharge diagnoses: the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9). Although ICD-9 codes specific for child maltreatment exist, they do not identify all…

Male Involvement in Child Care Activities: A Review of the Literature ...

African Journals Online (AJOL)

AJRH Managing Editor

1School of Nursing University of Botswana; 2School of Nursing University of Botswana; 3School of Nursing, University of. Botswana ... childrearing are critical because of their decision ... welfare clinic and rooming-in for the hospitalized child.

Probiotics do not improve the benefits of a hospital treatment protocol for acute diarrhea in the breastfed child.

Directory of Open Access Journals (Sweden)

Sergio Santana Porbén

2016-11-01

Full Text Available Rationale: Probiotics have been used in the treatment of acute diarrhea occurring in pediatric ages with mixed results. Objective: To assess the impact of a probiotic (CFU per capsule: Lactobacillus rhamnosus G: 2 x 109, Lactobacillus cassei: 1 x 109, Bifidobacterium brevis: 2 x 109 upon the features and duration of acute diarrhea in breastfed children. Study location: Digestive Diseases and Nutrition Service, “Juan Manuel Márquez” Pediatric Teaching Hospital (Marianao, Havana City, Cuba. Study design: Open, quasi-experimental trial. Thirty children with ages 0.05; Improvement of the features of stools: Non-Treated: 93.3% vs. Treated: 96.1% (p > 0.05. Use of probiotics produced an increase of Hemoglobin ( = -0.44; p 0.05 values of indicators of systemic inflammatory response. Conclusions: Inclusion of probiotics within an institutional protocol for treatment of acute diarrhea does not significantly change the stool pattern of the breastfed child, but might reduce the systemic inflammatory tone which, in turn, would result in a better use of body iron.

An integrative review of communication between parents and nurses of hospitalized technology-dependent children.

Science.gov (United States)

Giambra, Barbara K; Stiffler, Deborah; Broome, Marion E

2014-12-01

With advances in health care, the population of children who are technology-dependent is increasing and, therefore, the need for nurses to understand how best to engage in communication with the parents of these children is critical. Shared communication between the parents of hospitalized technology-dependent children and their nurses is essential to provide optimal care for the child. The components and behaviors of the parent-nurse communication process that improve mutual understanding of optimal care for the child had not previously been examined. Among parents of hospitalized technology-dependent children and their nurses, what communication behaviors, components, concepts, or processes improve mutual understanding of optimal care for the child? An integrative review of both qualitative and quantitative studies was conducted. Key words including communication, hospitalized, nurse, parent, pediatric, and technology-dependent were used to search databases such as Cumulative Index to Nursing and Allied Health and Medline for years 2000-2014. The data regarding the process of parent-nurse communication were extracted as they related to the mutual understanding of optimal care for the child. The data were grouped into themes and compared across studies, designs, populations, and settings. Six articles were identified that provided information regarding the processes of shared communication among the parents of hospitalized technology-dependent children and their nurses. Providing clear information, involving parents in care decisions, trust and respect for each other's expertise, caring attitudes, advocacy, and role negotiation were all found to be important factors in shared parent-nurse communication. The results of this integrative review inform our understanding of the parent-nurse communication process. The findings provide nurses with an understanding of strategies to better engage in respectful, engaging, and intentional communication with parents of

Perceptions of the risk of child abduction or loss and the utility of child electronic security devices.

Science.gov (United States)

Dixon, R M; Pasnak, R

1997-09-01

Perceptions of the susceptibility of young children to becoming lost or being abducted, and of the potential usefulness of child electronic security devices, were examined via a questionnaire. Data were provided by 41 volunteers, most of them from a local government office centre. The questionnaire asked for demographic data, and then for the risk of a child being abducted or lost when under the supervision of different caregivers and in different situations. The probable effectiveness of three common abductor ploys was also addressed. The questionnaire concluded with 10 questions about child electronic security devices. Respondents viewed mothers, fathers, and grandparents as equally responsible caregivers and young adults/babysitters as the least responsible. These effects diminished as the age of the children increased. The garden at home was judged to be the most secure environment for children of all ages, while an amusement park was judged the least secure environment. Children were perceived to be more at risk of an abduction when a stranger asked for physical assistance or to take them to the hospital because their parents were hurt, than when asked for directions. Furthermore, the respondents expressed a moderately strong need for child electronic security devices, and viewed parents who use them as more responsible than those who do not.

Caring for an intimate stranger: parenting a child with psychosis.

Science.gov (United States)

Darmi, E; Bellali, T; Papazoglou, I; Karamitri, I; Papadatou, D

2017-05-01

The care of an adult son or daughter with psychosis is filled with overwhelming demands caused by the symptomatology and illness exacerbations. Parents display disenfranchised grief over multiple losses and report increased levels of emotional burden. Most studies use quantitative methods and rely on pre-existing theoretical frameworks to investigate, through psychometric measures, the effects of being a carer. Meaning attributions to the disorder, and changes in parent-child relations over time, are poorly understood. This hermeneutic phenomenological study illuminates the subjective experience of parenting a son or daughter with psychosis, as it is lived and described by parents of young adults with psychosis. Findings suggest that the parents' perceptions of their child changes over the course of the disorder, leading to a redefinition of the parent-child relationship, causing alternations in attachment. Findings illuminate the parents' profound guilt over having contributed or not prevented the disorder, over not being 'good' parents and feeling ambivalent towards an 'intimate stranger.' Guilt is compensated by absolute dedication to the son or daughter's care, at the expense of their own well-being. Interventions for parents must be available as soon as possible, both during hospitalization and after discharge. Professionals should provide a therapeutic space, where parents could express intimate thoughts and feelings, address guilt, fear and resentment issues, be assisted in their parenting role as well as in the reconstruction of a sense of self and self-esteem. Professionals are invited to facilitate illness acceptance, provide accurate information, assist parents to redefine their relationship to the child and facilitate the integration of the traumatic experience into their personal and family narrative. Professionals must develop in depth awareness of their biases and attitudes, have an ongoing training on how to respond to the parents' needs, facilitate

Reiki training for caregivers of hospitalized pediatric patients: a pilot program.

Science.gov (United States)

Kundu, Anjana; Dolan-Oves, Rebecca; Dimmers, Martha A; Towle, Cara B; Doorenbos, Ardith Z

2013-02-01

To explore the feasibility of a Reiki therapy-training program for the caregivers of pediatric medical or oncology inpatients, at a large pediatric hospital, a series of Reiki training classes were offered by a Reiki Master. At completion of the training, an interview was conducted to elicit participant's feedback regarding the effectiveness and feasibility of the training program. Seventeen of the 18 families agreed to participate. Most families (65%) attended three Reiki training sessions, reporting that Reiki benefitted their child by improving their comfort (76%), providing relaxation (88%), and pain relief (41%). All caregivers identified becoming an active participant in their child's care as a major gain from participation in the Reiki training. A hospital-based Reiki training program for caregivers of hospitalized pediatric patients is feasible and can positively impact patients and their families. More rigorous research regarding the benefits of Reiki in the pediatric population is needed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Breastfeeding in the neonatal transitional period at a Baby-Friendly Hospital

Directory of Open Access Journals (Sweden)

Jéssica Machado Teles

2015-03-01

Full Text Available The objective of this study was to learn the breastfeeding rates in the neonatal transition period at a child-friendly hospital. A quantitative, exploratory, cross-sectional study was developed with 342 mother-baby pairs. Data were collected by means of interviews and analysis of medical records. Low breastfeeding rates were identified in the first hour of life of the newborns or neonatal reactivity period (53.2%. In the second transition period the rate was 20.7%, and 20.5% in the third period. Encouragement to breastfeeding is not appropriate for the phases of the neonatal transition period, as the rates for the first hour of life were expected to be higher than 90%, considering low risk newborns and births that occurred in a child-friendly hospital. Our findings indicate a need for adopting care strategies that favor the early contact and training of professionals at maternity hospitals toward the adequacy of breastfeeding to the neonatal transition period.

Student-initiated revision in child health.

Science.gov (United States)

Alfaham, M; Gray, O P; Davies, D P

1994-03-01

Most teaching of child health in Cardiff takes place in block attachments of 8 weeks. There is an introductory seminar of 2 days followed by a 6-week clinical attachment in a district general hospital in Wales, and then a revision period of one week designed to help students formalize and structure their basic knowledge and to clarify aspects of child health which they may have had difficulty in understanding. The revision programme has to take into account: the short time available, the small number of teaching staff, the most relevant basic knowledge and active participation by the student. This paper describes how this week has been improved through the use of student-initiated revision (SIR). The students' appraisal of this revision and in particular SIR is presented.

[Tunisian mothers' beliefs about their child's first psychotic episode].

Science.gov (United States)

Bourgou, S; Halayem, S; Bouden, A; Halayem, M B

2012-12-01

Initiating psychiatric treatment depends on several factors including clinical, personal, familial and economic factors. In the case of a first psychotic episode in an adolescent, parents, especially mothers, have a critical role in initiating psychiatric treatment for their child. In this study, we investigated mothers' beliefs about their child's first psychotic episode. Participants were adolescents consulting the department of Child and Adolescent Psychiatry of the Razi hospital in Tunisia. They were aged from 12 to 19 years at the onset of their medical follow-up. Their diagnoses were schizophrenia, schizoaffective disorder and schizophreniform disorder according to DSM-IV. A questionnaire was submitted to patients' mothers after their approval. It was divided into two parts. The first part was used to collect information on socio-demographic and clinical characteristics of the mothers and their children. The second part was composed of the following four questions in Tunisian dialect: (1) what did you think was the matter when you first noticed psychotic symptoms in your child? (2) what was the main reason for which you thought psychiatric treatment was necessary? (3) what obstacles did you perceive in initiating psychiatric treatment? (4) do you have any advice or suggestions for caregivers on how they could facilitate an early start of treatment? Twenty-two mothers were included. The mean age of the mothers at onset of the follow-up of their child was 42 years (SD: 4.81). Ten mothers had never been schooled, five had primary school level, four had secondary school level, three had bachelor's degree and two had a diploma of doctorate; 63.6% of the mothers were housewives. The mean age of patients was 13.77 years at the start of their medical follow-up (SD= ± 2.14). Most of the patients were male (14 males for eight girls). Most patients were diagnosed as having schizophrenia (91%); 4.5% were diagnosed with schizoaffective disorder and 4.5% with

Child slavery and child labour

OpenAIRE

McKinney, Stephen J.; Hill, R.J.; Hania, Honor

2015-01-01

Child slavery and child labour deny children their God-given dignity and freedom, and their right to education. Catholic Social Teaching is unequivocal in resolute condemnation of child slavery and child labour, in all of their forms.

Hospital-based child protection teams that care for parents who abuse or neglect their children recognize the need for multidisciplinary collaborative practice involving perinatal care and mental health professionals: a questionnaire survey conducted in Japan.

Science.gov (United States)

Okato, Ayumi; Hashimoto, Tasuku; Tanaka, Mami; Tachibana, Masumi; Machizawa, Akira; Okayama, Jun; Endo, Mamiko; Senda, Masayoshi; Saito, Naoki; Iyo, Masaomi

2018-01-01

Child abuse and/or neglect is a serious issue, and in many cases, parents are the perpetrators. Hospital-based child protection teams (CPTs) play pivotal roles in the management of not only abused and/or neglected children but also of their parents; this is generally conducted through multidisciplinary practice. The aim of this study is to survey hospital-based CPT members to determine the professions they perceive to be most applicable to participation in CPTs. The participants were members of CPTs affiliated with hospitals that had pediatric emergency departments and which were located in Chiba Prefecture; specifically, 114 CPT members from 23 hospitals responded to this survey. The two main questionnaire items concerned are as follows: 1) each respondent's evaluation of conducting assessments, providing support, and implementing multidisciplinary collaborative practice in the treatment of abusive and negligent parents, and 2) each CPT member's opinion on the professions that are most important for CPT activities. An exploratory factor analysis (EFA) was performed to explore the factor structure of the data, and a correlation analysis was performed using the result obtained. The EFA returned two factors: multidisciplinary collaborative practice (α = 0.84) and assessment and support (α = 0.89). A correlational analysis showed that multidisciplinary collaborative practice had a positive correlation for obstetricians ( r = 0.315, p = 0.001), neonatologists ( r = 0.261, p = 0.007), midwives ( r = 0.248, p = 0.011), and psychiatrists ( r = 0.194, p = 0.048); however, assessment and support was only significantly correlated with midwives ( r = 0.208, p = 0.039). This study showed that hospital-based CPT members highly evaluate multidisciplinary collaborative practice for the management of abusive and/or negligent parents, and they believe that, in addition to pediatric physicians and nurses, perinatal care and mental health professionals are the most important

Advanced practice nursing in child maltreatment: practice characteristics.

Science.gov (United States)

Hornor, Gail; Herendeen, Pamela

2014-01-01

Child maltreatment is a problem of epidemic proportions in the United States. Pediatric nurse practitioners and other advanced practice nurses (APNs) have been caring for maltreated children for decades, yet to date no comprehensive assessment of their practice characteristics or their clinical and academic contributions to the field has been performed. The purpose of this study is to describe the practice characteristics of APNs who care for maltreated children. A descriptive design was used for this study. Child advocacy centers and children's hospitals were contacted to inquire about employment of child maltreatment APNs in their institution, and contact information for the lead APN was obtained. The Nurse Practitioner Survey was then sent to lead APNs by e-mail. The majority of APNs who work primarily in child maltreatment are pediatric nurse practitioners who work in child advocacy centers. They are providing care to children with physical and/or sexual abuse concerns; however, APNs provide care for children with all types of child maltreatment concerns. APNs play a vital role in the care of abused/neglected children. Their important contributions include not only clinical care but also the provision of clinical and didactic education to other professionals, parents, and the public. Research and publication are also essential to their role. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

"Why Don't They Report?" Hospital Personnel Working with Children at Risk

Science.gov (United States)

Svärd, Veronica

2017-01-01

Hospital personnel have been shown to report child maltreatment to social services less frequently than other professionals. This quantitative study shows that one-half of the respondents within the four largest Swedish children's hospitals had never made a report. However, nurses' and nurse assistants' odds of being low reporters were…

Association between childhood abuse and psychiatric morbidities among hospitalized patients

Directory of Open Access Journals (Sweden)

Kshirod Kumar Mishra

2016-01-01

Full Text Available Background: Childhood abuse has been linked with increased risk of adult psychiatric disorders including major depression, substance abuse, anxiety disorders, posttraumatic stress disorder, and personality disorders. However, only a few from India attempted to study long-term consequences of childhood abuse. Our study aimed to understand the role of physical, sexual, and emotional abuse along with psychiatric co-morbidities in hospitalized patients. Materials and Methods: Patients admitted to psychiatric inpatient services in the age group of 14-45 years for the 1 st time were evaluated for a history of physical, sexual, and emotional abuse on the basis of retrospective chart review. Semi-structured Performa was used to evaluate the patient with a history of child abuse, and they were diagnosed according to International Classification of Diseases-10 diagnostic criteria. Result: The prevalence of child abuse in our inpatient services was 43.29%; emotional abuse (61.9% was most commonly reported among patient followed by physical (21.43% and sexual abuse (16.67%. We observed a significant difference in terms of length of hospital stay between abuse (10.29 ± 6.01 days and nonabuse group (5.90 ± 2.43 days (t = 4.902, df = 95, P < 0.0001. The boys experienced physical abuse at a younger age (7.43 ± 2.50 years than girls (13.50 ± 0.70 years. The sexual abuse and emotional abuse were reported at a younger age in girls than boys. We found high prevalence of substance use disorders (40.47%, psychosis (19.04%, and mood disorder (28.57% among abuse group. Conclusions: The study findings highlight the developing importance of the different forms of abuse on adult psychiatric diagnosis in India. The abused patients are at high risk of the development of psychiatric disorder than the nonabuse group. The increased length of hospitalization among abused group reflects severity and complexity of child abuse. The early detection of social factors

Children in hospital in Ireland - what do they eat and what do they weigh: a cross-sectional study

LENUS (Irish Health Repository)

Flinn, Aisling

2012-09-06

AbstractBackgroundOverweight and obesity is a growing problem in Ireland. Many parents are unaware when their child is overweight or obese. Our objectives were to examine parents’ perceptions of a healthy diet and their children’s BMI; and to evaluate the food offered to children in our paediatric in-patient unit.FindingsA retrospective questionnaire was distributed to 95 patients and their families admitted over one month. Seventy-eight had BMI values calculated (42 males, 36 females). Twenty-one children (26.9%) were overweight\\/obese: 14\\/21 parents (66.7%) thought their child had a normal weight. Sixty percent of children served dinner in the hospital were given fried potatoes. Four had fruit\\/vegetables. Forty-six parents brought food into hospital, of these 14 brought purchased food.ConclusionsThis study highlights the problem of child obesity in Ireland and parental underestimation of this problem. The nutritional value of food served to children in hospital needs to be improved and hospital admissions used as opportunities to promote healthy eating habits.

Children in hospital in Ireland - what do they eat and what do they weigh: a cross-sectional study

Directory of Open Access Journals (Sweden)

Flinn Aisling

2012-09-01

Full Text Available Abstract Background Overweight and obesity is a growing problem in Ireland. Many parents are unaware when their child is overweight or obese. Our objectives were to examine parents’ perceptions of a healthy diet and their children’s BMI; and to evaluate the food offered to children in our paediatric in-patient unit. Findings A retrospective questionnaire was distributed to 95 patients and their families admitted over one month. Seventy-eight had BMI values calculated (42 males, 36 females. Twenty-one children (26.9% were overweight/obese: 14/21 parents (66.7% thought their child had a normal weight. Sixty percent of children served dinner in the hospital were given fried potatoes. Four had fruit/vegetables. Forty-six parents brought food into hospital, of these 14 brought purchased food. Conclusions This study highlights the problem of child obesity in Ireland and parental underestimation of this problem. The nutritional value of food served to children in hospital needs to be improved and hospital admissions used as opportunities to promote healthy eating habits.

Hospital-based home care for children with cancer

DEFF Research Database (Denmark)

Hansson, Helena; Hallström, Inger; Kjaergaard, Hanne

2011-01-01

Hospital-based home care (HBHC) is widely applied in Pediatric Oncology. We reviewed the potential effect of HBHC on children's physical health and risk of adverse events, parental and child satisfaction, quality of life of children and their parents, and costs. A search of PubMed, CINAHL...

A survey of community child health audit.

Science.gov (United States)

Spencer, N J; Penlington, E

1993-03-01

Community child health medical audit is established in most districts surveyed. A minority have integrated audit with hospital paediatric units. Very few districts use an external auditor. Subject audit is preferred to individual performance audit and school health services were the most common services subjected to medical audit. The need for integrated audit and audit forms suitable for use in the community services is discussed.

A profile of babies born before arrival to hospital in a peri-urban setting

Directory of Open Access Journals (Sweden)

N. Parag*

2013-12-01

Conclusions: Prevalence of BBAs is comparable to other developing countries, and is associated with poor antenatal attendance, prematurity, delay in presentation to hospital and lengthier hospital stays. These factors have implications on prehospital care of newborns and access to maternal and child health care in general.

Perceived reciprocal value of health professionals' participation in global child health-related work.

Science.gov (United States)

Carbone, Sarah; Wigle, Jannah; Akseer, Nadia; Barac, Raluca; Barwick, Melanie; Zlotkin, Stanley

2017-05-22

Leading children's hospitals in high-income settings have become heavily engaged in international child health research and educational activities. These programs aim to provide benefit to the institutions, children and families in the overseas locations where they are implemented. Few studies have measured the actual reciprocal value of this work for the home institutions and for individual staff who participate in these overseas activities. Our objective was to estimate the perceived reciprocal value of health professionals' participation in global child health-related work. Benefits were measured in the form of skills, knowledge and attitude strengthening as estimated by an adapted Global Health Competency Model. A survey questionnaire was developed following a comprehensive review of literature and key competency models. It was distributed to all health professionals at the Hospital for Sick Children with prior international work experience (n = 478). One hundred fifty six health professionals completed the survey (34%). A score of 0 represented negligible value gained and a score of 100 indicated significant capacity improvement. The mean respondent improvement score was 57 (95% CI 53-62) suggesting improved overall competency resulting from their international experiences. Mean scores were >50% in 8 of 10 domains. Overall scores suggest that international work brought value to the hospital and over half responded that their international experience would influence their decision to stay on at the hospital. The findings offer tangible examples of how global child health work conducted outside of one's home institution impacts staff and health systems locally.

Mother-child health in Lacor-South Sudan (IMCHA) | CRDI - Centre ...

International Development Research Centre (IDRC) Digital Library (Canada)

The researchers will explore strategies for improved maternal care and child nutrition services, cervical cancer screening, and support for women's empowerment through outreach efforts from the two hospitals. Research findings will be validated through ministries of health at the local, district, and national levels to optimize ...

Perception of child adoption among parents/care‑givers of children ...

African Journals Online (AJOL)

15.1% and 8.9% of the respondents gave private hospitals and middle men, respectively, as sources of child adoption. Knowledge of the Government adoption laws and process was generally below average (49.2%) among the respondents. Conclusion: Continued advocacy and public enlightenment campaigns should be ...

Stress and coping of parents caring for a child with mitochondrial disease.

Science.gov (United States)

Senger, Brenda A; Ward, Linda D; Barbosa-Leiker, Celestina; Bindler, Ruth C

2016-02-01

Mitochondrial disease comprises a group of rare, genetic, life-limiting, neurodegenerative disorders known to affect children. Little is known about disease-related challenges, parental stress, and coping when caring for a child with a mitochondrial disease. This study explored disease-related characteristics and parental stressors and coping behaviors related to caring for a child with mitochondrial disease. Internet surveys were posted on known mitochondrial disease websites for parent completion. Surveys included demographic items and two questionnaires: Coping Inventory for Parents (CHIP) and Pediatric Inventory for Parents (PIP). Descriptive data were collected and correlations used to determine relationships between parenting stress, coping, and demographic variables. The majority of participants (n=231) were mothers (95%) of children with mitochondrial disease around the age of 10 years (M=9.85). On average, children had 6 organs involved (M=6.02) and saw 7 different specialists (M=7.49); 61% were hospitalized in the past year. Significant correlations (pstress and parent age, parent income, parent education, child age, child age at diagnosis, presence of developmental delays, number of hospitalizations, number of medical visits, number of organs involved, and number of specialists seen. Significant correlations were also found between parenting stress and coping behaviors such as family integration, social support and understanding health care. The ability to identify disease-related challenges, stressors, and coping strategies in parents of children with mitochondrial disease is novel and can assist nurses to provide disease-sensitive, family-focused care and improve child health outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Maintaining family life balance while facing a child's imminent death-A mixed methods study.

Science.gov (United States)

Eskola, Katri; Bergstraesser, Eva; Zimmermann, Karin; Cignacco, Eva

2017-10-01

To understand parents' experiences and needs during a child's end-of-life care at home and to identify systemic factors that influence its provision. A child's end-of-life phase is an extremely difficult time for the whole family. Parents have specific needs, especially when they care for a dying child at home. Concurrent embedded mixed methods design. This sub-study of the nationwide survey, 'Paediatric End-of-Life Care Needs in Switzerland' (2012-2015) included 47 children who received EOL care at home from 2011-2012. We extracted quantitative data from patients' medical charts and obtained information via parental questionnaire and then compared parents whose child died at home or in hospital by computing generalized estimation equations. We thematically analysed interviews with parents who provided EOL care at home. Parents created an intimate lifeworld and a sense of normality for the child at home. They constantly balanced the family's lifeworld with the requirements and challenges posed by the outside world. This work exhausted parents. Parental 'readiness' and social support drove EOL care for children at home. Parents needed practical help with housekeeping and had negative experiences when dealing with insurance. In only 34.8% of cases was a child's EOL home care supported by paediatric palliative care team. Paediatric end-of-life care at home is only feasible if parents make extraordinary efforts. If family-centred end-of-life home care is provided by a hospital-based paediatric palliative home care team, which includes paid housekeeping help and psychological support, parents' needs could be better met. © 2017 John Wiley & Sons Ltd.

Determinants of mother-to-child transmission of HIV despite PMTCT ...

African Journals Online (AJOL)

Determinants of mother-to-child transmission of. HIV despite PMTCT interventions in Enugu, Nigeria. K K Iloh, MBBS; O N Iloh, MBBS; A N Ikefuna, MBBS; N S Ibeziako, MBBS; A C Ubesie, MBBS, MPH; I J Emodi, MBBS. Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria.

Child drawings and salivary cortisol in children undergoing preoperative procedures associated with day surgery.

Science.gov (United States)

Wennström, Berith; Törnhage, Carl-Johan; Hedelin, Hans; Nasic, Salmir; Bergh, Ingrid

2013-12-01

Perioperative procedures in children can impair their emotional status negatively with stress and/or anxiety. Cortisol concentrations and drawings could be helpful in gaining information about a child's levels of stress and/or anxiety when attending the hospital for surgery. The purpose of this study was to determine the degree of anxiety and stress as well as to explore the association between objective measures of stress (cortisol concentration in saliva) and subjective assessment of hospital anxiety (children's drawings) as interpreted by the Swedish version of the Child Drawing: Hospital manual. A total of 93 children scheduled for day surgery were included. Salivary cortisol was sampled preoperatively on the day of surgery at which time the children were also requested to make a drawing of a person at the hospital. Results showed no association between salivary cortisol concentration and the CD:H score. The drawings and salivary cortisol concentration preoperatively on the day of surgery reflect different components of the conditions of fear, anxiety, or stress emerging in the situation. Copyright © 2013 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Investments for medical equipment in a mother and child health hospital: correlation with level of services/departments.

Science.gov (United States)

Trevisanuto, Daniele; Raggi, Roberto; Bavuusuren, Bayasgalantai; Tudevdorj, Erkhembaatar; Doglioni, Nicoletta; Zanardo, Vincenzo

2011-02-01

To assess whether investments for medical equipments assigned by a team of experts to a mother and child health hospital located in Mongolia were correlated with structural, organizational, and educational level of its services/departments. A score was used for evaluating the level of each service/department. It was based on a 'structural area' and an 'organizational and educational area'. Destination of funds was determined by a team of experts in collaboration with the head of the service/department. Thirty-three of 36 services/departments (91.6%) were evaluated. A total sum of 4,432,140 Euros to invest in medical equipment was estimated. Assigned investments were inversely correlated with the total (structural plus organizational and educational area) score (n = 33; r =  -0.59; p = 0.0002), and the specific scores for structural area (n = 33; r = -0.46; p = 0.005) and organizational and educational area (n = 33; r =  -0.56; p = 0.0006). A large part of the funds for medical equipment was destined to services/departments with low organizational and educational conditions, limiting the potential effect of the aid meanwhile supporting the most in need departments. Educational efforts and monitoring of specific long-term indicators are mandatory.

[Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966)].

Science.gov (United States)

Afschar-Hamdi, Sima; Schepker, Klaus

2017-09-01

Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966) The patient admissions at the children's ward of the State Psychiatric Hospital Weissenau in the years 1951, 1956, 1961 and 1966 were analyzed regarding documented coercive measures. Shortage of staff, mainly inadequately skilled personnel, a mixing of age groups in the patient cohort, neurological and psychiatric disorders and of patients who were in need of nursing and of those who needed treatment constituted the general work environment. Coercive measures against patients, mostly disproportionate isolations, were a constant part of daily life on the ward. This affected in particular patients who had to stay longer at the hospital and whose stay was financed by public authority. The uselessness of such measures was known, which can be seen e. g. in the Caretaker's Handbook of that time and the comments in the patient files. The situation still escalated in some cases (for example by transfer to an adult ward). For a long time, coercive measures against patients were part of everyday life at the children's ward of the Weissenau; the actual figures are suspected to be much higher.

Association of maternal age with child health: A Japanese longitudinal study.

Directory of Open Access Journals (Sweden)

Tsuguhiko Kato

Full Text Available Average maternal age at birth has been rising steadily in Western and some Asian countries. Older maternal age has been associated with adverse pregnancy and birth outcomes; however, studies on the relationship between maternal age and young children's health remain scarce. Therefore, we sought to investigate the association of maternal age with child health outcomes in the Japanese population. We analyzed data from two birth cohorts of the nationwide Japanese Longitudinal Survey of Babies in 21st Century (n2001 = 47,715 and n2010 = 38,554. We estimated risks of unintentional injuries and hospital admissions at 18 and 66 months according to maternal age, controlling for the following potential confounders: parental education; maternal parity, smoking status, and employment status; household income; paternal age, and sex of the child. We also included the following as potential mediators: preterm births and birthweight. We observed a decreasing trend in the risks of children's unintentional injuries and hospital admissions at 18 months according to maternal age in both cohorts. In the 2001 cohort, compared to mothers 40.0 years, respectively, controlling for confounders. Our findings were in line with previous findings from population-based studies conducted in the United Kingdom and Canada suggesting that older maternal age may be beneficial for early child health.

Parental Anxiety and Child Behaviour during Dental Sedation and General Anaesthesia

Directory of Open Access Journals (Sweden)

Angeline S. Y. Tan

2015-09-01

Full Text Available This study primarily sought to compare levels of child behavior and parental anxiety during tooth extraction under inhalation sedation (IS or general anaesthesia (GA. A prospective study was carried out within the Charles Clifford Dental Hospital, Sheffield, UK. The sample comprised 46 IS patients (mean age 11.5 years and 48 GA patients (mean age 9.4 years who attended the hospital for dental extractions. Child behavior was assessed before, during and after treatment using a Frankl Scale. After treatment, parents completed questionnaire, which sought a measure of parental anxiety before and during treatment, and parental satisfaction with the treatment outcome. Visual Analogues Scales (VAS were employed to grade the responses. The majority of children complied well throughout their treatment, with no significant differences in parental assessment of child anxiety levels between IS and GA patients. However, GA parents were significantly more anxious than IS parent before and during treatment. About a third of GA parents reported they were worried about the risks of GA. Conclusion; It would appear that parents of children undergoing a GA are significantly more anxious about the treatment than IS parents. Furthermore, IS has been shown to be a viable alternative to GA in alleviating anxiety in children and their parents during tooth extractions.

THE IMPORTANCE OF PLAY DURING HOSPITALIZATION OF CHILDREN

Science.gov (United States)

Koukourikos, Konstantinos; Tzeha, Laila; Pantelidou, Parthenopi; Tsaloglidou, Areti

2015-01-01

Introduction: Play constitutes an essential parameter of the normal psychosomatic development of children, as well as their statutory right. It is also an important means of communication in childhood. Objective: To review, detect and highlight all data cited regarding the role of play during the hospitalization of children. Methodology: Literature review was achieved by searching the databases Scopus, PubMed, Cinhal in English, using the following key words: therapeutic play, play therapy, hospitalized child, therapist. Results: During hospitalization, play either in the form of therapeutic play, or as in the form of play therapy, is proven to be of high therapeutic value for ill children, thus contributing to both their physical and emotional well-being and to their recovery. It helps to investigate issues related to the child’s experiences in the hospital and reduce the intensity of negative feelings accompanying a child’s admission to hospital and hospitalization. Play is widely used in pre-operative preparation and invasive procedures, while its use among children hospitalized for cancer is beneficial. Conclusion: The use of play in hospital may become a tool in the hands of healthcare professionals, in order to provide substantial assistance to hospitalized children, as long as they have appropriate training, patience, and will to apply it during hospitalization. PMID:26889107

Care of the abandoned child.

Science.gov (United States)

Raghunath, M

1991-01-01

Care of abandoned children in India is discussed in terms of reasons for abandonment, the physical condition of the children, and legal categories. The options available currently are the cottage system, sponsorship programs, foster care, or adoption. Child-care and rehabilitation that may be necessary is specified as is the importance of maintaining records. The gaps in child-care are exposed. The role of nongovernmental organization (NGOs) and new legislation in closing the gaps is presented. Abandonment is usually a direct result of poverty, but it can also be caused by mental or physical handicaps or illegitimacy. The numbers of abandoned children may reach 2 million. 40-60% of abandoned infants die during monsoons and summers. The legal categories are privately abandoned, children on remand, or court-committed children. The cottage system emphasizes deinstitutionalization, but there remains a great demand for care. Sponsorship aims to strengthen the family unit to prevent abandonment. Foster care provides an alternative family substitute, but is known only theoretically. Childcare may involve instant hospitalization, care is an institution, or foster care with a suitable family. Nursery care requires discipline in hygiene, sanitation, maintenance of individual medical records, and a general cheerful atmosphere. Records are important for the child in later life and for adoption. Rehabilitation is a sociolegal process which must be done properly or it can jeopardize a child's future security. Despite the Supreme Court guidelines of 1984, there is no uniform system of adoption practices, and the child's interests are overlooked when adoptions are promoted. NGOs play an important role in making social welfare programs work. However their efforts are of limited help without government support and legislation. There is a lack of proper legislation which is outside the control of political and religious interests; e.g., Hindu law only permits adoption of one child of

The Economic Burden Attributable to a Child's Inpatient Admission for Diarrheal Disease in Rwanda.

Science.gov (United States)

Ngabo, Fidele; Mvundura, Mercy; Gazley, Lauren; Gatera, Maurice; Rugambwa, Celse; Kayonga, Eugene; Tuyishime, Yvette; Niyibaho, Jeanne; Mwenda, Jason M; Donnen, Philippe; Lepage, Philippe; Binagwaho, Agnes; Atherly, Deborah

2016-01-01

Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction. This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child's caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$. Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction. Households often bear the largest share of the economic burden attributable to

The Economic Burden Attributable to a Child's Inpatient Admission for Diarrheal Disease in Rwanda.

Directory of Open Access Journals (Sweden)

Fidele Ngabo

Full Text Available Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction.This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child's caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$.Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction.Households often bear the largest share of the economic burden

Abusive head trauma and accidental head injury: a 20-year comparative study of referrals to a hospital child protection team

Science.gov (United States)

John, Simon; Vincent, Andrea L; Reed, Peter

2015-01-01

Aim To describe children referred for suspected abusive head trauma (AHT) to a hospital child protection team in Auckland, New Zealand. Methods Comparative review of demographics, histories, injuries, investigations and diagnostic outcomes for referrals under 15 years old from 1991 to 2010. Results Records were available for 345 children. Referrals increased markedly (88 in the first decade, 257 in the second), but the diagnostic ratio was stable: AHT 60%, accidental or natural 29% and uncertain cause 11%. The probability of AHT was similar regardless of socio-economic status or ethnicity. In children under 2 years old with accidental head injuries (75/255, 29%) or AHT (180/255, 71%), characteristics of particular interest for AHT included no history of trauma (88/98, 90%), no evidence of impact to the head (84/93, 90%), complex skull fractures with intracranial injury (22/28, 79%), subdural haemorrhage (160/179, 89%) and hypoxic ischaemic injury (38/39, 97%). In children over 2 years old, these characteristics did not differ significantly between children with accidental head injuries (21/47, 45%) and AHT (26/47, 55%). The mortality of AHT was higher in children over 2 years old (10/26, 38%) than under 2 years (19/180, 11%). Conclusions The striking increase in referrals for AHT probably represents increasing incidence. The decision to refer a hospitalised child with a head injury for assessment for possible AHT should not be influenced by socio-economic status or ethnicity. Children over 2 years old hospitalised for AHT are usually injured by mechanisms involving impact and should be considered at high risk of death. PMID:26130384

[Nutritional status and risk in hospitalized children].

Science.gov (United States)

Hankard, R; Bloch, J; Martin, P; Randrianasolo, H; Bannier, M F; Machinot, S; Cézard, J P

2001-11-01

A few studies report malnutrition in hospitalized patients. This one-day cross-sectional survey performed in January 1999 assessed nutritional status and protein-energy intake in a pediatric population hospitalized in medicine or surgery units. Every child older than six months, hospitalized for more than 48 h and free of nutritional support (parenteral, enteral, or special regimens for metabolic diseases) was included. Fifty-eight children among the 183 present the day of the study met the inclusion criteria and were included in the statistical analysis. They were hospitalized in medicine (48%), psychiatry (31%) and surgery (21%). The body mass index (BMI) was below -2 standard deviations (DS) in 21% of them. Excluding patients with anorexia nervosa, BMI was +2 SD, or in between these limits in respectively 12, 14 and 74%. Energy intake measured at the hospital was below 75% of the recommended dietary allowances in two-thirds of the children whether malnourished or not. Fifty percent of the malnourished children had been referred to a dietician the day of the study. Malnutrition is frequent in a population of hospitalized children. Energy intake and referral to a dietician are insufficient.

Early Childhood Special Educators and the Hospital Ethics Committee.

Science.gov (United States)

Lowenthal, Barbara

1989-01-01

The paper discusses issues of concern to early childhood special educators serving on hospital ethics committees to assist families with seriously ill and handicapped infants in neonatal intensive care units. Issues include infant euthanasia and the right to life, child abuse legislation, and possible effects on families. (Author/JDD)

The role of hospice in the transition from hospital to home for technology-dependent children-A qualitative study.

Science.gov (United States)

Price, Jayne; McCloskey, Sharon; Brazil, Kevin

2018-01-01

To report parent and professional perspectives of step-down care in assisting the transition from hospital to home, within one children's hospice in a constituent country of the United Kingdom. In recent years, increasing numbers of children-dependent on long term assisted ventilation have been noted. Meeting the complex physical, emotional and social needs of the child and family is challenging. Many of these children spend extended periods in hospital even when medically stable. This was a qualitative study using an inductive, semantic analytic approach within a realist epistemology. Data collection was carried out in 2013. Interviews took place with parents (n = 5) and focus groups with professionals (n = 26) who had experience of step-down care. Multiple benefits of step-down in the hospice were clear. Both sets of accounts suggested that for children and families life was "on hold" in hospital. Hospice was considered a home-like environment where the child and family could "live again". Parents reflected that, in hospice they were "living, not existing" while professionals highlighted hospice as nurturing and empowering the whole family, promoting the child's development while safely meeting their clinical needs. The study highlights a number of crucial benefits to the child and family both in the immediate and longer terms. The collective perspectives therefore endorse hospice as a potential viable choice for these children and their families during the always difficult, usually protracted transition from hospital to home. © 2017 John Wiley & Sons Ltd.

Transfusion transmissible infections among healthy blood donors at blood bank from children's hospital and institute of child health lahore

International Nuclear Information System (INIS)

Zameer, M.; Shahzad, F.; Khan, F.S.; Farooq, M.; Ali, H.; Saeed, U.

2017-01-01

Objective: To determine the frequency of HIV, HBV, HCV, syphilis and malaria in blood donors at Children Hospital and Institute of Child Health (ICH), Lahore and compare with other local and international published data. Study Design: Descriptive study. Place and Duration of Study: This was conducted at the blood bank of Children's Hospital and ICH, Lahore from October 2015 to February 2016. Patient and Methods: All adult male blood donors who had donated blood during above mentioned period, between 18 to 55 years of age were included in this study. Each and every donor was subjected to a predetermined, prepared questionnaire to find out their eligibility for donation. All blood donors' serum samples were screened for HBsAg, Anti-HCV, syphilis, HIV and malaria by immuno chromatography technique according to manufacturer instruction. Results: Statistical analysis showed that out of 10,048 blood donors, 7.94 percent (n=798) were infected with any one of the above mentioned diseases and 92.05 percent (n=9,250) had no infection. The overall frequency of HBsAg, HCV, HIV, syphilis and malaria were found to be 1.59 percent, 3.75 percent, 0.11 percent, 2.08 percent and 0.39 percent respectively. The co-infections of HCV + Syphilis, HBsAg + HCV, HBsAg + Syphilis, HCV + malarial parasite (M.P) and HBsAg + HIV + syphilis was 0.12 percent, 0.11 percent, 0.01 percent and 0.0099 percent respectively. Conclusion: There is a decreasing trend of HBsAg, HCV infections but increasing trend of HIV and syphilis infections in blood donors that is an alarming situation. (author)

Patterns of Spillover Between Marital Adjustment and Parent-Child Conflict During Pediatric Cancer Treatment.

Science.gov (United States)

Fladeboe, Kaitlyn; Gurtovenko, Kyrill; Keim, Madelaine; Kawamura, Joy; King, Kevin M; Friedman, Debra L; Compas, Bruce E; Breiger, David; Lengua, Liliana J; Katz, Lynn Fainsilber

2018-03-17

 When a child is diagnosed with cancer, problems may arise in family relationships and negatively affect child adjustment. The current study examined patterns of spillover between marital and parent-child relationships to identify targets for intervention aimed at ameliorating family conflict.  Families (N = 117) were recruited from two US children's hospitals within 2-week postdiagnosis to participate in a short-term prospective longitudinal study. Children with cancer were 2-10 years old (M = 5.42 years, SD = 2.59). Primary caregivers provided reports of marital and parent-child conflict at 1-, 6-, and 12-month postdiagnosis.  Results indicated that a unidirectional model of spillover from the marital to the parent-child relationship best explained the data. In terms of specific temporal patterns, lower marital adjustment soon after diagnosis was associated with an increase in parent-child conflict 6 months later, though this pattern was not repeated in the latter 6 months of treatment.  Targeting problems in marital relationships soon after diagnosis may prevent conflict from developing in the parent-child relationship.

Pediatric emergency care capacity in a low-resource setting: An assessment of district hospitals in Rwanda.

Directory of Open Access Journals (Sweden)

Celestin Hategeka

Full Text Available Health system strengthening is crucial to improving infant and child health outcomes in low-resource countries. While the knowledge related to improving newborn and child survival has advanced remarkably over the past few decades, many healthcare systems in such settings remain unable to effectively deliver pediatric advance life support management. With the introduction of the Emergency Triage, Assessment and Treatment plus Admission care (ETAT+-a locally adapted pediatric advanced life support management program-in Rwandan district hospitals, we undertook this study to assess the extent to which these hospitals are prepared to provide this pediatric advanced life support management. The results of the study will shed light on the resources and support that are currently available to implement ETAT+, which aims to improve care for severely ill infants and children.A cross-sectional survey was undertaken in eight district hospitals across Rwanda focusing on the availability of physical and human resources, as well as hospital services organizations to provide emergency triage, assessment and treatment plus admission care for severely ill infants and children.Many of essential resources deemed necessary for the provision of emergency care for severely ill infants and children were readily available (e.g. drugs and laboratory services. However, only 4/8 hospitals had BVM for newborns; while nebulizer and MDI were not available in 2/8 hospitals. Only 3/8 hospitals had F-75 and ReSoMal. Moreover, there was no adequate triage system across any of the hospitals evaluated. Further, guidelines for neonatal resuscitation and management of malaria were available in 5/8 and in 7/8 hospitals, respectively; while those for child resuscitation and management of sepsis, pneumonia, dehydration and severe malnutrition were available in less than half of the hospitals evaluated.Our assessment provides evidence to inform new strategies to enhance the capacity of

Pediatric emergency care capacity in a low-resource setting: An assessment of district hospitals in Rwanda

Science.gov (United States)

Shoveller, Jean; Tuyisenge, Lisine; Kenyon, Cynthia; Cechetto, David F.; Lynd, Larry D.

2017-01-01

Background Health system strengthening is crucial to improving infant and child health outcomes in low-resource countries. While the knowledge related to improving newborn and child survival has advanced remarkably over the past few decades, many healthcare systems in such settings remain unable to effectively deliver pediatric advance life support management. With the introduction of the Emergency Triage, Assessment and Treatment plus Admission care (ETAT+)–a locally adapted pediatric advanced life support management program–in Rwandan district hospitals, we undertook this study to assess the extent to which these hospitals are prepared to provide this pediatric advanced life support management. The results of the study will shed light on the resources and support that are currently available to implement ETAT+, which aims to improve care for severely ill infants and children. Methods A cross-sectional survey was undertaken in eight district hospitals across Rwanda focusing on the availability of physical and human resources, as well as hospital services organizations to provide emergency triage, assessment and treatment plus admission care for severely ill infants and children. Results Many of essential resources deemed necessary for the provision of emergency care for severely ill infants and children were readily available (e.g. drugs and laboratory services). However, only 4/8 hospitals had BVM for newborns; while nebulizer and MDI were not available in 2/8 hospitals. Only 3/8 hospitals had F-75 and ReSoMal. Moreover, there was no adequate triage system across any of the hospitals evaluated. Further, guidelines for neonatal resuscitation and management of malaria were available in 5/8 and in 7/8 hospitals, respectively; while those for child resuscitation and management of sepsis, pneumonia, dehydration and severe malnutrition were available in less than half of the hospitals evaluated. Conclusions Our assessment provides evidence to inform new strategies

Global Impact of Rotavirus Vaccination on Childhood Hospitalizations and Mortality From Diarrhea.

Science.gov (United States)

Burnett, Eleanor; Jonesteller, Christine L; Tate, Jacqueline E; Yen, Catherine; Parashar, Umesh D

2017-06-01

In 2006, 2 rotavirus vaccines were licensed. We summarize the impact of rotavirus vaccination on hospitalizations and deaths from rotavirus and all-cause acute gastroenteritis (AGE) during the first 10 years since vaccine licensure, including recent evidence from countries with high child mortality. We used standardized guidelines (PRISMA) to identify observational evaluations of rotavirus vaccine impact among children rotavirus AGE were reduced by a median of 67% overall and 71%, 59%, and 60% in countries with low, medium, and high child mortality, respectively. Implementation of rotavirus vaccines has substantially decreased hospitalizations from rotavirus and all-cause AGE. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Emotional and informational support for families during their child's illness.

Science.gov (United States)

Sarajärvi, A; Haapamäki, M L; Paavilainen, E

2006-09-01

To describe and compare the support provided by nursing staff to families during their child's illness from the viewpoint of families and nurses. A survey method was used. Data were collected by questionnaires planned for families and staff separately. The study population consisted of families who visited paediatric outpatient clinics, families with hospitalized children (n = 344) and the paediatric nursing staff (n = 60). Almost half of the families had received adequate emotional and informational support from the nursing staff for their physical and psychological reactions. One-fifth of the families reported that they had not been supported at all during the child's hospitalization. According to families and nurses, the support was provided in the forms of discussion, listening and giving time. Families' and nurses' suggestions for development of support were related to the time resources of the staff, to the flow of information, to more client-centred attitudes, to being appreciated and listened to and to home care guidance. However, the pervasiveness of this problem in the international literature suggests that deeper consideration of possible underlying reasons for this phenomenon is called for.

Recurrent rhabdomyolysis in a child. Case presentation.

Science.gov (United States)

Ertuğrul, Sabahattin; Yolbaş, İlyas; Aktar, Fesih; Yılmaz, Kamil; Tekin, Recep

2016-06-01

Viral myositis associated with infections rarely may cause rhabdomyolysis. There is no any pediatric case with severe recurrent rhabdomyolysis triggered by infections in the literature. We reported a two-year-old boy who was hospitalized three times due to severe rhabdomyolysis associated with viral myositis in the winter months. This is the first child case presentation with severe rhabdomyolysis triggered by infections. Prednisolone and intravenous immunoglobulin treatments were ineffective in this case. Sociedad Argentina de Pediatría.

Psychological screening in children with diabetes mellitus type-I at the Children's Hospital and the Institute of Child Health, Multan

International Nuclear Information System (INIS)

Khan, W.I.; Waqar, M.; Rabbani, M.W.; Afzal, E.; Adnan, M.

2013-01-01

Objective: To determine the frequency of psychological problems in diabetic children. Methods: The cross-sectional study was conducted at the Diabetic clinic of the Children's Hospital and the Institute of Child Health, Multan, Pakistan, from March to December 2011. Diabetic patients aged 7-15 years, who were on insulin therapy for at least one year were included in the study. Demographic data, history and physical examination were recorded. Glycosylated haemoglobin level was checked in all cases, and the Childhood Depression Inventory was used to assess the psychological well-being of the children. A minimum score of 13/54 was used to screen for depression. SPSS 19 was used for statistical analysis. Results: Out of 86 diabetic children, clinical depression was observed in 29 (33.7%). Poor socioeconomic status (21/29; 72.4%), longstanding disease (16/29; 55.1%) and adolescence age (20/29; 69%) were the major factors associated with depressive symptoms. Conclusion: Depression is a commonly associated psychological disorder in diabetic children, and should be addressed along with medical and dietary management. (author)

CLINICAL-EPIDEMIOLOGICAL ISSUES OF ACQUIRED CHILD METHEMOGLOBINEMIA

Directory of Open Access Journals (Sweden)

Letiția-Doina DUCEAC

2016-03-01

Full Text Available Nowadays, intoxication with nitrates continues to represent an important aspect in child pathology. Methemoglobinemia symptoms appear when the human body is exposed to high amounts of toxic compounds.The aim of this work was to evaluate the main clinical, biological and development issues of affected patients hospitalized in a specialized clinic. Acquired methemoglobinemia cases of the ”blue child syndrome” type are more frequent than in born ones. The factors considered for the study were the environment from which patients came, a thorough clinical inspection, data on age, nutrition, methemoglobinemia values, other treatments followed, associated diseases and evolution prognosis. The conclusion of the investigation was that a low living standard, a poor health education, the climate, the presence of ground fertilizers and the type of nourishment determined a significant increase of methemoglobinemia patients.

Parent-Child Agreement on Parent-to-Child Maltreatment.

Science.gov (United States)

Compier-de Block, Laura H C G; Alink, Lenneke R A; Linting, Mariëlle; van den Berg, Lisa J M; Elzinga, Bernet M; Voorthuis, Alexandra; Tollenaar, Marieke S; Bakermans-Kranenburg, Marian J

2017-01-01

Parent-child agreement on child maltreatment was examined in a multigenerational study. Questionnaires on perpetrated and experienced child maltreatment were completed by 138 parent-child pairs. Multi-level analyses were conducted to explore whether parents and children agreed about levels of parent-to-child maltreatment (convergence), and to examine whether parents and children reported equal levels of child maltreatment (absolute differences). Direct and moderating effects of age and gender were examined as potential factors explaining differences between parent and child report. The associations between parent- and child-reported maltreatment were significant for all subtypes, but the strength of the associations was low to moderate. Moreover, children reported more parent-to-child neglect than parents did. Older participants reported more experienced maltreatment than younger participants, without evidence for differences in actual exposure. These findings support the value of multi-informant assessment of child maltreatment to improve accuracy, but also reveal the divergent perspectives of parents and children on child maltreatment.

Portal hypertensive gastropathy: association with Child-Pugh score in liver cirrhosis

Science.gov (United States)

Sungkar, T.; Zain, L. H.; Siregar, G. A.

2018-03-01

Portal Hypertensive Gastropathy (PHG) occurs as a complication of cirrhotic or non-cirrhotic portal hypertension. The association between the severity of portal hypertensive gastropathy and the hepatic function, as assessed by the Child-Pugh score in patients with liver cirrhosis are poorly defined. We evaluated association between PHG and Child-Pugh score in patients with liver cirrhosis. Adults liver cirrhosis patients admitted at Adam Malik Hospital Medan during January 2016-December 2016, were included in this study. Endoscopic PHG grade, Child-Pugh score were assessed. A total of 49 patients were enrolled. Majority of cases of liver cirrhosis are due to chronic viral hepatitis B infections (65.3 %). Portal hypertensive gastropathy were observed in 46 cases; twenty-five patients (51%) showed severe portal hypertensive gastropathy. The overall prevalence of PHG and the proportion of patients with severe PHG differ about the Child-Pugh classification. PHG was present in 66.7 % of patients from Child-Pugh class A, 96 % of patients with class B, and 95.2 % of those from class C, and severe forms were present in 0 %, 36 %, and 76.2 %, respectively (P< 0.000). In conclusions, the present data suggest that the severity of portal hypertensive gastropathy is related to Child-Pugh score.

Program Director Survey: Attitudes Regarding Child Neurology Training and Testing.

Science.gov (United States)

Valencia, Ignacio; Feist, Terri B; Gilbert, Donald L

2016-04-01

As a result of major clinical and scientific advances and changes in clinical practice, the role of adult neurology training for Child Neurology and Neurodevelopmental Disability (NDD) certification has become controversial. The most recently approved requirements for board eligibility for child neurology and neurodevelopmental disability residents still include 12 months in adult neurology rotations. The objective of this study was to assess United States child neurology and neurodevelopmental disability residency program directors' opinions regarding optimal residency training. The authors developed an 18-item questionnaire and contacted all 80 child neurology and neurodevelopmental disability program directors via e-mail, using SurveyMonkey. A total of 44 program directors responded (55%), representing programs that train 78 categorical and 94 total resident positions, approximately 70% of those filled in the match. Respondents identified multiple areas where child neurology residents need more training, including genetics and neuromuscular disease. A substantial majority (73%) believed child neurology and neurodevelopmental disability residents need less than 12 adult neurology training months; however, most (75%) also believed adult hospital service and man-power needs (55%) and finances (34%) would pose barriers to reducing adult neurology. Most (70%) believed reductions in adult neurology training should be program flexible. A majority believed the written initial certification examination should be modified with more child neurology and fewer basic neuroscience questions. Nearly all (91%) felt the views of child neurology and neurodevelopmental disability program directors are under-represented within the Accreditation Council for Graduate Medical Education Residency Review Committee. The requirement for 12 adult neurology months for Child Neurology and Neurodevelopmental Disability certification is not consistent with the views of the majority of program

Impact of a Child Life and Music Therapy Procedural Support Intervention on Parental Perception of Their Child's Distress During Intravenous Placement.

Science.gov (United States)

Ortiz, Gabriela S; OʼConnor, Todd; Carey, Jessa; Vella, Adam; Paul, Audrey; Rode, Diane; Weinberg, Alan

2017-02-21

Child life specialists and music therapists have a unique and integral role in providing psychosocial care to pediatric patients and families. These professionals are trained to provide clinical interventions that support coping and adjustment and reduce the risk of psychological trauma related to hospital visits and health care encounters. The researchers devised a multimodal approach using a combined child life and music therapy intervention to address procedure-related distress in patients receiving intravenous (IV) placement in the pediatric emergency department. The aim of this study was to investigate the efficacy of this collaborative intervention by evaluating parental perception of their child's distress. This study was a prospective analysis investigating the impact of a child life and music therapy intervention on children aged 4 to 11 years old receiving an IV placement in the pediatric emergency department. Efficacy was evaluated by comparing scores between a 4-question pretest and subsequent 4-question posttest that asked the child's parent to evaluate how they anticipated their child would respond to the procedure, and then to evaluate how they perceived their child to have responded after the procedure. Qualitative data were collected in the form of open-ended comments, which were accommodated at the end of the posttest. Data were analyzed by the Cochran-Mantel-Haenszel method for testing repeated ordinal responses and the PROC GENMOD procedure in the SAS system software. A total of 41 participants were enrolled in this study. Results of the statistical analysis revealed significant differences between all pre- and posttest scores (P music therapy intervention. Improvement was demonstrated across all 4 questions, suggesting that the child life and music therapy intervention supported healthy, adaptive coping and helped to minimize distress experienced by patients during IV placement. These results underscore the importance and potential clinical

Correlating parenting styles with child behavior and caries.

Science.gov (United States)

Howenstein, Jeff; Kumar, Ashok; Casamassimo, Paul S; McTigue, Dennis; Coury, Daniel; Yin, Han

2015-01-01

This study evaluated the relationship between parenting style, sociodemographic data, caries status, and child's behavior during the first dental visit. Parents/legal guardians of new patients aged three to six years presenting to Nationwide Children's Hospital dental clinic for an initial examination/hygiene appointment completed the Parenting Styles and Dimensions Questionnaire (PSDQ) to assess parenting style and a 15-question demographic survey. Blinded and calibrated expanded function dental auxiliaries or dental hygienists (EFDA/DH) performed a prophylaxis and assessed child behavior using the Frankl scale (inter-rater reliability was 92 percent). A blinded and calibrated dentist performed an oral examination. 132 parent/child dyads participated. Children with authoritative parents exhibited more positive behavior (Pcaries (Pparents. Children attending daycare exhibited more positive behavior compared to children who did not (Pbehavior (P>.04) and less caries (P>.024) compared to children with Medicaid or no dental insurance. Authoritative parenting and having private dental insurance were associated with less caries and better behavior during the first dental visit. Attending daycare was associated with better behavior during the first dental visit.

Effect of quality of family environment on the child's adaptation capabilities

Directory of Open Access Journals (Sweden)

Ivana Kreft

2008-08-01

Full Text Available The aim of the paper was to investigate how the quality of family environment is related to the child's adaptation capabilities. Child's adaptation was evaluated with a special assessment called SPP-3 (Systematic Psychological Assessment of a 3-year Old Child, that screens the population of 3-year olds to look for inadequate adaptation patterns. I assumed that in families where parents have higher education and where the environment is more stimulating children will show more effective and adaptive behaviour. Seventy-five children and parents who attended the psychological assessment in their regional hospitals first concluded the psychological examination (SPP-3 and then filled-in two questionnaires: The Family Environment Questionnaire (Zupančič, Podlesek, & Kavčič, 2004 and The Home Literacy Environment Questionnaire (Marjanovič Umek, Podlesek, & Fekonja, 2005. The results showed that quality of family environment does effect the child's adaptive capabilities and is associated with parental level of education. Of special importance for the child's socialization is the parents' ability to use effective control (to have consistent and clear demands. Hypothesis that the level of parental education affects the child's adaptation capabilities was not confirmed. Perhaps the parents' relations with the child are of greater importance, and these are probably not related to parents' education. The results show that child's adaptation capabilities are associated with parenting methods, so preventive psychological counselling may also be used to help parents choose more effective methods in order to allow the child to develop effective adaptive behaviour.

A escuta pedagógica à criança hospitalizada: discutindo o papel da educação no hospital

Directory of Open Access Journals (Sweden)

Rejane de S. Fontes

2005-01-01

Full Text Available The aim of this study is to understandthe role of education in the health ofthe hospitalised child, by means of ananalysis of the teacher’s activity in apublic hospital (The Antônio PedroUniversity Hospital – Niterói, RJ. Thecentral question which guided the de-velopment of the research, based uponparticipant observation of situationswhich involved interaction betweenchildren, children and adults andbetween children and the environment,was: How can education contribute tothe health of the hospitalised child?The categories of analysis employedwere: language, toys, emotion andknowledge, based upon theoreticalreferences proposed by Wallon andVygotsky. The conclusions suggest thateducation helps the child to re-signifyhis/her life in the hospital environmentand that an attentive and sensitivepedagogical ‘listening’ can help to escue the subjectivity and self-esteemof hospitalised children, and contributeto their well-being and health. Theresearch reveals that the possibilitiesof action for the teacher in this newenvironment are great; nevertheless,the challenge of constructing adifferent educational practice to thatwhich takes place in the schoolinstitution is great and demandsspecific principles and other levels ofknowledge that lend support to thiscomplex pedagogical work in the hos-pital field.

Parents' experiences managing their child's complicated postoperative recovery.

Science.gov (United States)

Purcell, Mary; Longard, Julie; Chorney, Jill; Hong, Paul

2018-03-01

Tonsillectomy is commonly performed as same-day surgery and parents are heavily relied upon for management of children's postoperative recovery. The objective of this study was to provide an in-depth description of the experiences parents face when managing their child's complicated postoperative recoveries at home. An exploratory qualitative study at an academic pediatric hospital in Eastern Canada was performed. Participants included 12 parents of children aged 3-6 years who underwent adeno/tonsillectomy and experienced unexpected outcomes or complications during the postoperative recovery period. Parents participated in semi-structured interviews within 6 months of their child's surgery. Interviews were transcribed verbatim and thematic analysis was used to identify themes in the parents' experiences. Parents described struggling to make the decision to come back to hospital, that adequate information does not prevent emotional difficulties, and feeling somewhat responsible for the unexpected outcome or complicated course of recovery. Communication with healthcare providers was considered very important in helping with the recovery process. This research helps to inform healthcare professionals about how they might better support families during complicated recovery processes. Areas of action may include clear communication, setting expectations, and psychosocial support. Copyright © 2018 Elsevier B.V. All rights reserved.

Persisting high hospital and community childhood mortality in an urban setting in Guinea-Bissau

DEFF Research Database (Denmark)

Veirum, Jens Erik; Biai, Sidu; Jakobsen, Marianne

2007-01-01

AIM: To describe paediatric hospitalization in a West African capital in relation to overall childhood mortality in the community and to evaluate the potential impact of improved management at the hospital. METHODS: Hospital data on child admissions in a 6-year period were linked to information...... been hospitalized, and 24% of all deaths in the community occurred in-hospital. Community infant and under-three mortality rates were 110 and 207 per 1,000 person-years, respectively. In-hospital mortality remained persistently high from 1991 to 1996 and the overall in-hospital mortality was 12...... minor improvements in acute case management of sick children attending the hospital would be expected to result in substantial reduction in overall childhood mortality. Persistently high acute in-hospital mortality reflects the need of immediate and appropriate care at the hospital. Treatment should...

Two overlooked contributors to abandonment of childhood cancer treatment in Kenya: parents' social network and experiences with hospital retention policies.

Science.gov (United States)

Mostert, S; Njuguna, F; Langat, S C; Slot, A J M; Skiles, J; Sitaresmi, M N; van de Ven, P M; Musimbi, J; Vreeman, R C; Kaspers, G J L

2014-06-01

The principal reason for childhood cancer treatment failure in low-income countries is treatment abandonment, the most severe form of nonadherence. Two often neglected factors that may contribute to treatment abandonment are as follows: (a) lack of information and guidance by doctors, along with the negative beliefs of family and friends advising parents, which contributes to misconceptions regarding cancer and its treatment, and (b) a widespread policy in public hospitals by which children are retained after doctor's discharge until medical bills are settled. This study explored parents' experiences with hospital retention policies in a Kenyan academic hospital and the impact of attitudes of family and friends on parents' decisions about continuing cancer treatment for their child. Home visits were conducted to interview parents of childhood cancer patients who had been diagnosed between 2007 and 2009 and who had abandoned cancer treatment. Retrospective chart review revealed 98 children diagnosed between 2007 and 2009 whose parents had made the decisions to abandon treatment. During 2011-2012, 53 families (54%) could be reached, and 46 (87%) of these agreed to be interviewed. Parents reported the attitudes of community members (grandparents, relatives, friends, villagers, and church members); 61% believed that the child had been bewitched by some individual, and 74% advised parents to seek alternative treatment or advised them to stop medical treatment (54%). Parents also reported that they were influenced by discussions with other parents who had a child being treated, including that their child's life was in God's hands (87%), the trauma to the child and family of forced hospital stays (84%), the importance of completing treatment (81%), the financial burden of treatment (77%), and the incurability of cancer (74%). These discussions influenced their perceptions of cancer treatment and its usefulness (65%). Thirty-six families (78%) had no health insurance, and

[Comparison of the prognostic value of mortality Child Pugh Score and forecasting models of chronic liver disease in patients with decompensated cirrhosis of the Hospital Nacional Cayetano Heredia, Lima-Peru].

Science.gov (United States)

Valenzuela Granados, Vanessa; Salazar-Quiñones, Maria; Cheng-Zárate, Lester; Malpica-Castillo, Alexander; Huerta Mercado, Jorge; Ticse, Ray

2015-01-01

The assessment of prognosis is an essential part of the evaluation of all patients with liver cirrhosis. Currently continues to develop new models to optimize forecast accuracy mortality score is calculated by the Child-Turcotte-Pugh (CTP) and the model for end-stage liver disease (MELD). Compare the prognostic accuracy of hospital mortality and short-term mortality CTP, MELD and other models in patients with decompensated liver cirrhosis. Prospective descriptive study, comparison type of diagnostic test that included 84 patients. The score CTP, MELD and other models were calculated on the first day of hospitalization. The prognostic accuracy of mortality was assessed by the area under the ROC curve (AUROCs) of score CTP, MELD and other models. Hospital mortality and mortality in the short-term monitoring was 20 (23.8%) and 44 (52.4%), respectively. The AUROCs CTP, MELD, MELD Na, MESO, iMELD, RefitMELD and RefitMELD Na to predict hospital mortality was 0.4488, 0.5645, 0.5426, 0.5578, 0.5719, 0.5598 and 0.5754; and to predict short-term mortality was 0.5386, 0.5747, 0.5770, 0.5781, 0.5631, 0.5881 and 0.5693, respectively. By comparing each AUROCs of the CTP score, MELD and other models proved to be no better than the other (p>0.05). This study has not shown the predictive utility of the CTP score, MELD and other models (MELD Na, MESO, iMELD, Refit Refit MELD and MELD Na) to evaluate hospital mortality or short-term mortality in a sample of patients with decompensated cirrhosis of the Hospital Cayetano Heredia.

Nonoffending Guardian Assessment of Hospital-Based Sexual Abuse/Assault Services for Children.

Science.gov (United States)

Du Mont, Janice; Macdonald, Sheila; Kosa, Daisy; Smith, Tanya

2016-01-01

In circumstances in which child sexual abuse/assault is suspected, pediatric guidelines recommend referral to services such as multidisciplinary hospital-based violence treatment centers, for specialized medical treatment, forensic documentation, and counseling. As little is known about how such services are perceived, the objective of this case report was to measure the satisfaction of nonoffending guardians of child sexual abuse/assault victims who presented for care at Ontario's hospital-based sexual assault treatment centers. Of the 1,136 individuals who reported sexual abuse/assault and were enrolled in a province-wide service evaluation, 58 were 11 years old and younger. Thirty-three guardians completed a survey. Ratings of care were overwhelmingly positive, with 97% of respondents indicating that they would recommend these services. Nonetheless, it is important to evaluate these pediatric sexual assault services frequently to ensure ongoing optimal, family-centered care.

Analysis the Development of Mother and Infant Health in Sampang District Hospital

Directory of Open Access Journals (Sweden)

Rukmini Rukmini

2016-01-01

Full Text Available Background: The hospital have a strategic role in efforts to reduce maternal and infant mortality. This study aimed to determine the development of maternal and infant health services carried out in Sampang District hospital between 2010 and May 2012. Methods: The quantitative study with ecology design carried out in Sampang District hospital east Java Province Indonesia in 2012. The collection of secondary data such as coverage of maternal and infant health care in the period of 2010 to May 2012, as well as qualitative data collection with in depth interview to the Head of Service, Obstetrics and Gynecology Specialist Doctors and midwives. Data were analyzed descriptively. Result: In Sampang District hospital in period 2010 – May 2012 showed, an increase in maternal and child health services, where an increase in the handling of complications of pregnancy, normal delivery or Sectio Caesar and management of newborn complications and maternal and neonatal deaths are relatively increased . The coverage of family planning services was still low and the vast majority was IUD. Conclusion: The maternal and child health services in Sampang District hospital in period of 2010 – May 2012, showed an increase in the quantity of service coverage. The majority cases of delivery in hospitals were referral cases and complications. Howefer, the number of Sectio Caesar, maternal and neonatal mortality were still high. Recommendation: Sampang District Health Offi ce and Sampang District Hospital should create a policis and programs to reduce neonatal mortality in an integrated, continuous with proper implementation of standard procedures at every level of service, supported by well trained human resources, infrastructure and adequate fi nancing.

Smallpox vaccination and all-cause infectious disease hospitalization

DEFF Research Database (Denmark)

Sørup, Signe; Villumsen, Marie; Ravn, Henrik

2011-01-01

There is growing evidence from observational studies and randomized trials in low-income countries that vaccinations have non-specific effects. Administration of live vaccines reduces overall child morbidity and mortality, presumably due to protection against non-targeted infections. In Denmark, ......, the live vaccine against smallpox was phased out in the 1970s due to the eradication of smallpox. We used the phasing-out period to investigate the effect of smallpox vaccination on the risk of hospitalization for infections.......There is growing evidence from observational studies and randomized trials in low-income countries that vaccinations have non-specific effects. Administration of live vaccines reduces overall child morbidity and mortality, presumably due to protection against non-targeted infections. In Denmark...

Prevalence of Neonatal Jaundice on Central Hospital, Warri, Delta ...

African Journals Online (AJOL)

Methods: 272 babies (aged 1 – 30 days) the Neonatal Clinic of the Department of Child Health, Central Hospital, Warri, Delta State between June 2009 and June 2010 were examined daily for evidence of jaundice. Those with serum bilirubin ³15mg/100ml were subjected to additional clinical and laboratory investigations to ...

Routinely sleeping away from home and the association with child asthma readmission.

Science.gov (United States)

Moncrief, Terri; Beck, Andrew F; Olano, Kelly; Huang, Bin; Kahn, Robert S

2014-12-01

The increased prevalence of transitions between households may have implications for child asthma morbidity. We, therefore, sought to enumerate the prevalence of regularly spending nights sleeping away from home among children admitted to the hospital for asthma and to examine the relationship of nights away to asthma-related readmission. This was a population-based, prospective cohort of 774 children, aged 1-16 years, who were admitted with asthma or bronchodilator-responsive wheezing and enrolled in the Greater Cincinnati Asthma Risks Study. The study took place at Cincinnati Children's Hospital Medical Center, an urban, academic children's hospital in the Midwest. The primary exposure was regularly spending nights away from home. Selected covariates included caregiver marital status, shift work, child's race, income, psychological distress, and running out of/not having medications on hand. The primary outcome was asthma-related readmission within 12 months. A total of 19 % were readmitted within 12 months. The 33 % of children that spent ≥1 night away from home per week were significantly more likely to be readmitted than those who spent no nights away (25 % vs. 16 %, p = 0.002). Spending nights away from home [adjusted relative risk (aRR) 1.5, 95 % confidence interval (CI) 1.2-2.0] and lower income (aRR 2.6, 95 % CI 1.1-6.4) were the strongest independent predictors of readmission after adjusting for child age, gender, and race, and caregiver marital status, shift work, risk of psychological distress, and running out of meds. Increased awareness of the multiple settings in which children with asthma live may help shape more comprehensive approaches to asthma care.

A multifaceted intervention to improve the quality of care of children in district hospitals in Kenya: a cost-effectiveness analysis.

Science.gov (United States)

Barasa, Edwine W; Ayieko, Philip; Cleary, Susan; English, Mike

2012-01-01

To improve care for children in district hospitals in Kenya, a multifaceted approach employing guidelines, training, supervision, feedback, and facilitation was developed, for brevity called the Emergency Triage and Treatment Plus (ETAT+) strategy. We assessed the cost effectiveness of the ETAT+ strategy, in Kenyan hospitals. Further, we estimate the costs of scaling up the intervention to Kenya nationally and potential cost effectiveness at scale. Our cost-effectiveness analysis from the provider's perspective used data from a previously reported cluster randomized trial comparing the full ETAT+ strategy (n = 4 hospitals) with a partial intervention (n = 4 hospitals). Effectiveness was measured using 14 process measures that capture improvements in quality of care; their average was used as a summary measure of quality. Economic costs of the development and implementation of the intervention were determined (2009 US$). Incremental cost-effectiveness ratios were defined as the incremental cost per percentage improvement in (average) quality of care. Probabilistic sensitivity analysis was used to assess uncertainty. The cost per child admission was US$50.74 (95% CI 49.26-67.06) in intervention hospitals compared to US$31.1 (95% CI 30.67-47.18) in control hospitals. Each percentage improvement in average quality of care cost an additional US$0.79 (95% CI 0.19-2.31) per admitted child. The estimated annual cost of nationally scaling up the full intervention was US$3.6 million, approximately 0.6% of the annual child health budget in Kenya. A "what-if" analysis assuming conservative reductions in mortality suggests the incremental cost per disability adjusted life year (DALY) averted by scaling up would vary between US$39.8 and US$398.3. Improving quality of care at scale nationally with the full ETAT+ strategy may be affordable for low income countries such as Kenya. Resultant plausible reductions in hospital mortality suggest the intervention could be cost

A multifaceted intervention to improve the quality of care of children in district hospitals in Kenya: a cost-effectiveness analysis.

Directory of Open Access Journals (Sweden)

Edwine W Barasa

Full Text Available To improve care for children in district hospitals in Kenya, a multifaceted approach employing guidelines, training, supervision, feedback, and facilitation was developed, for brevity called the Emergency Triage and Treatment Plus (ETAT+ strategy. We assessed the cost effectiveness of the ETAT+ strategy, in Kenyan hospitals. Further, we estimate the costs of scaling up the intervention to Kenya nationally and potential cost effectiveness at scale.Our cost-effectiveness analysis from the provider's perspective used data from a previously reported cluster randomized trial comparing the full ETAT+ strategy (n = 4 hospitals with a partial intervention (n = 4 hospitals. Effectiveness was measured using 14 process measures that capture improvements in quality of care; their average was used as a summary measure of quality. Economic costs of the development and implementation of the intervention were determined (2009 US$. Incremental cost-effectiveness ratios were defined as the incremental cost per percentage improvement in (average quality of care. Probabilistic sensitivity analysis was used to assess uncertainty. The cost per child admission was US$50.74 (95% CI 49.26-67.06 in intervention hospitals compared to US$31.1 (95% CI 30.67-47.18 in control hospitals. Each percentage improvement in average quality of care cost an additional US$0.79 (95% CI 0.19-2.31 per admitted child. The estimated annual cost of nationally scaling up the full intervention was US$3.6 million, approximately 0.6% of the annual child health budget in Kenya. A "what-if" analysis assuming conservative reductions in mortality suggests the incremental cost per disability adjusted life year (DALY averted by scaling up would vary between US$39.8 and US$398.3.Improving quality of care at scale nationally with the full ETAT+ strategy may be affordable for low income countries such as Kenya. Resultant plausible reductions in hospital mortality suggest the intervention could be

Parental alcohol use disorders and child delinquency: the mediating effects of executive functioning and chronic family stress.

Science.gov (United States)

Grekin, Emily R; Brennan, Patricia A; Hammen, Constance

2005-01-01

This study examines the relationship between parental alcohol use disorders (AUDs) and child violent and nonviolent delinquency. It also explores the mediating effects of executive functioning and chronic family stress on the parental AUD/child delinquency relationship. Participants were 816 families with children (414 boys and 402 girls) born between 1981 and 1984 at Mater Misericordiae Mother's Hospital in Brisbane, Australia. Parents and children completed semistructured interviews, questionnaires and neuropsychological tests that assessed parental alcohol use, family psychiatric history, chronic family stress, child delinquency and child executive functioning. Paternal (but not maternal) AUDs predicted child violent and nonviolent delinquency. Executive functioning mediated the relationship between paternal AUDs and violent delinquency, whereas family stress mediated the relationship between paternal AUDs and both violent and nonviolent delinquency. Results support a biosocial conceptualization of the paternal AUD/delinquency relationship. They suggest that paternal AUDs may be associated with child executive functioning and family stress, which may in turn lead to child delinquency.

Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt

NARCIS (Netherlands)

Hoytema van Konijnenburg, Eva M. M.; Diderich, Hester M.; Teeuw, Arianne H.; Klein Velderman, Mariska; Oudesluys-Murphy, Anne Marie; van der Lee, Johanna H.; Biezeveld, Maarten H.; Brilleslijper-Kater, Sonja N.; Edelenbos, Esther; Flapper, Boudien C.; van Goudoever, Johannes B.; Lindauer, Ramón J. L.; Mahdi, Ulrike; Poldervaart, Jacoba D.; Sanders, Marian K.; Schoonenberg, N. Jolande; Sieswerda-Hoogendoorn, Tessa; van Sommeren, Pauwlina G. W.; Vogt, Anne; Wilms, Janneke F.; Baeten, Paul; Fekkes, Minne; Pannebakker, Fieke D.; Sorensen, Peggy J. G.; Verkerk, Paul H.

2016-01-01

To improve identification of child maltreatment, a new policy ('Hague protocol') was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care

Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt

NARCIS (Netherlands)

Hoytema van Konijnenburg, E.M.; Diderich, H.M.; Teeuw, A.H.; Klein Velderman, M.; Oudesluys-Murphy, A.M.; Lee, J.H. van der

2016-01-01

To improve identification of child maltreatment, a new policy (‘Hague protocol’) was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care

Spatial Analysis of Potentially Preventable Pneumonia and Asthma Hospitalizations for Children in the Texas Coastal Bend Area

Science.gov (United States)

Lin, Na

Pneumonia and asthma, two common Ambulatory Care Sensitive Conditions (ACSCs), were two top reasons for the admission of children to the hospitals and emergency rooms in the United States in 2011. Pneumonia and asthma are potentially preventable if the child's environment is properly managed. Underlying vulnerabilities such as low socioeconomic status (SES) and proximity to air pollution play an important role in ACSCs hospitalization. Pneumonia and asthma are two common reasons for hospitalizations among children and missed school days in Texas Coastal Bend Area. This thesis examines the relationships between neighborhood socioeconomic characteristics, meteorological conditions and children ACSCs hospitalization, including pneumonia and asthma among children age 0-17 in this area. Hospital discharge data from 2007 to 2009 based on Zip Code Tabulation Area (ZCTA) were examined along with American Community Survey (ACS) data, air pollution data from Environmental Protection Agency (EPA) and temperature data from National Climatic Data Center (NCDC). Hotspot and Local Moran's I analyses were applied to identify the concentrations of the illnesses. Two regressions (OLS and GWR) were applied to identify factors that contribute the most to ACSCs hospitalization. Pearson's correlation was calculated to examine the relationship between meteorological condition and child hospitalization for asthma and pneumonia. A human subject survey was conducted to examine the relationships between neighborhood environment and children asthma cases. The main finding was that children from families with health insurance, children from single father families and children from poor families were more likely to visit hospital for ACSCs and pneumonia care. "Hispanic families" and especially "Hispanic families with father but no mother" also contributed most to child hospitalization for ACSCs and pneumonia, suggesting that family preventative health care education is needed for Hispanic

Radiation Protection in Pediatric Radiology: Results of a Survey Among Dutch Hospitals.

Science.gov (United States)

Bijwaard, Harmen; Valk, Doreth; de Waard-Schalkx, Ischa

2016-10-01

A survey about radiation protection in pediatric radiology was conducted among 22 general and seven children's hospitals in the Netherlands. Questions concerned, for example, child protocols used for CT, fluoroscopy and x-ray imaging, number of images and scans made, radiation doses and measures taken to reduce these, special tools used for children, and quality assurance issues. The answers received from 27 hospitals indicate that radiation protection practices differ considerably between general and children's hospitals but also between the respective general and children's hospitals. It is recommended that hospitals consult each other to come up with more uniform best practices. Few hospitals were able to supply doses that can be compared to the national Diagnostic Reference Levels (DRLs). The ones that could be compared exceeded the DRLs in one in five cases, which is more than was expected beforehand.

Benefícios da permanência de participação da mãe no cuidado ao filho hospitalizado Beneficios de la permanencia de participación de la madre en el cuidado al hijo hospitalizado Benefits of mothers' permanence and participation in the care for their hospitalized child

Directory of Open Access Journals (Sweden)

Rosemeire Cristina Moretto Molina

2009-12-01

ón por el poder cuidar del hijo. Es preciso que los enfermeros repiensen su comportamiento en lo que se refiere a la madre acompañante y adopten actitudes que favorezcan su participación en el cuidado del hijo hospitalizado.The purpose of the present study was to identify, according to the mothers' perspective, the benefits related to her permanence and participation in the care for her child hospitalized at a Pediatric Intensive Care Unit (PICU. The theoretical framework was Cross-cultural Nursing Theory, and the methodological framework was the assistant convergent research approach. Data was collected from six mothers of children hospitalized at a PICU of a University Hospital, in the period from January to May 2007, through interviews and active observation. Analysis was conducted following four generic processes: collection, synthesis, theorization and application. The results evidenced that the mothers' presence and care increased the attachment between mother and child, increased mothers' confidence, and made the child calmer. This produced positive feelings such as joy and satisfaction for being able to care for their child. Nurses should review their behavior toward the mothers accompanying their child at the hospital, and adopt attitudes that support her participation in the care for her hospitalized child.

Paediatric utilisation of a teaching hospital and a community health ...

African Journals Online (AJOL)

to Red Cross Children's Hospital (RXH) that could be more ... better access and perceived quality. S Atr Med ... tertiary resources, low levels of efficiency and staff ... However, central to improved patterns of utilisation is the .... the modei were: (/) age of the child; (it) duration of residence ... There was no significant association.

Factors That Influence Mandatory Child Abuse Reporting Attitudes of Pediatric Nurses in Korea.

Science.gov (United States)

Lee, In Sook; Kim, Kyoung Ja

This study aimed to identify knowledge of child abuse, awareness of child abuse reporting, factors that influence attitudes toward mandatory reporting, and professionalism among a sample of pediatric nurses in Korea. One hundred sixteen pediatric nurses working at two university hospitals in Korea took part in the study and completed self-administered questionnaires. The data were analyzed using descriptive statistics, t tests, analysis of variance, Pearson correlation coefficients, and hierarchical regression analysis. Knowledge of child abuse, awareness of child abuse reporting, and attitudes toward mandatory reporting were low. Regarding nursing professionalism, social perceptions had the lowest mean score and nursing autonomy had the highest mean score. Attitudes toward mandatory reporting significantly correlated with professionalism. In the hierarchical regression model, the influences of nursing autonomy and intentions to report child abuse on attitudes toward mandatory reporting were statistically significant (F = 2.176, p = .013), explaining 32% of the variation in attitudes toward mandatory reporting. The results of this study could be used to improve systems and policies addressing child abuse and to further develop reporting procedures for identifying children at risk of abuse, to ensure their protection as a professional responsibility.

Socioeconomic status, child enrichment factors, and cognitive performance among preschool-age children: results from the Follow-Up of Growth and Development Experiences study.

Science.gov (United States)

Christensen, Deborah L; Schieve, Laura A; Devine, Owen; Drews-Botsch, Carolyn

2014-07-01

Lower cognitive performance is associated with poorer health and functioning throughout the lifespan and disproportionately affects children from lower socioeconomic status (SES) populations. Previous studies reporting positive associations between child home enrichment and cognitive performance generally had a limited distribution of SES. We evaluated the associations of SES and child enrichment with cognitive performance in a population with a wide range of SES, particularly whether enrichment attenuates associations with SES. Children were sampled from a case-control study of small-for-gestational-age (SGA) conducted in a public hospital serving a low SES population (final n=198) and a private hospital serving a middle-to-high SES population (final n=253). SES (maternal education and income) and perinatal factors (SGA, maternal smoking and drinking) were obtained from maternal birth interview. Five child home enrichment factors (e.g. books in home) and preschool attendance were obtained from follow-up interview at age 4.5 years. Cognitive performance was assessed with the Differential Ability Scales (DAS), a standardized psychometric test administered at follow-up. SES and enrichment scores were created by combining individual factors. Analyses were adjusted for perinatal factors. Children from the public birth hospital had a significantly lower mean DAS general cognitive ability (GCA) score than children born at the private birth hospital (adjusted mean difference -21.4, 95% CI: -24.0, -18.7); this was substantially attenuated by adjustment for individual SES, child enrichment factors, and preschool attendance (adjusted mean difference -5.1, 95% CI: -9.5, -0.7). Individual-level SES score was associated with DAS score, beyond the general SES effect associated with hospital of birth. Adjustment for preschool attendance and home enrichment score attenuated the association between individual SES score and adjusted mean DAS-GCA among children born at both of the

Child Health Care Services in Austria.

Science.gov (United States)

Kerbl, Reinhold; Ziniel, Georg; Winkler, Petra; Habl, Claudia; Püspök, Rudolf; Waldhauser, Franz

2016-10-01

We describe child health care in Austria, a small country in Central Europe with a population of about 9 million inhabitants of whom approximately 1.7 million are children and adolescents under the age of 20 years. For children and adolescents, few health care indicators are available. Pediatric and adolescent health provision, such as overall health provision, follows a complex system with responsibilities shared by the Ministry of Health, 19 social insurance funds, provinces, and other key players. Several institutions are affiliated with or cooperate with the Ministry of Health to assure quality control. The Austrian public health care system is financed through a combination of income-based social insurance payments and taxes. Pediatric primary health care in Austria involves the services of general pediatricians and general practitioners. Secondary care is mostly provided by the 43 children's hospitals; tertiary care is (particularly) provided in 4 state university hospitals and 1 private university hospital. The training program of residents takes 6 years and is completed by a final examination. Every year, this training program is completed by about 60 residents. Copyright © 2016 Elsevier Inc. All rights reserved.

NURSES’ VIEWS ABOUT PARENT PARTICIPATION IN THE CARE OF HOSPITALIZED CHILDREN

Directory of Open Access Journals (Sweden)

Sevil Ozkan

2017-12-01

Full Text Available Aim: To determine views of nurses’, who worked at pediatric clinics, about parent participation in the care of hospitalized children. Methods: This descriptive research was performed with 155 nurses who worked at pediatric clinics of four hospitals located in the city center of Konya, in March-May, 2014. Data were collected using a questionaire which was developed according to literature. Data were evaluated in terms of number, percentage, mean, standard deviation via SPSS 20 programme. Results: In study, 81.9% of nurses agreed to views about parent participation can result “reduce fear and anxiety of child" and "facilitation child's coping with painful practices". It was found that most of nurses agreed “it provides that parents know everything about child's care and treatment” (74.8% and “professional communication between nurses and families can return social communication style" (81.3. Gender of parents, comunication style, education levels, knowing caring process of children, children's disease process, age and doctor's order about parent participation were determined effective factors in parent participation. Conclusion: It was found that nurses’ views about effect of parent participation on children were mostly positive but they also had negative views about its effects on parents and nursing. [J Contemp Med 2017; 7(4.000: 355-364

Educational paper Detection of child abuse and neglect at the emergency room

NARCIS (Netherlands)

Teeuw, Arianne Hélène; Derkx, Bert H. F.; Koster, Willeke A.; van Rijn, Rick R.

2012-01-01

The emergency room (ER) represents the main system entry for crises-based health care visits. It is estimated that 2% to 10% of children visiting the ER are victims of child abuse and neglect (CAN). Therefore, ER personnel may be the first hospital contact and opportunity for CAN victims to be

The incidence of child abuse in the contemporary society: a fact or ...

African Journals Online (AJOL)

The study investigated the incidence of child abuse in the contemporary society. It examined the dimension of the incidence whether it is a fact or a farce. 300 participants, from school of Nursing, Mid-wifery and Medical Laboratory of Bishop Shanahan Hospital Nsukka. 285 females and 15 males freely participated.

Rural-Urban Disparities in Child Abuse Management Resources in the Emergency Department

Science.gov (United States)

Choo, Esther K.; Spiro, David M.; Lowe, Robert A.; Newgard, Craig D.; Hall, Michael Kennedy; McConnell, Kenneth John

2010-01-01

Purpose: To characterize differences in child abuse management resources between urban and rural emergency departments (EDs). Methods: We surveyed ED directors and nurse managers at hospitals in Oregon to gain information about available abuse-related resources. Chi-square analysis was used to test differences between urban and rural EDs.…

[The midwife-child health nurse collaboration, a link between the maternity unit and neonatology].

Science.gov (United States)

Pallaro, Audrey; Polzin, Karine

2016-01-01

Collaborative work forms part of the well-treatment and improvement of quality of care approach. It is also of benefit to the medical and paramedical teams. Within the parent-child unit of Libourne hospital, the midwife and child health nurse collaborate throughout the pregnancy, and especially during the post-partum period. The teams work together notably around the care of "high-risk" births and in particular when the newborn is hospitalised in a kangaroo care unit. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Comprehensive approach to the child with gastrostomy

Directory of Open Access Journals (Sweden)

Erika Šmid

2013-10-01

Full Text Available Endoscopic gastrostomy tube placement is the method of choice for enteral feeding of adults and children. It is most commonly needed in children with neurological impairment, and in those with swallowing difficulties. Complications are relatively common but in most cases not severe. Among the most common complications are bacterial and fungal infections of the skin around the tube.In adults, it is usually performed with local anesthesia, whereas in children general anesthesia is recommended.During the child’s hospitalization, parents are usually present in order to learn how to take care of the child at home. We offer them theoretical and practical knowledge about the life of a child with gastrostomy. We provide them information on feeding, skin care, possible complications, and actively include them in all steps of the process of gastrostomy nursing care as soon as possible.Likewise adults, children also have to be treated as equals, andfor this reason we have to know how to communicate with them, with special attention on child’s non-verbal communication. Nursing care to the child often presents an unfamiliar and even undesirable situation. It is therefore the role of the nurse to mitigate it by appropriate communication.It takes four to five days for parents to obtain sufficient information to be able to take care of their child at home. Upon discharge, they receive written information on percutaneous gastrostomy care.

Maternal Thyroid Dysfunction and Risk of Seizure in the Child: A Danish Nationwide Cohort Study

Directory of Open Access Journals (Sweden)

Stine Linding Andersen

2013-01-01

Full Text Available Thyroid hormones are essential for brain development, and maternal thyroid disease may affect child neurocognitive development. Some types of seizures may also depend upon early exposure of the developing central nervous system, and we hypothesized that maternal thyroid dysfunction could increase the risk of seizure in the child. In a Danish population-based study we included 1,699,693 liveborn singletons, and from the Danish National Hospital Register we obtained information on maternal diagnosis of hyper- or hypothyroidism and neonatal seizure, febrile seizure, and epilepsy in the child. Maternal diagnosis of thyroid dysfunction before or after birth of the child was registered in two percent of the singleton births. In adjusted analyses, maternal hyperthyroidism and hypothyroidism first time diagnosed after birth of the child were associated with a significant increased risk of epilepsy in the child. Moreover, hypothyroidism diagnosed after birth of the child was associated with a significant increased risk of neonatal and febrile seizures. No significant association was seen for maternal diagnosis prior to birth of the child. We speculate if some degree of maternal thyroid dysfunction was already present during the pregnancy in mothers diagnosed after birth of the child and if this untreated condition may present a neurodevelopmental risk.

Maternal thyroid dysfunction and risk of seizure in the child: a Danish nationwide cohort study.

Science.gov (United States)

Andersen, Stine Linding; Laurberg, Peter; Wu, Chun Sen; Olsen, Jørn

2013-01-01

Thyroid hormones are essential for brain development, and maternal thyroid disease may affect child neurocognitive development. Some types of seizures may also depend upon early exposure of the developing central nervous system, and we hypothesized that maternal thyroid dysfunction could increase the risk of seizure in the child. In a Danish population-based study we included 1,699,693 liveborn singletons, and from the Danish National Hospital Register we obtained information on maternal diagnosis of hyper- or hypothyroidism and neonatal seizure, febrile seizure, and epilepsy in the child. Maternal diagnosis of thyroid dysfunction before or after birth of the child was registered in two percent of the singleton births. In adjusted analyses, maternal hyperthyroidism and hypothyroidism first time diagnosed after birth of the child were associated with a significant increased risk of epilepsy in the child. Moreover, hypothyroidism diagnosed after birth of the child was associated with a significant increased risk of neonatal and febrile seizures. No significant association was seen for maternal diagnosis prior to birth of the child. We speculate if some degree of maternal thyroid dysfunction was already present during the pregnancy in mothers diagnosed after birth of the child and if this untreated condition may present a neurodevelopmental risk.

Age-appropriate feeding practices and nutritional status of infants attending child welfare clinic at a Teaching Hospital in Nigeria

Directory of Open Access Journals (Sweden)

Umar M Lawan

2014-01-01

Full Text Available Background: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. Materials and Methods: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ≤12 months and caregivers was systematically selected and studied. The data were analyzed using the MINITAB ® 12.21 (USA statistical software. Results: All the infants studied were still on breast milk. Most of the mothers demonstrated correct body positioning (89.9 and attachment (78.7% during breastfeeding, and effective suckling was demonstrated in 77.0%. Interestingly, none of the infants was either exclusively breastfed for 6 months or currently on exclusive breastfeeding. Furthermore, only 64 (58.2% of the 110 infants that were more than 6 months of age had appropriately been started on complementary feeding from 6 months of age. Overall, most caregivers (88.7% had "fair" to "good" infant feeding practices. The practices were significantly associated with their level of education, and their relationship with the infants. Up to 40.0% and 73.7% of the infants had varying degrees of wasting and stunting respectively. Infant feeding practices and the age of the infants emerged as the only factors significantly associated with stunting, while both the caregivers′ practices and age of the infants emerged as significant predictors of wasting in the infants. Conclusion and Recommendations: Barely 3 years to the 2015 target of the millennium development goals (MDGs, infant feeding and nutritional status still poses a serious threat to the dream of realizing the MDG-4. The Ministry of Health and relevant developing partners in this region should as a matter of urgency, formulate and implement a strong community-based public health intervention program to

Amputation for a puff adder (Bitis arietans) envenomation in a child ...

African Journals Online (AJOL)

spreading halfway to the knee. The injury arose from a puff adder bite while walking on the bank of the Nile. The father took four days to transport the .... by an African Puff Adder (Bitis arietans). J Emerg Med. 1997; 15: 827-831. Figure 2. The child after the operation with hospital orderlies and father (West family photograph)

Hospital Contacts With Infection and Risk of Schizophrenia

DEFF Research Database (Denmark)

Nielsen, Philip Finn Rising; Benros, Michael E; Mortensen, Preben B

2014-01-01

Infections and immune responses have been suggested to play an important role in the etiology of schizophrenia. Several studies have reported associations between maternal infections during pregnancy and the child's risk of schizophrenia; however, infection during childhood and adolescence...... a hospital contact with infection before their schizophrenia diagnosis (45%). Our results indicate that individuals who have had a hospital contact with infection are more likely to develop schizophrenia (relative risk [RR] = 1.41; 95% CI: 1.32-1.51) than individuals who had not had such a hospital contact....... Bacterial infection was the type of infection that was associated with the highest risk of schizophrenia (RR = 1.63; 95% CI: 1.47-1.82). Our study does not exclude that a certain type of infection may have a specific effect; yet, it does suggest that schizophrenia is associated with a wide range...

Living and telling stories of illness and hospitalization through fairy tales.

Directory of Open Access Journals (Sweden)

Rossella Caso

2012-06-01

Full Text Available What link exists beetween health and storytelling? The hypothesis that reading aloud could be an effective instrument in order to support the well-being of the hospitalized child, and that writing to stimulate the expression of their own inner world is the theoretical reference of the bibliotherapy, methology based on the notion that reading could be an effective instrument to promote the development and the well-being of the child and to favour him/her to get the maximum gain during the hospitalization experience. As for the writing, when they tell, children “tell about themselves” and they speak their wishes, feelings, emotions, fears, in a way that is figurative. Read their writings can become, in this sense, as well as a way to take-care-in, an useful key to the world of childhood and, ultimately, a way to improve the quality of care given to them. 

Parent-Child Agreement on Parent-to-Child Maltreatment

NARCIS (Netherlands)

Compier-de Block, Laura H.C.G.; Alink, Lenneke R.A.; Linting, Mariëlle; van den Berg, Lisa J.M.; Elzinga, Bernet M.; Voorthuis, Alexandra; Tollenaar, Marieke S.; Bakermans-Kranenburg, Marian J.

2017-01-01

Parent-child agreement on child maltreatment was examined in a multigenerational study. Questionnaires on perpetrated and experienced child maltreatment were completed by 138 parent-child pairs. Multi-level analyses were conducted to explore whether parents and children agreed about levels of

Child poverty and changes in child poverty.

Science.gov (United States)

Chen, Wen-Hao; Corak, Miles

2008-08-01

This article offers a cross-country overview of child poverty, changes in child poverty, and the impact of public policy in North America and Europe. Levels and changes in child poverty rates in 12 Organisation for Economic Co-operation and Development (OECD) countries during the 1990s are documented using data from the Luxembourg Income Study project, and a decomposition analysis is used to uncover the relative role of demographic factors, labor markets, and income transfers from the state in determining the magnitude and direction of the changes. Child poverty rates fell noticeably in only three countries and rose in three others. In no country were demographic factors a force for higher child poverty rates, but these factors were also limited in their ability to cushion children from adverse shocks originating in the labor market or the government sector. Increases in the labor market engagement of mothers consistently lowered child poverty rates, while decreases in the employment rates and earnings of fathers were a force for higher rates. Finally, there is no single road to lower child poverty rates. Reforms to income transfers intended to increase labor supply may or may not end up lowering the child poverty rate.

Evaluation of paediatric injury hospitalization incidence at Hospital Ward in Grudziądz

Directory of Open Access Journals (Sweden)

Ewa Barczykowska

2016-05-01

, hospitalization, child hospitalizated, trauma.

Building child trauma theory from longitudinal studies: a meta-analysis.

Science.gov (United States)

Alisic, Eva; Jongmans, Marian J; van Wesel, Floryt; Kleber, Rolf J

2011-07-01

Many children are exposed to traumatic events, with potentially serious psychological and developmental consequences. Therefore, understanding development of long-term posttraumatic stress in children is essential. We aimed to contribute to child trauma theory by focusing on theory use and theory validation in longitudinal studies. Forty studies measuring short-term predictors and long-term posttraumatic stress symptoms were identified and coded for theoretical grounding, sample characteristics, and correlational effect sizes. Explicit theoretical frameworks were present in a minority of the studies. Important predictors of long-term posttraumatic stress were symptoms of acute and short-term posttraumatic stress, depression, anxiety, and parental posttraumatic stress. Female gender, injury severity, duration of hospitalization, and elevated heart rate shortly after hospitalization yielded small effect sizes. Age, minority status, and socioeconomic status were not significantly related to long-term posttraumatic stress reactions. Since many other variables were not studied frequently enough to compute effect sizes, existing theoretical frameworks could only be partially confirmed or falsified. Child trauma theory-building can be facilitated by development of encouraging journal policies, the use of comparable methods, and more intense collaboration. Copyright © 2011 Elsevier Ltd. All rights reserved.

NURSING CARE MODEL DEVELOPMENT BY COPE APPROACH FOR REDUCING PARENT’S HOSPITALIZATION STRESS WITH CANCER CHILDREN

Directory of Open Access Journals (Sweden)

Ilya Krisnana

2017-04-01

Full Text Available Introduction: Hospitalization stress on child affect on their parents. Parent empowerment is the important aspect to develop in nursing care for reducing hospitalization stress. The objective of this study was to develop the nursing care model of reduction hospitalization stress through the COPE (creating opportunity for parent empowerment approach on the parent whose child was diagnosed cancer. Method: This study used explanative research with cross sectional design. The population were parents whose child was diagnosed cancer in pediatric hematological ward RSUD Dr. Soetomo Surabaya, conducted on 3–15th May 2012. Sample were 30 mother who met inclusion criteria: 1 toddler and preschool age, 2 first time admition on Bona 1 or Bona 2, 3read and write well and 4 noncritical condition. The independent variable were antecedens (attitude, social economic status, motivation, diffusion of innovation, empowerment (knowledge, participation, skill and environment. The dependent variable was parent’s hospitalization stress. Data were collected by using questionnaires and observation. The data were analyzed by PLS (Partial Least Square with loading factor =0.5 and T-statistic=1.96. Result: The result showed that antecedens factors affected to COPE diffusion of innovation process. Motivation was the strongest factor to influence the diffusion and innovation process (path coeffi cient=0.450;T-stat=5.278. The diffusion of innovation process affected to empowerment variable (path coeffi cient=0.487; T-stat=6.507. Discussion: It can be concluded that environment was the strongest factor as the compiler component of empowerment. Environment include physical and non-physical component. Empowerment affected to parent’s hospitalization stress with path coefficient=0.360 and T-statistik=4.980.

[Nobody wants to lose a child--nurses' observations of family reactions].

Science.gov (United States)

de Souza, L J; Barroso, M G

1997-01-01

The presence of veterinary products in the houses without any minimum security procedures has led to a poisoning case for a one-year old child who developed a serious systemic reaction. This child was interned at a Pediatric Intensive Care Unit at a public hospital in Fortaleza, Ceara. This study aims at identifying the family reaction facing a poisoning of a child and analyzing these reactions, interpreting its social cultural context. It has been developed as an ethnographic study case, consisting of the exploration, decision and discovery phases. It has been observed through the results that the family recognizes the existence of risk factors in home environment but does not adopt any coherent preventive methods with this experience. We do believe that these occurrences reduction demand transforming educative actions which may lead the family to be conscious towards the problematic that concerns poisoning for children, occurred under their responsibility.

Mourning Child Grief Support Group Curriculum: Early Childhood Edition, Kindergarten-Grade 2.

Science.gov (United States)

Lehmann, Linda; Jimerson, Shane R.; Gaasch, Ann

The Mourning Child Early Childhood grief support curriculum is intended for use with early elementary-aged children, specifically children in kindergarten through grade two, who have experienced the death of someone special to them. It is designed for use by professionals who work in schools, hospitals, hospices, mental health agencies, or any…

Impact of Child Life Services on Children and Families Admitted to Start the Ketogenic Diet.

Science.gov (United States)

Kossoff, Eric H; Sutter, Lindsay; Doerrer, Sarah C; Haney, Courtney A; Turner, Zahava

2017-08-01

Traditionally the ketogenic diet is started as an inpatient admission to the hospital. Starting in January 2015, child life services were made formally available during ketogenic diet admissions to help families cope. One-page surveys were then provided to 15 parents on the day of discharge and again after 3 months. Every family believed that the child life services were helpful. Children who were developmentally appropriate/mildly delayed had higher parent-reported anxiety scores than those who were moderate to severely delayed (4.4 vs 1.0, P = .02). At 3 months, child life services were deemed very helpful for the parents (mean score: 8.9, range: 5-10), and were more helpful for the parent than the child (mean 6.2, range 1-10, P = .047). One of the most helpful services was a prior phone call to parents 1 week prior. In this small pilot study, child life involvement during the start of the ketogenic diet was highly useful.

Fear of clowns in hospitalized children: prospective experience.

Science.gov (United States)

Meiri, Noam; Schnapp, Zeev; Ankri, Amichi; Nahmias, Itay; Raviv, Amnon; Sagi, Omer; Hamad Saied, Mohamad; Konopnicki, Muriel; Pillar, Giora

2017-02-01

Medical clowns (MC) have become an integral part of the pediatric staff of hospital wards. While several studies have demonstrated the huge benefits of MC, there are almost no data regarding fear of clowns, a known phenomenon that means an irrational fear of clowns. In the current study, we sought to examine the prevalence of fear of clowns in pediatrics wards, and to characterize the affected children. The clinical work of three certified MCs was prospectively assessed. Every child with fear of clowns was noted, data were retrieved from the medical records, and the parents/child completed a specific questionnaire with a research assistant. Fear of clowns was defined as crying, anxiety response or effort to avoid contact with the MCs in small children, while in older children, it was determined if the child either reported fear of MCs or made actions to avoid clowns' intervention. A total of 1160 children participated in the study. All were hospitalized in the department of pediatrics or the pediatric emergency medicine department at Carmel Medical Center, and were exposed to a MC intervention session. Of the 1160 children, 14 children experienced fear of clowns (1.2%). The average age of children who experienced fear of clowns was 3.5 years (range 1-15). Interestingly, most of the children demonstrating fear of clowns were girls (12 out of 14, 85.7%). We found no association between fear of clowns and specific diagnosis, fever, clinical appearance, religion, or ethnicity. The prevalence of fear of clowns in the general pediatric hospitalized population was 1.2%, with a significant predominance of girls (85.7%). Children who experienced significant fear of clowns also experienced significant fear of encountering or thinking about a MC visit. Fear of clowns can affect children at any age (range 1-15), any ethnicity, religion, or degree of illness. Further large scale studies are required to better understand this unique phenomenon of fear of clowns. What is Known

Teacher-Child Relationships: Contribution of Teacher and Child Characteristics

Science.gov (United States)

Choi, Ji Young; Dobbs-Oates, Jennifer

2016-01-01

This study investigates potential predictors of teacher-child relationships (i.e., closeness and conflict) focusing on child gender, teacher-child ethnicity match, and teacher education. Additionally, the study explores the possible moderation effect of teacher education on the associations between teacher-child relationships and child gender or…

Maternal emotion regulation during child distress, child anxiety accommodation, and links between maternal and child anxiety.

Science.gov (United States)

Kerns, Caroline E; Pincus, Donna B; McLaughlin, Katie A; Comer, Jonathan S

2017-08-01

Environmental contributions are thought to play a primary role in the familial aggregation of anxiety, but parenting influences remain poorly understood. We examined dynamic relations between maternal anxiety, maternal emotion regulation (ER) during child distress, maternal accommodation of child distress, and child anxiety. Mothers (N=45) of youth ages 3-8 years (M=4.8) participated in an experimental task during which they listened to a standardized audio recording of a child in anxious distress pleading for parental intervention. Measures of maternal and child anxiety, mothers' affective states, mothers' ER strategies during the child distress, and maternal accommodation of child anxiety were collected. Mothers' resting respiratory sinus arrhythmia (RSA) reactivity during the recording was also acquired. Higher maternal negative affect and greater maternal ER switching (i.e., using multiple ER strategies in a short time without positive regulatory results) during child distress were associated with child anxiety. Sequential mediation modeling showed that maternal anxiety predicted ineffective maternal ER during child distress exposure, which in turn predicted greater maternal accommodation, which in turn predicted higher child anxiety. Findings support the mediating roles of maternal ER and accommodation in linking maternal and child anxiety, and suggest that ineffective maternal ER and subsequent attempts to accommodate child distress may act as mechanisms underlying the familial aggregation of anxiety. Copyright © 2017 Elsevier Ltd. All rights reserved.

Child: A Learning Model and a Bi-directional Phenomenon.

Science.gov (United States)

Shastri, Priyvadan C

2015-01-01

Forty-five years of work with children has enriched my knowledge. Child development and psychology has made basic concepts of general psychology and abnormal psychology clearer. 'Meanings' have become more meaningful. It has made me a better professional; large number of communication and teaching skill has been the end result of such a long association with diverse groups of children who needed special care. Apart from professional skills as a clinician and as a teacher, it has made me a better person and a better parent. I have been fortunate to work with a large number and different groups of children who were in some way very special. Some were classified under various disabilities or diagnosed under different categories. I also had the privilege of working with different institutions, e.g., child guidance clinics run by a paediatrics department and a psychiatry department of a general hospital and a teaching hospital. Years of association with College of Special Work and Institute of Social Science have made me understand the very important facet of sociocultural influence on the development of human behaviour. I was further fortunate to work with children in closed and open institutions, residential care units and day care units, institutions where court committed children were observed, treated, trained and cared for, destitute children and delinquent children in remand homes, rescue homes and custodial care homes. I was fortunate to be part of the group which dealt with children who were in conflict with the law, belonging to diverse categories like street children, working children, child sex workers and sexually abused children. This paper is a reflection on experience gained over the decades.

Mothers’ Experiences of Participating in the Medical Care of their Child with Cancer

DEFF Research Database (Denmark)

Korning Lund, Line; Bregnballe, Vibeke

Background: Only a few research studies have addressed parents’ experiences of participating in the medical care and treatment of their child diagnosed with cancer. Objective: To explore how mothers of children diagnosed with cancer experienced participating in the medical care of their child both...... at hospital and at home. Design and methods: A qualitative study with a hermeneutical approach. The empirical data consisted of three semi-structured interviews with mothers of children diagnosed with cancer within the last three months. The interviews were analysed in accordance with Kvale and Brinkmann....... Findings/results: Six themes were found: "Distraction, control and security", "Difficulty dealing with the child's psychological reaction", "Fluctuating surplus of mental resources calls for match of expectation", "Preparing systems for the medical care on their own", "Complying with the medical care...

Traumatic ureteropelvic disruption in the child

International Nuclear Information System (INIS)

Reda, E.T.; Lebowitz, R.L.

1986-01-01

Traumatic disruption of the ureter from the renal pelvis is a rare injury because the ureteropelvic junction is situated deep in the retroperitoneum and is thus protected by the spine and paraspinal muscles. The mechanism for this injury is thought to be the stretching of the proximal ureter by sudden extreme hyperextension of the trunk. As a non-fatal injury, this occurs only in the child because of the greater elasticity and mobility of the young skeleton. At The Children's Hospital we have seen 3 cases of avulsion of the ureter from the pelvis following blunt trauma. (orig.)

Consumerism in healthcare can be detrimental to child health: lessons from children with functional abdominal pain.

Science.gov (United States)

Lindley, K J; Glaser, D; Milla, P J

2005-04-01

To determine prognostic indicators in children with severe functional abdominal pain (FAP) and to test the hypothesis that "healthcare consumerism" in these families might be deleterious to the child. Retrospective analysis of a cohort of 23 children aged 12 months after onset. Poor outcome was associated with refusal to engage with psychological services, involvement of more than three consultants, lodging of a manipulative complaint with hospital management by the child's family, and lack of development of insight into psychosocial influences on symptoms. Three of four adverse prognostic indicators reflected healthcare consumerism by the families. Actions of families who lack insight into their child's illness may perpetuate FAP in childhood. A culture of parental consumerism in healthcare, however well intentioned, needs to be accompanied by robust systems to protect the interests of the child.

Psychotropic drug effects contributing to psychiatric hospitalization of children: a preliminary study.

Science.gov (United States)

Fialkov, M J; Hasley, S

1984-12-01

Over an 11-month period on a Children's Psychiatric Unit 5% of 60 first admissions for hospitalization were apparently associated with adverse effects of psychotropic medication. Forty (66%) of the first admissions had used, prior to hospitalization, a wide variety of drugs including stimulants, major and minor tranquilizers, anticonvulsants, antidepressants and over-the-counter drugs containing antihistamines and analgesics. It is suggested that inappropriate and injudicious use of psychotropic medications may be associated with unanticipated adverse behavioral effects, which can result in deterioration of a child's functioning to the point of necessitating psychiatric hospitalization. Early identification of these unwanted psychotropic effects has diagnostic, prognostic, economic, and legal implications.

Child Sexual Abuse and Exploitation: Guest Editor’s Introduction

Directory of Open Access Journals (Sweden)

Michael Salter

2015-07-01

Full Text Available One of the most unnerving aspects of child sexual abuse is that it is constantly manifesting in unexpected ways. The current Royal Commission into Institutional Responses to Child Sexual Abuse has collected testimony of abuse in churches, schools, out-of-home care, hospitals and religious communities, demonstrating the breadth of institutional arrangements whose structures and cultures have facilitated child sexual abuse. Cases of serious and prolonged sexual abuse in family contexts have been excluded from the terms of reference of the Royal Commission but nonetheless continue to surface in media reports. In 2013, twelve children were permanently removed from an extended family living in rural NSW in what has been described as one of the worst cases of child abuse in Australia, involving intergenerational incest going back at least three generations (Auebach 2014. Another recent high-profile case involved the use of the Internet to facilitate the sexual exploitation of an adopted child by his parents in Queensland (Ralston 2013. These cases challenge the received wisdom that child sexual abuse is characterised by the victimisation of one child by one opportunistic offender. Such incidents suggest instead that child sexual abuse takes varied and systemic forms, and can operate to perpetuate and entrench toxic cultures and power structures.   This special issue on Child Sexual Abuse and Exploitation is a timely contribution to ongoing efforts to understand the multiplicity of child sexual abuse. It is an interdisciplinary collection of insights drawn from criminology, sociology, psychiatry, psychology and psychoanalysis, and includes papers from academic researchers alongside academic practitioners whose writing is grounded in their work with affected individuals and communities. A key aim of the special issue is to contextualise the diversity of child sexual abuse socially, politically and historically, recognising the dynamic and iterative

Mother's time allocation, child care and child cognitive development

OpenAIRE

BRILLI, Ylenia

2015-01-01

This paper analyzes the effects of maternal employment and non-parental child care on child cognitive development, taking into account the mother's time allocation between leisure and child-care time. I estimate a behavioral model, in which maternal labor supply, non-parental child care, goods expenditure and time allocation decisions are considered to be endogenous choices of the mother. The child cognitive development depends on maternal and non-parental child care and on the goods bought f...

Mourning Child Grief Support Group Curriculum: Middle Childhood Edition, Grades 3-6.

Science.gov (United States)

Lehmann, Linda; Jimerson, Shane R.; Gaasch, Ann

The Mourning Child Early Childhood grief support curriculum is intended for use with late elementary and middle school-aged children, specifically children in grades three through six, who have experienced the death of someone special to them. It is designed for use by professionals who work in schools, hospitals, hospices, mental health agencies,…

Factors associated with unintentional injury among the paediatric age population in the hospitals of Amhara National Regional State, Ethiopia

Directory of Open Access Journals (Sweden)

Bewket Tadesse Tiruneh

Full Text Available Background: Childhood unintentional injuries cause nearly 875,000 deaths each year. The aim of this study was to assess the prevalence and factors associated with unintentional injury of children presenting to the hospitals of Amhara Regional State, Ethiopia. Methods: In a hospital-based, cross-sectional study undertaken in one month, from April 1 to 30th 2016, 893 children less than 18 years of age were included. Data were collected using an interviewer-administered questionnaire. Training was given to all data collectors and supervisors. Data was entered into EPI info version 7 and then exported to SPSS version 20, for further analysis. Results: Unintentional injury caused 62% (554 of all injuries in attending children. Several factors affected the likelihood of injuries, namely the age of the child, age of the parents or guardians, sex of the child, and whether the child lived with the parents. Modifiable factors were the child’s behaviour, awareness of danger, the child’s level of educational, if the child’s parent had received adequate injury counselling, and whether a child was left in the care of another child. The source of light in the house, and house floor material were also significant factors at p < 0.05. Conclusion: The prevalence of unintentional injury was high. Many of the factors associated with injuries are modifiable and safety issues for children need urgent attention. Keywords: Unintentional injury, Paediatric, Ethiopia, Low resource

Parents' Perceived Satisfaction of Care, Communication and Environment of the Pediatric Intensive Care Units at a Tertiary Children's Hospital.

Science.gov (United States)

Abuqamar, Maram; Arabiat, Diana H; Holmes, Sandra

2016-01-01

This study aims to identify parental perceptions on pediatric intensive care-related satisfaction within three domains: environment, child's care provided and communication. In addition, it aims to identify whether parent's socio-demographics and child's clinical variables predict parents' perceived satisfaction. In this study, a total of 123 parents whose child received care in the PICU of a tertiary children's hospital in Amman completed the Arabic version of the parents satisfaction survey (PSS). A cross-sectional, descriptive-correlational design was used to collect data. All data were collected between June and October of 2013. Central tendency measures and percentages of replies for each domain revealed that at least 7 items were rated poorly satisfied. More than half of the parents were not satisfied with the noise level of the PICU, the time nurses spent at the child's bedside, as well as the way the healthcare team prepare them for the child's admission. Almost 90% of the parents believed that the nurses ignored their child's needs by not listening to parents and by responding slowly to child's needs. Stepwise regression analysis showed that that the number of hospital admissions, health insurance and the severity of illness was the main predictor of parents' satisfaction. In conclusion, the availability of health care professionals, the support and the information they share with the child's parents are all significant to parent's satisfaction and hence to better quality of care. Targeting the domains of low satisfaction reported by the parents could increase parent's satisfaction and achieve quality improvement required for this population. Copyright © 2016 Elsevier Inc. All rights reserved.

Identification and Evaluation of Abused Children at Imam Hossein Hospital.

Science.gov (United States)

Arabghol, Fariba; Derakhshanpour, Firooze; Davari Ashtiyani, Rozita; Chimeh, Narges; Panaghi, Layli

2016-03-01

Child abuse is a phenomenon that confronts the child, family, and society with irretrievable physical and mental injuries, and its negative effects continue until adulthood. The present study was conducted to identify and evaluate cases of abused children at a medical center. This is a descriptive-analytic study. The subjects were all children and adolescents who were referred to Imam Hussein hospital within 6 months due to physical or psychiatric reasons and were diagnosed with child abuse and neglect by a child and adolescent psychiatrist. The number of these children was 73. Children and their parents were assessed by schedule for affective disorders and schizophrenia (SADS), Kiddie-SADS, and child abuse and demographic questionnaires. The statistical methods of mean and standard deviation were used to analyze the data. 56 cases (76%) were physically abused, 53 cases (72.6%) were emotionally abused, and 3 cases (12.3%) were neglected. The most common psychiatric disorder in abused children was ADHD (65.8%). The next most common were oppositional defiant disorder, obsessive compulsive disorder, general anxiety disorder, and enuresis. About 80% of the abused children had at least one psychiatric disorder. The most common psychiatric disorders in mothers were general anxiety disorder (34.8%) and depression (33.3%), and in fathers, it was substance abuse (19.7%). Child abuse is a common phenomenon that relates to psychiatric disorders in the abused child or abuser parents. It seems that on-time identification and appropriate interventions can prevent further negative consequences for the child, family, and society.

Toddler Developmental Delays After Extensive Hospitalization: Primary Care Practitioner Guidelines.

Science.gov (United States)

Lehner, Dana C; Sadler, Lois S

2015-01-01

This review investigated developmental delays toddlers may encounter after a lengthy pediatric hospitalization (30 days or greater). Physical, motor, cognitive, and psychosocial development of children aged 1 to 3 years was reviewed to raise awareness of factors associated with developmental delay after extensive hospitalization. Findings from the literature suggest that neonatal and pediatric intensive care unit (NICU/PICU) graduates are most at risk for developmental delays, but even non-critical hospital stays interrupt development to some extent. Primary care practitioners (PCPs) may be able to minimize risk for delays through the use of formal developmental screening tests and parent report surveys. References and resources are described for developmental assessment to help clinicians recognize delays and to educate families about optimal toddler development interventions. Pediatric PCPs play a leading role in coordinating health and developmental services for the young child following an extensive hospital stay.

Inspection at Our Lady’s Hospital, Navan

LENUS (Irish Health Repository)

Healy, Kathy

2012-08-11

Going to the hospital for surgery is an event that most people may find daunting. Anticipation of the unknown, lack of control over events and unfamiliarity with the environment may result in feelings of anxiety and stress. This research paper used a quantitative descriptive survey to establish the information needs of parents of children admitted for same day surgery. The main aims of this study were to establish what information parents had received prior to their child\\'s admission for same day surgery, and how they perceived this information. It also determined what other information they required. The findings demonstrated that the majority of parents in this study were satisfied with the information they had received. However they wanted further advice on the waiting times involved, the equipment used in the operating room department, pain relief and the procedures in the recovery room.

Child abuse and neglect experts' determination of when a child being left home alone constitutes child neglect.

Science.gov (United States)

Jennissen, Charles A; Evans, Erin; Oral, Resmiye; Denning, Gerene

2018-04-10

Only 14 states have laws or guidelines regarding the minimum age a child may be left home alone. These ages range from 6 to 14 years. Our objective was to identify factors that influence child neglect determination by experts with regards to parents leaving children home alone. American Academy of Pediatrics Section on Child Abuse and Neglect members (N = 523) were surveyed from July-August, 2015. Respondents were asked whether scenarios involving a child of varying age knowingly left home alone for 4 h were neglect in the presence or absence of injury to the child and the legality of the situation. Comparisons were performed using the chi-square test. One hundred ninety-three members responded (36.9%). In the scenario where there were no relevant laws and the child was uninjured, nearly 100% of the child experts determined this as being child neglect when the child was 6 years old. For 8, 10, 12, and 14 year olds, this was 88, 48, 4, and 1%, respectively. However, a significantly higher percentage of experts considered it child neglect for most ages when there was a law making the scenario illegal as compared when there was no law, and when the child was injured versus when they were not. The only demographic variable that showed a difference in child neglect determination was that females were more likely to consider higher aged children as having been neglected when there were no laws but the child was injured. The vast majority of experts (85%) stated that leaving a child home alone for 4 h should be illegal if the child is < 9 years old, and nearly one-half (44%) said it should be illegal for children < 11 years old. A number of factors affect how experts view children being left home alone as potential child neglect. Our data suggests that such cases may be evaluated differently due to variations in state laws, even though the risk to the child is the same. These results call for child safety law reform to provide greater uniformity in the

Ear for recovery: protocol for a prospective study on parent-child communication and psychological recovery after paediatric injury.

Science.gov (United States)

Alisic, Eva; Barrett, Anna; Bowles, Peter; Babl, Franz E; Conroy, Rowena; McClure, Roderick J; Anderson, Vicki; Mehl, Matthias R

2015-02-04

One in six children who have been admitted to hospital with an injury develop persistent stress symptoms that put their development at risk. Parents play a crucial role in children's psychological recovery, however, it is unknown how specific parenting behaviours can help or hinder. We aim to describe the nature and quantity of parent-child communication after a child has been injured, and to examine how these interactions are related to children's psychological recovery. We are conducting a prospective observational study among children aged 3-16 years, who have been admitted to a tertiary children's hospital with a serious injury. Data collection involves a naturalistic observation of spontaneous, everyday parent-child communication at home, shortly after discharge, and an assessment of children's psychological recovery at 6 weeks and 3 months post-injury. Main analyses comprise descriptive statistics, cluster analysis and analyses of variance. This study has been approved by the Human Research Ethics Committee of the Royal Children's Hospital Melbourne (33103) and Monash University Human Research Ethics Committee (CF13/2515-2013001322). We aim to disseminate the findings through international peer-reviewed journals, international conferences and social media. Participants will be sent a summary of the overall study findings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The young child in Yemen.

Science.gov (United States)

Bornstein, A

1974-01-01

4 surveys were undertaken in Yemen through interviews with women in their homes in an effort to obtain information on the sociological and psychological aspects of young children and their mothers, the conditions of working mothers with young children, and traditional midwives and midwifery practices. The survey on child socialization and upbringing included 30 families. The survey on working mothers included 54 women selected at random among more than 300 women employed in a textile factory. 40 midwives were also interviewed; most were of the traditional type but the group also included 6 with 4 years of nursing school training and some hospital and midwifery experience. Focus is on ecological and economic background; social organization; housing, water supply and sanitation; the role of women; family planning; pregnancy and delivery; infant feeding and care; childhood; attitude of parents to education; weaning foods; swaddling babies; working mothers; health conditions and services; education; and the future for families in Yemen. There is a marked preference for sons in Yemen which is explained by the patriarchal character of the society and the place of defense in tribal unity and integration. Childbearing and rearing are heavy physical burdens for women. Among the families interviewed, 70% of the mothers did not want more children after the 4th child. During pregnancy mothers did not receive supplementary nutrition nor did they change their pattern of work or take any other special precautions. The social environment for child bearing is favorable, but conditions of delivery are primitive and even dangerous in the event of complications.

Prevalence of nasal carriage and diversity of Staphylococcus aureus among inpatients and hospital staff at Korle Bu Teaching Hospital, Ghana

DEFF Research Database (Denmark)

Egyir, Beverly; Guardabassi, Luca; Nielsen, Søren Saxmose

2013-01-01

%) was more common than for other agents (resistant S. aureus carriage was observed among IP compared with HS (P = 0.01). High genetic diversity was shown by spa typing, with 55 spa types found among 105 isolates; the predominant spa types were t355 (10%) and t084 (10......There is a paucity of data on Staphylococcus aureus epidemiology in Africa. Prevalence of nasal carriage and genetic diversity of S. aureus were determined among hospital staff (HS) and inpatients (IP) at the largest hospital in Ghana. In total, 632 nasal swabs were obtained from 452 IP and 180 HS...... in the Child Health Department (CHD) and Surgical Department (SD). S. aureus carriage prevalences were 13.9% in IP and 23.3% in HS. The chance of being a carrier was higher in HS (P = 0.005) and IP staying ≤7 days in hospital (P = 0.007). Resistance to penicillin (93%), tetracycline (28%) and fusidic acid (12...

Substantiated Reports of Child Maltreatment From the Canadian Incidence Study of Reported Child Abuse and Neglect 2008: Examining Child and Household Characteristics and Child Functional Impairment.

Science.gov (United States)

Afifi, Tracie O; Taillieu, Tamara; Cheung, Kristene; Katz, Laurence Y; Tonmyr, Lil; Sareen, Jitender

2015-07-01

Identifying child and household characteristics that are associated with specific child maltreatment types and child functional impairment are important for informing prevention and intervention efforts. Our objectives were to examine the distribution of several child and household characteristics among substantiated child maltreatment types in Canada; to determine if a specific child maltreatment type relative to all other types was associated with increased odds of child functional impairment; and to determine which child and household characteristics were associated with child functional impairment. Data were from the Canadian Incidence Study of Reported Child Abuse and Neglect (collection 2008) from 112 child welfare sites across Canada (n = 6163 children). Physical abuse, sexual abuse, and emotional maltreatment were highly prevalent among children aged 10 to 15 years. For single types of child maltreatment, the highest prevalence of single-parent homes (50.6%), social assistance (43.0%), running out of money regularly (30.7%), and unsafe housing (30.9%) were reported for substantiated cases of neglect. Being male, older age, living in a single-parent home, household running out of money, moving 2 or more times in the past year, and household overcrowding were associated with increased odds of child functional impairment. More work is warranted to determine if providing particular resources for single-parent families, financial counselling, and facilitating adequate and stable housing for families with child maltreatment histories or at risk for child maltreatment could be effective for improving child functional outcomes.

Substantiated Reports of Child Maltreatment From the Canadian Incidence Study of Reported Child Abuse and Neglect 2008: Examining Child and Household Characteristics and Child Functional Impairment

Science.gov (United States)

Afifi, Tracie O; Taillieu, Tamara; Cheung, Kristene; Katz, Laurence Y; Tonmyr, Lil; Sareen, Jitender

2015-01-01

Objective: Identifying child and household characteristics that are associated with specific child maltreatment types and child functional impairment are important for informing prevention and intervention efforts. Our objectives were to examine the distribution of several child and household characteristics among substantiated child maltreatment types in Canada; to determine if a specific child maltreatment type relative to all other types was associated with increased odds of child functional impairment; and to determine which child and household characteristics were associated with child functional impairment. Method: Data were from the Canadian Incidence Study of Reported Child Abuse and Neglect (collection 2008) from 112 child welfare sites across Canada (n = 6163 children). Results: Physical abuse, sexual abuse, and emotional maltreatment were highly prevalent among children aged 10 to 15 years. For single types of child maltreatment, the highest prevalence of single-parent homes (50.6%), social assistance (43.0%), running out of money regularly (30.7%), and unsafe housing (30.9%) were reported for substantiated cases of neglect. Being male, older age, living in a single-parent home, household running out of money, moving 2 or more times in the past year, and household overcrowding were associated with increased odds of child functional impairment. Conclusions: More work is warranted to determine if providing particular resources for single-parent families, financial counselling, and facilitating adequate and stable housing for families with child maltreatment histories or at risk for child maltreatment could be effective for improving child functional outcomes. PMID:26175390

The role of the father in child sleep disturbance: child, parent, and parent-child relationship.

Science.gov (United States)

Millikovsky-Ayalon, Maaian; Atzaba-Poria, Naama; Meiri, Gal

2015-01-01

The majority of studies on child sleep problems focus primarily on mothers, neglecting paternal influences. Guided by the transactional framework, we explored how child temperament, paternal and maternal stress, and the parent-child interactions differ between families having children with sleep disturbances and a selected comparison group. The role of paternal involvement in child caregiving as a moderator of these differences was assessed. The sample consisted of 51 children (1-3 years old) and their mothers and fathers. Data were collected during home visits, when mothers and fathers completed questionnaires and were interviewed. In addition, mother-child and father-child interactions were videotaped. Results indicate that compared to the comparison group, fathers rated children with sleep disturbances as fussier, both their mothers and fathers experienced higher levels of stress, and reported using more bedtime interactions that interfere with child's sleep-wake self-regulation. In addition, their fathers were less sensitive during father-child interaction and less involved in child caregiving. Finally, paternal involvement moderated the group differences seen in maternal stress, suggesting that high paternal involvement acted as a buffer to protect parents of children with sleep disturbances from experiencing parental stress. The important role of fathers in families having children with sleep disturbances is discussed. © 2014 Michigan Association for Infant Mental Health.

Parent-provider communication during hospitalization.

Science.gov (United States)

Fisher, Mark J; Broome, Marion E

2011-02-01

Parents and health care providers interact and communicate with each other during a child's hospitalization. The purpose of this study was to compare communication experiences of parents, nurses, and physicians. A unique aspect of this study involved combining three individual data sources into a collective unit of study (triad). Triads involved in the care of three children in the inpatient setting of an urban children's hospital served as the sample for this study (n = 10). Participants were asked semistructured questions during face-to-face interviews. Findings included (a) the importance of providing information by health care providers using a caring and inclusive approach, (b) the benefits of establishing interpersonal connections and nurturing relationships, and (c) the identification of specific behaviors in all members of the triad that contribute to and sustain positively perceived communication. Future research directions examining triadic interactions, communication, and relationships among parents, nurses, and physicians are recommended. Copyright © 2011 Elsevier Inc. All rights reserved.

The Analysis of the Causes of Prolonged Hospitalization after Transarterial Chemoembolization in Patients with Unresectable Hepatocellular Carcinoma

International Nuclear Information System (INIS)

Chang, Nam Kyu; Jeong, Yong Yeon; Park, Seo Yeon; Kim, Jae Kyu

2011-01-01

We wanted to analyze the causes of prolonged hospitalization (over 7 days) after transarterial chemoembolization (TACE) in patients with unresectable Hepatocellular Carcinoma and its related factors. We analyzed the total hospital days after patients with unresectable Hepatocellular Carcinoma received transarterial chemoembolization, and these patients were treated during the recent 6 month at our hospital. Two hundred twenty three sessions showed a short term hospital stay (less than 7 days) and 57 sessions showed a prolonged hospital stay (more than 7 days), so a total of 280 sessions were analyzed. The hospital stay less than seven days was set for the control group and this was correlated with the patient's age, gender, the level of bilirubin and albumin, the platelet counts, the AST/ALT ratio, the a-FT, the presence of portal vein thrombosis and ascites, several scoring systems (Child-Pugh, CLIP, and OKUDA score) and the need for additional embolization at the time of the procedure. Compared with that of the control group, ascites (p=0.004), portal vein thrombosis (p=0.000), a platelet count below the hundred thousand (p=0.012), a Child-Pugh score more than B (p=0.023), a CLIP score more than 2 (p=0.000) and a OKUDA score more than II (p=0.000) showed significant differences. The evaluation of patients' factors would be useful to predict extended post-procedural hospitalization after hepatic chemoembolisation

Hospitalized children as social actors in the assessment and management of their pain

OpenAIRE

Kortesluoma, R.-L. (Riitta-Liisa)

2009-01-01

Abstract By acknowledging pain as subjective and only fully perceived by the person in pain, the main aim of this study was to report on the use of qualitative child interviewing and drawings as a research method to elicit hospitalized children’s perceptions and descriptions of their pain experience. Further, the second aim was to contribute to the improvement of pain assessment and management in hospitalized children by approaching the question from the children’s point of view through th...

A case report for differential diagnosis: Integrative medicine vs child abuse.

Science.gov (United States)

Ribeiro, Cristina Silveira; Rodrigues, Fernanda; Ribeiro, Catarina; Magalhães, Teresa

2010-11-01

The authors present the case of a ten-year-old Chinese boy who was taken to a hospital due to the presence of suspicious bruises on his body. The child was examined in the National Institute of Legal Medicine by forensic doctors and a forensic psychologist. Clinical characteristics of the case are summarized stressing that a better understanding of some kinds of integrative medicine (IM) may help to differentiate injuries resulting from those practices. This is the only and unique case diagnosed by the medico-legal services in Portugal. In fact a great range of IM practice has the potential to create confusion in the diagnosis of physical child abuse. This study focuses on the differential diagnosis of one specific kind of frequent skin injury usually seen in situations of both child abuse and IM (in this case TuiNa) - bruises. As the number of people who practice Traditional Chinese Medicine and other forms of IM increases in the Western world, the child protection community would benefit from familiarizing itselves with these practices to prevent social and/or legal conflicts that may arise from mistaken diagnoses of abuse. The objective of this case report is to emphasize the relevance of comprehensive and interdisciplinary evaluation of child abuse cases taking into account the specifics of each case, to achieve a proper diagnosis. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Suicide and suicide attempts in children and adolescents in the child welfare system.

Science.gov (United States)

Katz, Laurence Y; Au, Wendy; Singal, Deepa; Brownell, Marni; Roos, Noralou; Martens, Patricia J; Chateau, Dan; Enns, Murray W; Kozyrskyj, Anita L; Sareen, Jitender

2011-11-22

Few population studies have examined the psychiatric outcomes of children and adolescents in the child welfare system, and no studies have compared outcomes before and after entry into care. Our objective was to assess the relative rate (RR) of suicide, attempted suicide, admission to hospital and visits to physicians' offices among children and adolescents in care compared with those not in care. We also examined these outcomes within the child welfare population before and after entry into care. We used population-level data to identify children and adolescents 5 to 17 years of age who were in care in Manitoba for the first time between Apr. 1, 1997, and Mar. 31, 2006, and a comparison cohort not in care. We compared the two cohorts to obtain RRs for the specified outcomes. We also determined RRs within the child welfare population relative to the same population two years before entry into care. We identified 8279 children and adolescents in care for the first time and a comparison cohort of 353 050 children and adolescents not in care. Outcome rates were higher among those in care than in the comparison cohort for suicide (adjusted RR 3.54, 95% confidence interval [CI] 2.11-5.95), attempted suicide (adjusted RR 2.11, 95% CI 1.84-2.43) and all other outcomes. However, adjusted RRs for attempted suicide (RR 0.27, 95% CI 0.21-0.34), admissions to hospital and physician visits decreased after entry into care. Children and adolescents in care were at greater risk of suicide and attempting suicide than those who were not in care. Rates of suicide attempts and hospital admissions within this population were highest before entry into care and decreased thereafter.

Child Abuse in Northern Sri Lanka.

Science.gov (United States)

Sathiadas, M G; Mayoorathy, S; Varuni, K; Ranganathan, Shalini Sri

2017-02-01

To identify areas of deficiencies and gaps in child protection services in Northern Sri Lanka. Also, to help in recommending strategies, programmes of interventions for addressing issues of child abuse and advice the legal system. A retrospective study was done to determine the socio-demographic details, type of abuse, clinical profile, relationship of the perpetrator and nature of abuse among children admitted to a tertiary care centre from 2009 through 2014, a period after cessation of a 60-y conflict. Data were obtained from hospital based records and records maintained at the district probation office. Seven hundred twenty cases were referred to the tertiary care centre with abuse. Majority of the children were from the Jaffna district, the northern city of the war affected area and mean age of the children affected was 14.5 ± 2.6 y. Females were affected more than the males and 352 children were seen following sexual abuse. The clinical examination showed penetrative injury in 15 %. The perpetrator was known in 70 % of the situations and the victim was coerced into a relationship for abuse. Attempted suicide was seen in significant numbers during the immediate post war period and school dropout and delinquent behaviour was seen in later years. The problem of child abuse is considerable in this region and there is an urgent need to strengthen the services offered to the victims. Urgent steps are needed to safeguard these children, especially in the war affected areas.

Outcomes for children hospitalized with abusive versus noninflicted abdominal trauma.

Science.gov (United States)

Lane, Wendy Gwirtzman; Lotwin, Irwin; Dubowitz, Howard; Langenberg, Patricia; Dischinger, Patricia

2011-06-01

Abusive abdominal trauma (AAT) is the second leading cause of child abuse mortality. Previous outcome studies have been limited to data from trauma centers. The goals of this study were (1) to examine mortality, length of hospitalization, and hospital charges among a national sample of children hospitalized for AAT; and (2) to compare these outcomes with children with noninflicted abdominal trauma. Hospitalization data for children aged 0 to 9 years were obtained from the 2003 and 2006 Kids' Inpatient Database. Cases were identified using International Classification of Diseases, Ninth Revision, Clinical Modification and external cause of injury codes. Multivariable regression analyses were used to compare outcomes of children with AAT versus those with noninflicted injury. Children with AAT were younger, and more often insured by Medicaid. Among children surviving to discharge, those with AAT had longer hospitalizations (adjusted mean [95% confidence interval (CI)] length of stay: 7.9 (6.6-9.3) vs 6.4 (6.1-6.7) days, P assist families at risk should be supported.

Tobacco control policies and perinatal and child health: a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Timor Faber

2018-03-01

Full Text Available Background Tobacco smoking and smoke exposure during pregnancy and childhood cause considerable childhood morbidity and mortality. We aimed to determine whether implementation of the World Health Organization's recommended tobacco control policies (MPOWER were of benefit to perinatal and child health. Methods We searched 19 electronic databases, hand-searched references and citations, and consulted experts to identify (quasi-experimental studies assessing the association between implementation of MPOWER policies and child health. Our primary outcomes of interest were: perinatal mortality, preterm birth, hospital attendance for asthma exacerbations, and hospital attendance for respiratory tract infections (RTIs. Where possible and appropriate, we combined data from different studies in random-effects meta-analyses. Results We identified 41 eligible studies that assessed (combinations of MPOWER policies: smoke-free legislation (n=35, tobacco taxation (n=11, and smoking cessation services (n=3. Following implementation of smoke-free legislation, rates of preterm birth decreased by -3.77% (10 studies, 27,530,183 individuals; 95%CI -6.37 to -1.16, hospital attendance for asthma exacerbations decreased by -9.83% (five studies, 684,826 events; 95%CI -16.62 to -3.04, and hospital attendance for RTIs decreased by -3.45% (two studies, 1,681,020 events; 95%CI -4.64, -2.25 for all RTIs, and by -18.48% (three studies, 887,414 events; 95%CI -32.79 to -4.17 for lower RTIs. Associations appeared to be stronger when comprehensive smoke-free laws were implemented. Among two studies assessing the association between smoke-free legislation and perinatal mortality, one demonstrated significant reductions in stillbirth and neonatal mortality. Meta-analysis of studies on other MPOWER policies was not possible; all four studies on increasing tobacco taxation and one of two on offering disadvantaged pregnant women help to quit smoking that reported on our primary

Identification and selection of cases and controls in the Pneumonia Etiology Research for Child Health project

NARCIS (Netherlands)

Deloria-Knoll, Maria; Feikin, Daniel R.; Scott, J. Anthony G.; O'Brien, Katherine L.; DeLuca, Andrea N.; Driscoll, Amanda J.; Levine, Orin S.; Black, Robert E.; Bhutta, Zulfiqar A.; Campbell, Harry; Cherian, Thomas; Crook, Derrick W.; de Jong, Menno D.; Dowell, Scott F.; Graham, Stephen M.; Klugman, Keith P.; Lanata, Claudio F.; Madhi, Shabir A.; Martin, Paul; Nataro, James P.; Piazza, Franco M.; Qazi, Shamim A.; Zar, Heather J.; Baggett, Henry C.; Brooks, W. Abdullah; Chipeta, James; Ebruke, Bernard; Endtz, Hubert P.; Groome, Michelle; Hammitt, Laura L.; Howie, Stephen R. C.; Kotloff, Karen; Maloney, Susan A.; Moore, David; Otieno, Juliet; Seidenberg, Phil; Tapia, Milagritos; Thamthitiwat, Somsak; Thea, Donald M.; Zaman, Khaleque

2012-01-01

Methods for the identification and selection of patients (cases) with severe or very severe pneumonia and controls for the Pneumonia Etiology Research for Child Health (PERCH) project were needed. Issues considered include eligibility criteria and sampling strategies, whether to enroll hospital or

An epidemiological perspective on gastroenteritis in child day care centers : Assessment of impact and risk

NARCIS (Netherlands)

Enserink, R.

2014-01-01

The impact of gastroenteritis related to Dutch DCCs is substantial, particularly among the very young attendees. Attending a DCC roughly doubles a child’s probability of experiencing an episode of gastroenteritis that requires a visit to a general practitioner or hospital. A child might experience a

Controlled study of child health supervision: behavioral results.

Science.gov (United States)

Guteilus, M F; Kirsch, A D; MacDonald, S; Brooks, M R; McErlean, T

1977-09-01

Extensive child health supervision, with emphasis on counseling and anticipatory guidance, was provided for the first three years of life to an experimental series of 47 normal first-born black infants from low-income families living in the environs of Children's Hospital in Washington, D.C. The mothers were unmarried schoolgirls in normal physical and mental health. A control series consisted of 48 similar mother-child dyads from the same area. Data were collected, in part by an outside evaluator, at yearly intervals on both experimental and control series in a form suitable for coding on computer cards. Comparison of differences in behavioral results between the two series showed statistically significant findings in favor of the experimental children, as well as numerous favorable trends during the first six years of life. Positive effects became evident in diet and eating, habits, in some developmental problems of growing up (such as toilet training), and in certain abstract qualities including self-confidence. Significant differences were also noted between the experimental and control mothers for various child rearing practices and personality characteristics. No significant difference or trend favored the control series. We believe that a causal relationship existed between the intervention and at least some of the significant findings.

Parental leave: comparing children's hospitals with Fortune 500 companies.

Science.gov (United States)

Weiss, A H; Gordon, E J; O'Connor, M E

1998-07-01

To identify parental leave policies and availability of support systems for new parents employed by children's hospitals and compare these benefits with those offered by Fortune 500 companies. Telephone or facsimile survey of all (n=118) children's hospitals and pediatric medical centers in the National Association of Children's Hospitals and Related Institutions 1995 Directory of Members, and 118 geographically matched Fortune 500 companies. Policies for maternity and paternity leave, adoption benefits, and support services for new parents were compared. Ninety-four children's hospitals (80%) and 82 Fortune 500 companies (69%) responded to the survey. No difference in duration of maternity (P>.30) or paternity (P=.12) leave was found. Sixty-two companies (77%) classified maternity leave as short-term disability while 47 hospitals (50%) classified it as sick time (Pleave as short-term disability generally gives better benefits to employees with short duration of service, whereas classifying maternity leave as sick time usually favors employees with longer employment. Companies provided more financial support for adoption expenses (Ppaid or unpaid leave for adoption (P=.14). Hospitals provided more on-site day care (69% vs 42%; Pparental leave benefits than Fortune 500 companies; however, they offer better support systems for parents returning to work after the birth of a child.

ABC of child abuse. Role of the child psychiatry team.

OpenAIRE

Nicol, A. R.

1989-01-01

In summary, a child psychiatrist can make an important contribution to the management of child abuse. At least one child psychiatrist in each district should take an interest in this work and should be given the time to do so. As for other professionals, child abuse is an aspect of the work of child psychiatrists that is particularly harrowing and time consuming.

Parents' perceptions of child abuse and child discipline in Bangkok, Thailand.

Science.gov (United States)

Auemaneekul, Naruemon

2013-12-01

Violation of a child's right to protection is an issue for children all over the world. In Thailand, the greatest barrier to intervening in child abuse issues is the lack of awareness and the positive attitudes and beliefs on using violence as a way to discipline children. The incongruent definition used amongst Thai society and relevant sectors, causes incidences to be under reported and an obstacle to child survival and development. The present study is a qualitative study and aims to explore the perceptions of child abuse and child discipline definitions amongst parents in the Bangkok Metropolitan Area in order to extend broader knowledge for interpretation, definitions and to differentiate the line between child abuse and child discipline. Focus group discussions were used as the primary data collection method and content analysis was applied as the data analysis. The results produced two categories of parents' perceptions regarding child abuse and discipline. First, was the perception of the causes of child punishment and child discipline, and second was the meaning and difference between child abuse and child discipline. The study results would be beneficial for policy makers, health and related sectors to understand the meaning of the terms used amongst family members in order to apply and promote child protection strategies in culturally appropriate

Child labor in the US

Directory of Open Access Journals (Sweden)

Wegmann David

2003-01-01

Full Text Available This paper presents a report on child labor in the U.S. that reviewed the positive and negative aspects of work for youth. Working was found to provide young people with valuable lessons about responsibility, punctuality, interacting with people and learning about money management, increasing self-esteem and helping them become independent and skilled. Research findings suggested that working during high school may contribute to increased rates of employment and better wages up to a decade after high school completion. Research concerning the hazards associated with work indicated that, each year, tens of thousands of young people are seen in hospital emergency departments for work-related injuries, hundreds require hospitalization, and more than 70 die of work-related injuries. Long work hours during the school year were associated with problem behaviors. The report points out some important questions: updating regulations on allowable work hours, eliminating less stringent regulation of agricultural work, revising outdated rules against hazardous work, developing and implementing a comprehensive plan for monitoring the injuries, illnesses, and hazards, building workplace health and safety information into school-based programs, and developing criteria for designating "commendable workplaces for youth."

Health impact assessments in hospital community benefit: A multiple case study of the use of HIAs at Children’s Hospital Colorado

Directory of Open Access Journals (Sweden)

Gregory Jackson Tung

2017-09-01

Full Text Available Objective:  To explore the use of Health Impact Assessments (HIAs within non-profit hospital community benefit activities. Methods:  We constructed case studies of three HIAs that were conducted in collaboration with Children’s Hospital Colorado as part of the hospital’s community benefit portfolio. These HIAs were part of a pilot that was funded by the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. Results:  HIAs provided Children’s Hospital Colorado with a transparent and systematic process for generating evidence-based recommendations with community and stakeholder feedback within the hospital’s community benefit activities. HIAs were used to generate recommendations to inform community benefit planning activities and to generate public policy recommendations to enhance child health. The case studies highlighted several issues that need to be addressed in order to further advance the use of HIA within hospital community benefit activities including: use of HIA on explicit health issues, hospital capacity for HIA, potentially broadening the scope of HIA recommendations, and the use of HIA to generate recommendations from broad priority areas. Conclusion: HIAs can help meet the need for established, evidence-based, and stakeholder responsive tools and processes to be used within non-profit hospital community benefit activities. In meeting this need, the non-profit hospital community benefit area can potentially serve as a major institutional home for the practice of HIA. There is a need for additional research and practice innovation to further explore and refine the use of HIA within non-profit hospital community benefit activities.

Compliance with the vaccination schedule in children hospitalized with pneumonia and associated factors

Science.gov (United States)

da Silva, Amanda Tabosa Pereira; Lima, Eduardo Jorge da Fonseca; Caminha, Maria de Fátima Costa; da Silva, Andresa Tabosa Pereira; Rodrigues, Edil de Albuquerque; dos Santos, Carmina Silva

2018-01-01

ABSTRACT OBJECTIVE: To verify the adequacy and factors associated with compliance with the immunization schedule (BCG, DTP-Hib, MMR, PCV-10) in children hospitalized with pneumonia at a pediatric referral hospital in Northeast Brazil. METHODS: This is a cross-sectional, descriptive study with an analytical component, with a sample of 452 children hospitalized with pneumonia at the Instituto de Medicina Integral Prof. Fernando Figueira, between 2010 and 2013. The inclusion criterion was children aged from one month to less than five years of age with proof in the immunization record. The exclusion criterion was the presence of hospital-acquired pneumonia or concomitant disease. We have evaluated the adequacy of the immunization schedule for the BCG, tetravalent, MMR, and 10-valent pneumococcal conjugate (PCV-10) vaccines. We used the chi-square test and Fisher's exact test followed by multivariate Poisson regression, estimating the crude and adjusted prevalence ratios and respective 95% confidence intervals. The variables with p < 0.20 in the univariate analysis were included in the multivariate analysis. RESULTS: There was good adequacy in the immunization schedule, except for PCV-10, which presented a percentage lower than 85%. We have observed an association between adequate compliance with the immunization schedule and education level of the mother (89.9% complete high school), sex of the child (87.2% female), age of the child (94.2% younger than six months), and breastfeeding (84.3% breastfed). CONCLUSIONS: Given the high rate of education level of the mother and the high percentage of breastfeeding, we can understand that there is a better understanding of the health of the child by the mothers studied in this study, showing the effectiveness of public policies for infant feeding. However, children did not have good adequacy of the immunization schedule of PCV-10, one of the main vaccines against pneumonia, which can be one of the main factors in the causes of

New hospital-based policy for children whose parents present at the ER due to domestic violence, substance abuse and/or a suicide attempt

NARCIS (Netherlands)

Hoytema van Konijnenburg, Eva M. M.; Sieswerda-Hoogendoorn, Tessa; Brilleslijper-Kater, Sonja N.; van der Lee, Johanna H.; Teeuw, Arianne H.

2013-01-01

Child maltreatment is a major social problem with many adverse consequences, and a substantial number of maltreated children are not identified by health care professionals. In 2010, in order to improve the identification of maltreated children in hospitals, a new hospital-based policy was developed

Maternal depression and anxiety disorders (MDAD and child development: A Manitoba population-based study.

Directory of Open Access Journals (Sweden)

Brenda Comaskey

Full Text Available To examine the association between maternal depression and anxiety disorders (MDAD and child development assessed during the kindergarten year.Administrative data from several health and social databases in Manitoba, Canada, were used to study 18,331 mother-child pairs. MDAD over the period from one year prior to the child's birth to the kindergarten year was defined using physician diagnoses and filled prescriptions. Child development was assessed during the kindergarten year using the Early Development Instrument (EDI which measures vulnerability across five domains of development. Structural equation modeling was used to examine associations between timing, recurrence and severity of MDAD and child outcomes. Health at Birth (preterm, low birth weight, neonatal intensive care stay and long birth hospitalization, Family Context (teen mother, lone parent, socio-economic status (SES, child age and child sex were covariates.MDAD had a modest negative association with child EDI scores across all models tested, particularly for social, emotional and physical development. Prenatal MDAD had a stronger negative association with outcomes than other time periods; however, recurrent MDAD had a stronger negative association with outcomes than any specific time period or MDAD severity. The influence of MDAD was mediated by Family Context, which had a strong, negative association with outcomes, particularly language and cognitive development.The number of time periods a child was exposed to MDAD in early childhood was more negatively associated with five areas of child development than timing or severity. Prenatal exposure may be more sensitive to MDAD than other time periods. The familial context (teen mother, lone parenthood and low SES had a stronger influence on child outcomes than MDAD. Findings can be used to inform interventions which address maternal mental health from the prenatal period onward, and to support disadvantaged families to encourage

Practical use and implementation of PET in children in a hospital PET centre

DEFF Research Database (Denmark)

Borgwardt, Lise; Larsen, Helle Jung; Pedersen, Kate

2003-01-01

Children are not just small adults-they differ in their psychology, normal physiology and pathophysiology, and various aspects should be considered when planning a positron emission tomography (PET) scan in a child. PET in children is a growing area, and this article describes the practical use...... and implementation of PET in children in a hospital PET centre. It is intended to be of use to nuclear medicine departments implementing or starting to implement PET scans in children. Topics covered are: dealing with children, dosimetry, organisation within the department and relations with other departments......, preparation of the child (provision of information to the child and parents and the fasting procedure), the imaging procedure (resting, tracer injection, positioning, sedation and bladder emptying) and pitfalls in the interpretation of PET scans in children, including experiences with telemedicine....

Practical use and implementation of PET in children in a hospital PET centre

International Nuclear Information System (INIS)

Borgwardt, Lise; Larsen, Helle Jung; Pedersen, Kate; Hoejgaard, Liselotte

2003-01-01

Children are not just small adults - they differ in their psychology, normal physiology and pathophysiology, and various aspects should be considered when planning a positron emission tomography (PET) scan in a child. PET in children is a growing area, and this article describes the practical use and implementation of PET in children in a hospital PET centre. It is intended to be of use to nuclear medicine departments implementing or starting to implement PET scans in children. Topics covered are: dealing with children, dosimetry, organisation within the department and relations with other departments, preparation of the child (provision of information to the child and parents and the fasting procedure), the imaging procedure (resting, tracer injection, positioning, sedation and bladder emptying) and pitfalls in the interpretation of PET scans in children, including experiences with telemedicine. (orig.)

Practical use and implementation of PET in children in a hospital PET centre

Energy Technology Data Exchange (ETDEWEB)

Borgwardt, Lise; Larsen, Helle Jung; Pedersen, Kate; Hoejgaard, Liselotte [Department of Clinical Physiology, Nuclear Medicine and PET, University Hospital of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen (Denmark)

2003-10-01

Children are not just small adults - they differ in their psychology, normal physiology and pathophysiology, and various aspects should be considered when planning a positron emission tomography (PET) scan in a child. PET in children is a growing area, and this article describes the practical use and implementation of PET in children in a hospital PET centre. It is intended to be of use to nuclear medicine departments implementing or starting to implement PET scans in children. Topics covered are: dealing with children, dosimetry, organisation within the department and relations with other departments, preparation of the child (provision of information to the child and parents and the fasting procedure), the imaging procedure (resting, tracer injection, positioning, sedation and bladder emptying) and pitfalls in the interpretation of PET scans in children, including experiences with telemedicine. (orig.)

A review of infant and young child feeding practice in hospital and ...

African Journals Online (AJOL)

Early complementary feeding is a problem in the Midlands. This study has identified that age-specific feeding of infants and young children is not recognised in state hospitals, due to the inadequate frequency of feeding. There is a discrepancy between intention and practice among healthcare professionals in feeding ...

Sluggish cognitive tempo is associated with suicide risk in psychiatrically hospitalized children.

Science.gov (United States)

Becker, Stephen P; Withrow, Amanda R; Stoppelbein, Laura; Luebbe, Aaron M; Fite, Paula J; Greening, Leilani

2016-12-01

Although identified as a significant public health concern, few studies have examined correlates of suicide risk in school-aged children. Recent studies show a relation between sluggish cognitive tempo (SCT) symptoms and a range of adverse outcomes linked to suicidal ideation, including depression, emotion dysregulation, lowered self-esteem, and peer problems/social withdrawal, yet no study to date has examined SCT in relation to suicide risk. We tested the hypothesis that SCT would be associated with suicide risk in a sample of 95 psychiatrically hospitalized children (74% male; 62% black) between the ages of 8 and 12 (M = 10.01, SD = 1.50). Parents completed measures of their child's psychiatric symptoms, including SCT and depression, as well as a measure of their own psychopathology. Children completed measures assessing loneliness and depression. Both parents and children completed measures of suicide risk. White children reported greater suicide risk than nonwhite children. After controlling for demographic characteristics, loneliness, parental psychopathology, and correlated psychiatric symptoms, including both parent- and child self-reported depressive symptoms, SCT remained uniquely associated with children's suicide risk. Results were consistent across both parent and child measures of suicide risk. This multi-informant study provides strong preliminary support for an association between SCT symptoms and suicide risk in psychiatrically hospitalized children, above and beyond loneliness, depression, and demographic characteristics. Findings are discussed in the context of the interpersonal theory of suicide. Additional studies are needed to replicate and extend these findings, with a particular need for studies that examine the cognitive processes and daydreaming content of individuals displaying elevated SCT symptomatology. © 2016 Association for Child and Adolescent Mental Health.

Child-Mother and Child-Father Play Interaction Patterns with Preschoolers

Science.gov (United States)

John, Aesha; Halliburton, Amy; Humphrey, Jeremy

2013-01-01

The study focused on qualitative and quantitative differences between maternal and paternal play interaction behaviours with their preschool children. Home observations of 18 child-mother and child-father play interactions were qualitatively analysed to derive interaction themes. In addition, the quality of child-mother and child-father…

Stress and epilepsy: a population-based cohort study of epilepsy in parents who lost a child

DEFF Research Database (Denmark)

Christensen, Jakob; Li, Jiong; Vestergaard, Mogens

2007-01-01

OBJECTIVE: The goal of the study described here was to study the risk for epilepsy in parents exposed to severe stress caused by loss of a child. METHODS: The risk of being diagnosed with epilepsy (Danish National Hospital Register) in a cohort of parents who had lost a child under the age of 18...... was compared with the risk among parents who had not lost a child. RESULTS: The adjusted relative risk (RR) of epilepsy in parents who had lost a child was 1.50 (95% CI: 1.21-1.86). The RR was modified by time since bereavement and was 2.46 (95% CI: 1.49-4.07) in mothers and 1.92 (95% CI: 1.09-3.36) in fathers...... within the first 3 years of loss of a child, and 2.10 (95% CI: 1.53-2.88) in mothers and 0.66 (95% CI: 0.41-1.06) in fathers 4 to 18 years after loss. CONCLUSIONS: Stress was associated with a moderately increased risk of being diagnosed with epilepsy. Udgivelsesdato: 2007-Nov...

No hospital left behind? Education policy lessons for value-based payment in healthcare.

Science.gov (United States)

Maurer, Kristin A; Ryan, Andrew M

2016-01-01

Value-based payment systems have been widely implemented in healthcare in an effort to improve the quality of care. However, these programs have not broadly improved quality, and some evidence suggests that they may increase inequities in care. No Child Left Behind is a parallel effort in education to address uneven achievement and inequalities. Yet, by penalizing the lowest performers, No Child Left Behind's approach to accountability has led to a number of unintended consequences. This article draws lessons from education policy, arguing that financial incentives should be designed to support the lowest performers to improve quality. © 2015 Society of Hospital Medicine.

Maternal-child health fellowship: maintaining the rigor of family medicine obstetrics.

Science.gov (United States)

Magee, Susanna R; Radlinski, Heidi; Nothnagle, Melissa

2015-01-01

The United States has a growing shortage of maternity care providers. Family medicine maternity care fellowships can address this growing problem by training family physicians to manage high-risk pregnancies and perform cesarean deliveries. This paper describes the impact of one such program-the Maternal Child Health (MCH) Fellowship through the Department of Family Medicine at Brown University and the careers of its graduates over 20 years (1991--2011). Fellowship graduates were mailed a survey regarding their training, current practice and teaching roles, and career satisfaction. Seventeen of 23 fellows (74%) responded to the survey. The majority of our fellowship graduates provide maternity care. Half of our respondents are primary surgeons in cesarean sections, and the majority of these work in community hospitals. Nearly all of our graduates maintain academic appointments and teach actively in their respective departments of family medicine. Our maternal child health fellowship provides family physicians with the opportunity to develop advanced skills needed to provide maternity care for underserved communities and teaching skills to train the next generation of maternal child health care providers.

Child Labor: A Forgotten Focus for Child Welfare.

Science.gov (United States)

Otis, Jack; Pasztor, Eileen Mayers; McFadden, Emily Jean

2001-01-01

Discusses the worldwide problem of child labor and efforts to advocate for the welfare of these impoverished children. Considers factors that contribute to the continued use of child labor and the resistance of these labor practices to reform. Discusses child labor in the United States, and urges public advocacy for labor reform within child…

[Influence of malnutrition on childhood mortality in a rural hospital in Rwanda].

Science.gov (United States)

Ngirabega, J-d-D; Munyanshongore, C; Donnen, P; Dramaix, M

2011-10-01

Recent estimates of the role of malnutrition on childhood mortality have led to a call for action by decision makers in the fight against child malnutrition. Further evaluation is needed to assess the burden of malnutrition in terms of morbidity and mortality, as well as to assess the impact of various interventions. The objective of this study is to determine the effect of malnutrition on mortality in a pediatric service of a rural hospital in Rwanda. A prospective cohort study included children aged 6-59 months coming from the catchment area of the hospital and admitted to the pediatric ward between January 2008 and June 2009. Anthropometric, clinical and biological data were gathered at the time of admission. The effect of malnutrition at the time of admission on mortality during hospitalization was analyzed by using logistic regression. At the time of admission, the prevalences of wasting, underweight and stunting among children was 14.2%, 37.5% and 57.3% respectively. Fifty-six children died during hospitalization. The period mortality rate was 6.9%. After adjustment for age, sex, malaria thick smear and breathing with chest retractions, death was associated with underweight and stunting with adjusted odds rations of 4.6 (IC95% 2.5-8.4) and 4.0 (IC95% 2.0-8.2) respectively. The study confirmed the influence of malnutrition on child mortality in pediatrics wards. These results can be of great help for improving the awareness of the community decision-makers in the fight to prevent malnutrition. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Child Bride and Child Sex: Combating Child Marriages in Nigeria ...

African Journals Online (AJOL)

This paper considers the basis of child marriages in Northern Nigeria. It is an Islamic practice rooted in the interpretation of the Quran. Significantly, the caveat that copulation should be delayed until such girls are mature is often ignored as these child brides are engaged in sex. This paper analyzes the report of a Senator in ...

Management of physical child abuse in South Africa:Literature review and children's hospital data analysis

NARCIS (Netherlands)

Janssen, T.L. (T. L.); M. van Dijk (Monique); Al Malki, I. (I.); A.B. van As (Àrjan Bastiaan)

2013-01-01

textabstractBackground: The reason for this review is the lack of data on the management of physical abused children in Africa. The primary goal of the first part is to outline the management of physical child abuse in (South) Africa and provide suggestions for other governments in Africa on which

[Neoliberalism in health: the torture of the health care workers of the Bogota's Instituto Materno Infantil (child and maternity hospital)].

Science.gov (United States)

Abadía, César B; Pinilla, María Y A; Ariza, Katerine R; Ruíz, Héctor C S

2012-06-01

To link, from a historical point of view, the most significant transformations of the Instituto Materno Infantil (IMI) [the oldest child and maternity hospital of the country] during its process of crisis, closure and liquidation with the experiences of the hospital workers. To find experience-based and theoretical elements that can interconnect the process of health care privatization of the country with the workers' experiences of resistance and pain/suffering. Critically-oriented ethnography based on continuous collective field work, historical research (primary and secondary sources) and semi-structured interviews with 5 women who worked at the IMI for more than 15 years. A time line of 4 main periods: Los años de gloria [The golden years] (up to 1990); Llega el neoliberalismo [Neoliberalism arrives] (1990-2000); La crisis y las resistencias [Crisis and resistances] (2001-2005); and Liquidación [Liquidation (2006-20??)]. The narratives of the interviewed women unveil multiple aggressions that have intensified since 2006, have caused pain and suffering and are examples of violations of human and labour rights. We suggest to analyze the links between the different kinds of violence and pain and suffering as torture. This category is defined as the set of violent actions that cause physical and emotional pain, which are performed by actors in positions of power over other people who challenge that power and are part of modern States' ideological principles around a defined moral social order. For the IMI workers' case, the ideological principle that is being challenged is health care neoliberalism. From the analyses of bureaucracy, confinement, torturing agents, and the breaking-off of the body-mind unit we conclude that this relationship between neoliberalism and torture aims to eliminate the last health care workers of the country who had job stability and full-benefits through public labour contracts. Their elimination furthers the accumulation of capital

Differentiation of homicidal child molesters, nonhomicidal child molesters, and nonoffenders by phallometry.

Science.gov (United States)

Firestone, P; Bradford, J M; Greenberg, D M; Nunes, K L

2000-11-01

The purpose of this study was to examine the ability of phallometry to discriminate among homicidal child molesters, nonhomicidal child molesters, and a comparison group of nonoffenders. Twenty-seven child molesters who had committed or had attempted a sexually motivated homicide, 189 nonhomicidal child molesters, and 47 nonoffenders were compared on demographic variables and psychometrically determined responses to aural descriptions of sexual vignettes. Two phallometric indexes were used: the pedophile index and the pedophile assault index. The pedophile index was computed by dividing the subject's highest response to an aural description of sex with a "consenting" child by his highest response to description of sex with a consenting adult. The pedophile assault index was computed by dividing the subject's highest response to an aural description of assault involving a child victim by his highest response to description of sex with a "consenting" child. Homicidal child molesters, nonhomicidal child molesters, and nonoffenders were not significantly different in age or IQ. Homicidal and nonhomicidal child molesters had significantly higher pedophile index scores than nonoffenders. Significantly more homicidal child molesters (14 [52%] of 27) and nonhomicidal child molesters (82 [46%] of 180) than nonoffenders (13 [28%] of 47) had pedophile index scores equal to or greater than 1.0, but homicidal and nonhomicidal child molesters did not differ from each other. Significantly more homicidal child molesters (17 [63%] of 27) than either nonhomicidal child molesters (71 [40%] of 178) or nonoffenders (17 [36%] of 47) had pedophile assault index scores equal to or greater than 1.0, and nonhomicidal child molesters and nonoffenders were not significantly different from each other. Within-group analyses revealed that of the three groups, only the nonhomicidal child molesters exhibited a significant difference between their pedophile index scores and their pedophile assault

Impact of a Baby-Friendly hospital on breastfeeding indicators in Shaqlawa district in Erbil governorate, Kurdistan region of Iraq.

Science.gov (United States)

Shaker, N Z; Hasan, S S; Ismail, Z A

2016-03-15

This study aimed to assess the impact of the Baby-Friendly Hospital Initiative on WHO-defined breastfeeding indicators in Shaqlawa district in Kurdistan region of Iraq. A household survey was carried out on a purposive non-probability sample of 200 mothers with a child aged < 30 months. Mothers were interviewed using a structured form to determine demographic data and feeding practices of the most recent child. The rate of early initiation of breastfeeding was 38.1%, exclusive breastfeeding was 15.4% and continued breastfeeding was 61.0% and 39.5% at 1 and 2 years of age respectively. A significant relationship was found between delivery at the Baby- Friendly accredited hospital and early initiation of breastfeeding but not with exclusive or continued breastfeeding. While continued breastfeeding at 1 year and 2 year was good, early initiation and exclusive breastfeeding indicators were not at an acceptable level, which indicates an ineffective role for the Baby-Friendly Hospital Initiative.

Radiation protection for the parent and child in diagnostic nuclear medicine

International Nuclear Information System (INIS)

Mountford, P.J.

1991-01-01

Administration of a radiopharmaceutical to a parent or child for diagnostic purposes will result in certain specific radiation hazards, yet it can yield information vital to patient management. These hazards have been cited as a reason for the reluctance of some referring clinicians and, indeed, nuclear medicine practitioners to exploit paediatric radiopharmaceutical investigations (Piepsz et al. 1991). Ignorance of these hazards has the following consequences. Firstly, a valuable diagnostic procedure could be denied to a parent or child patient without justification, thereby compromising their management. Secondly, inappropriate recommendations could result in either excessive restrictions or an unnecessarily high radiation dose to a patient's family and to hospital staff. All members of a nuclear medicine service should be familiar with these radiation risks in order to provide appropriate guidance and to dispel any unwarranted fears. (orig.)

Feasibility of integrated home/hospital physiotherapeutic support for children with cancer.

Science.gov (United States)

Savio, Christian; Garaventa, Alberto; Gremmo, Marina; Camoriano, Riccardo; Manfredini, Luca; Fieramosca, Sara; Dini, Giorgio; Miano, Maurizio

2007-01-01

Children suffering from cancer often have to undergo physiotherapy that either extends the duration of in-patient hospitalisation or requires more frequent visits to the outpatient clinic. To improve care and to decrease the length of hospitalisation of children being treated at the Dept. of Haematoloy/Oncology of the Gaslini Children's Hospital, a programme of Home Care was set up in April 2000. In June 2003, rehabilitation was added to the procedures that were feasible at home and included i.v. therapy administration, blood examinations, transfusion and/or psychological support, as well as palliative care for terminally ill children. The physiotherapy sessions were done in the ward, in the Rehabilitation Unit Gym, or at home, depending on the clinical conditions and the needs of the child and the family. Between June 2003 and May 2005, 46 children, whose median age was 7 years (range 6 months-21 years) suffering from CNS tumours (13), leukaemia (13), neuroblastoma (7), bone tumours (6), sarcoma (4) and lymphoma (3), underwent 1,398 physiotherapy sessions for neuro-motor re-education (534), motor rehabilitation (485), strain re-education and training (250), respiratory care (79), or to improve comfort during the terminal phase of the disease (50). To maintain continuity of care, the treatments were performed at home (931), in the hospital ward (282), or in the gymnasium of our Physiotherapy Service (185). The physiotherapist was able to start or to continue assistance at home or in the hospital, and to keep up the programme based on the child's needs. Integrated home/hospital physiotherapy for children suffering from cancer is feasible and is useful for maintaining continuity of treatment without lengthening hospitalisation.

The Rise and Need for Mobile Apps for Maternal and Child Health Care in China: Survey Based on App Markets.

Science.gov (United States)

Zhang, Puhong; Dong, Le; Chen, Huan; Chai, Yanling; Liu, Jianbo

2018-06-08

-monitoring," the researchers found 47 specific tools supporting activities such as pregnancy preparation, fetal heart monitoring, blood glucose and blood pressure monitoring, and doctor visits. A few apps were equipped with external devices (n=3) or sensors. No app with intelligent decision-support features to support disease management for conditions such as gestational diabetes and pregnancy-induced hypertension was found. A small number of apps (n=5) had a Web connection with hospital information systems to support appointment making, payments, hospital service guidance, or checking of laboratory results. There are thousands of maternal and child health apps in the Chinese market. Child care, pregnancy, and before pregnancy were the mostly covered maternal and child health stages, in that order. Various app features and tools were adopted by maternal and child health apps, but the use of internal or external sensors, intelligent decision support, and tethering with existing hospital information systems was rare and these features need more research and development. ©Puhong Zhang, Le Dong, Huan Chen, Yanling Chai, Jianbo Liu. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 08.06.2018.

Evaluation of risk factors for severe pneumonia in children: the Pneumonia Etiology Research for Child Health study

NARCIS (Netherlands)

Wonodi, Chizoba B.; Deloria-Knoll, Maria; Feikin, Daniel R.; DeLuca, Andrea N.; Driscoll, Amanda J.; Moïsi, Jennifer C.; Johnson, Hope L.; Murdoch, David R.; O'Brien, Katherine L.; Levine, Orin S.; Scott, J. Anthony G.; Black, Robert E.; Bhutta, Zulfiqar A.; Campbell, Harry; Cherian, Thomas; Crook, Derrick W.; de Jong, Menno D.; Dowell, Scott F.; Graham, Stephen M.; Klugman, Keith P.; Lanata, Claudio F.; Madhi, Shabir A.; Martin, Paul; Nataro, James P.; Piazza, Franco M.; Qazi, Shamim A.; Zar, Heather J.; Baggett, Henry C.; Brooks, W. Abdullah; Chipeta, James; Ebruke, Bernard; Endtz, Hubert P.; Groome, Michelle; Hammitt, Laura L.; Howie, Stephen R. C.; Kotloff, Karen; Maloney, Susan A.; Moore, David; Otieno, Juliet; Seidenberg, Phil; Tapia, Milagritos; Thamthitiwat, Somsak; Thea, Donald M.; Zaman, Khaleque

2012-01-01

As a case-control study of etiology, the Pneumonia Etiology Research for Child Health (PERCH) project also provides an opportunity to assess the risk factors for severe pneumonia in hospitalized children at 7 sites. We identified relevant risk factors by literature review and iterative expert

Risk factors for preterm birth in five Maternal and Child Health hospitals in Beijing.

Directory of Open Access Journals (Sweden)

Yun-Ping Zhang

Full Text Available BACKGROUND: Preterm birth, the birth of an infant prior to 37 completed weeks of gestation, is the leading cause of perinatal morbidity and mortality. Preterm infants are at greater risk of respiratory, gastrointestinal and neurological diseases. Despite significant research in developed countries, little is known about the causes of preterm birth in many developing countries, especially China. This study investigates the association between sciodemographic data, obstetric risk factor, and preterm birth in five Maternal and Child Health hospitals in Beijing, China. METHODS AND FINDINGS: A case-control study was conducted on 1391 women with preterm birth (case group and 1391 women with term delivery (control group, who were interviewed within 48 hours of delivery. Sixteen potential factors were investigated and statistical analysis was performed by univariate analysis and logistic regression analysis. Univariate analysis showed that 14 of the 16 factors were associated with preterm birth. Inter-pregnancy interval and inherited diseases were not risk factors. Logistic regression analysis showed that obesity (odds ratio (OR = 3.030, 95% confidence interval (CI 1.166-7.869, stressful life events (OR = 5.535, 95%CI 2.315-13.231, sexual activity (OR = 1.674, 95%CI 1.279-2.191, placenta previa (OR 13.577, 95%CI 2.563-71.912, gestational diabetes mellitus (OR = 3.441, 95%CI1.694-6.991, hypertensive disorder complicating pregnancy (OR = 6.034, 95%CI = 3.401-10.704, history of preterm birth (OR = 20.888, 95%CI 2.519-173.218 and reproductive abnormalities (OR = 3.049, 95%CI 1.010-9.206 were independent risk factors. Women who lived in towns and cities (OR = 0.603, 95%CI 0.430-0.846, had a balanced diet (OR = 0.533, 95%CI 0.421-0.675 and had a record of prenatal care (OR = 0.261, 95%CI 0.134-0.510 were less likely to have preterm birth. CONCLUSIONS: Obesity, stressful life events, sexual activity, placenta previa

Stressful Life Events and Child Anxiety: Examining Parent and Child Mediators

Science.gov (United States)

Platt, Rheanna; Williams, Sarah R.; Ginsburg, Golda S.

2015-01-01

While a number of factors have been linked with excessive anxiety (e.g., parenting, child temperament), the impact of stressful life events remains under-studied. Moreover, much of this literature has examined bivariate associations rather than testing more complex theoretical models. The current study extends the literature on life events and child anxiety by testing a theory-driven meditational model. Specifically, one child factor (child cognitions/locus of control), two parent factors (parent psychopathology and parenting stress), and two parent-child relationship factors (parent-child dysfunctional interaction and parenting style) were examined as mediators in the relationship between stressful life events and severity of child anxiety. One hundred and thirty anxious parents and their nonanxious, high-risk children (ages ranged from 7 to 13 years) participated in this study. Results indicated that levels of parenting stress, parental anxious rearing, and dysfunctional parent-child interaction mediated the association between stressful life events and severity of anxiety symptoms. Child cognition and parent psychopathology factors failed to emerge as mediators. Findings provide support for more complex theoretical models linking life events and child anxiety and suggest potential targets of intervention. PMID:25772523

Reports of Child Abuse in India from Scientific Journals and Newspapers - An Exploratory Study

Directory of Open Access Journals (Sweden)

Nalini PR

2014-02-01

Full Text Available Background: Child abuse is a state of emotional, physical, economic and sexual maltreatment meted out to a person below the age of eighteen and is a globally prevalent phenomenon. A total of 33,098 cases of crimes against children were reported in India during 2011 as compared to 26,694 cases during 2010, suggesting a recent increase of 24 percent. Objectives: To explore the contents of the published articles/reports on child abuse in India from scientific journals and newspapers identifying areas and gaps for further research and program development. Material and Methods: Published articles in scientific journals during the years 2007-2012 with free access and online versions of English newspapers (2007-2012 in India were searched using the search engines such as ‘PubMed’ and ‘Google’. The key words used were ‘child abuse in (on, about India. First two researchers independently reviewed the content of articles/newspaper reports and decided the categories emerging from the articles and reports. Later on, the quantification of these categories was done by identifying the number of times it was reported in the reports. Results: The nature and extent of reporting child abuse in scientific journal is different from that of newspapers. In Journals, our search provided us with 9 articles, of which prevalence studies were predominant (4 followed by case reports (3 and Knowledge, Attitude, Practice studies (2. The studies were mostly conducted in the hospital setting. We obtained 38 reports from newspapers. Child abuse was found more among girls. Among type of abuse, sexual abuse was more common (84.2%. About 52.6% of the abusers were members known to the victim. The maximum cases were reported from West India especially in Goa, followed by South region. Most reports reported legal action on accused. Little was reported on what happened to a victim, indicators of abuse and settings of the abuse. The motives and consequences of the abuses were

[Benefits from the use of toys during nursing care delivered to hospitalized children].

Science.gov (United States)

Jansen, Michele Ferraz; dos Santos, Rosane Maria; Favero, Luciane

2010-06-01

It is a qualitative research study, descriptive-exploratory in nature, which aims to verify the benefits from the use of toys during nursing care to hospitalized children. Ten subjects participated in the study: three children and seven mothers of hospitalized children. Data were collected between May and July, 2008 by means of specific instruments for each age group and further organized in thematic categories: the use of toys to lessen hospitalization stress; toys facilitating understanding and acceptance of procedures; and the experience of using toys and hospitalization process. The results show that the use of toys is an excellent nursing resource to render care to admitted children. The features of the toys facilitated communication, participation, acceptance of procedure and child motivation, what enabled them to keep their individuality, lessen the stress and the possibility to implement children's and families' non-traumatic care.

Welcoming expertise: Bereaved parents' perceptions of the parent-healthcare provider relationship when a critically ill child is admitted to the paediatric intensive care unit.

Science.gov (United States)

Butler, Ashleigh E; Copnell, Beverley; Hall, Helen

2017-11-15

Entering the paediatric intensive care unit with a critically ill child is a stressful experience for parents. In addition to fearing for their child's well-being, parents must navigate both a challenging environment and numerous new relationships with healthcare staff. How parents form relationships with staff and how they perceive both their own and the healthcare providers' roles in this early stage of their paediatric intensive care journey is currently unknown. This paper explores bereaved parents' perceptions of their role and their relationships with healthcare providers when their child is admitted to the intensive care unit, as part of a larger study exploring their experiences when their child dies in intensive care. A constructivist grounded theory approach was utilised to recruit 26 bereaved parents from 4 Australian intensive care units. Parents participated in audio-recorded, semi-structured interviews lasting 90-150min. All data were analysed using the constant comparative analysis processes, supported by theoretical memos. Upon admission, parents viewed healthcare providers as experts, both of their child's medical care and of the hospital system. This expertise was welcomed, with the parent-healthcare provider relationship developing around the child's need for medical care. Parents engaged in 2 key behaviours in their relationships with staff: prioritising survival, and learning 'the system'. Within each of these behaviours are several subcategories, including 'Stepping back', 'Accepting restrictions' and 'Deferring to medical advice'. The relationships between parents and staff shift and change across the child's admission and subsequent death in the paediatric intensive care unit. However, upon admission, this relationship centres around the child's potential survival and their need for medical care, and the parent's recognition of the healthcare staff as experts of both the child's care and the hospital system. Copyright © 2017 Australian

Parent-Child Interaction Therapy: Enhancing Parent-Child Relationships

Directory of Open Access Journals (Sweden)

Anthony J. Urquiza

2012-07-01

Full Text Available Disruptive child behavior problems are common problems for parents and can be associated with serious delinquent behaviors and aggressive/violent behaviors in adolescence and adulthood. Parenting interventions to address disruptive child behavior problems has gained widespread acceptance. One of these parenting interventions is Parent-Child Interaction Therapy (PCIT. PCIT is a 14- to 20-week, founded on social learning and attachment theories, designed for children between 2 and 7 years of age with disruptive, or externalizing, behavior problems. This article will provide a brief review of the history of PCIT, a description of the basic components of PCIT, and an overview of recent developments that highlight the promise of PCIT with maltreating parent-child relationships, traumatized children, and in developing resilience in young children. In addressing the three basic treatment objectives for PCIT (i.e., reduction in child behavior problems, improving parenting skills, enhancing the quality of parent-child relationships, there is an abundance of research demonstrating very strong treatment effects and therefore, its value to the field. Recent research has also demonstrated the value of PCIT in reducing trauma symptoms in young children.

Treatment of eating disorders in child and adolescent psychiatry.

Science.gov (United States)

Herpertz-Dahlmann, Beate

2017-11-01

Recent research on the multimodal treatment of eating disorders in child and adolescent psychiatry has yielded a significant increase in randomized controlled trials and systematic reviews. This review aims to present relevant findings published during the last 2 years related to medical and psychological treatment of anorexia nervosa, bulimia nervosa and avoidant/restrictive food intake disorder (ARFID). For anorexia nervosa, recent reports described the efficacy of different treatment settings, lengths of hospital stay and high vs. low-calorie refeeding programmes. For both anorexia and bulimia nervosa, a number of randomized controlled trials comparing individual and family-oriented treatment approaches were published. For the newly defined ARFID, only very preliminary results on possible treatment approaches implying a multidisciplinary treatment programme were obtained. Although there is some evidence of the effectiveness of new child and adolescent psychiatric treatment approaches to eating disorders, the relapse rate remains very high, and there is an urgent need for ongoing intensive research.

Parental practice of child car safety in Enugu, Southeast Nigeria

Directory of Open Access Journals (Sweden)

Ndu KI

2016-11-01

Full Text Available KI Ndu,1,* U Ekwochi,1,* DC Osuorah,2,* OC Ifediora,3 FO Amadi,1 IN Asinobi,1 OW Okenwa,1 JC Orjioke,1 FN Ogbuka,1 TO Ulasi4 1Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria; 2Child Survival Unit, Medical Research Council UK, The Gambia Unit, Fajara, Gambia; 3Griffiths University Medical School, Gold Coast, QLD, Australia; 4Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria *These authors contributed equally to this work Abstract: Child safety restraints and seat belts are regarded as the most successful safety and cost-effective protective devices available to vehicle occupants, which have saved millions of lives. This cross-sectional descriptive study evaluated the practice and use of child car restraints (CCRs among 458 purposively selected respondents resident in two local government areas in Enugu State, Nigeria. Self-administered questionnaires were sent to parents of children attending private schools who owned a car. Chi-square and multivariate analyses were used to assess the determinants of the use of car restraints in children among respondents. In all, 56% and 45% of adults and children, respectively, used car restraints regularly. The awareness of child safety laws and actual use of age-appropriate CCRs among respondents was negatively and weakly correlated (r=–0.121, P=0.310. Only respondent’s use of seat belt during driving (P=0.001 and having being cautioned for non-use of CCRs (P=0.005 maintained significance as determinants of the use of CCRs in cars on multivariate analysis. The most frequent reasons given for the non-use of CCRs included the child being uncomfortable, 64 (31%; restraints not being important, 53 (26%, and restraints being too expensive, 32 (15%. Similarly, for irregular users, exceptions for non-use included the child being asleep (29%, inadequate number of CCRs (22%, and the child being sick (18

Carefree in child care ?: child wellbeing, caregiving quality, and intervention programs in center-based child care

OpenAIRE

Werner, Claudia Denise

2014-01-01

The use of center child care in Western countries has increased over the last three decades and is nowadays the most frequently used type of non-parental care for children aged zero to four (OECD, 2013). The aim of the current dissertation is to shed more light on indicators of child care quality in center child care and to answer the question whether narrow-focused caregiver interventions are effective in improving child care quality. The reported meta-analysis shows that narrow-focus interv...

Development of a Self-Management Theory-Guided Discharge Intervention for Parents of Hospitalized Children.

Science.gov (United States)

Sawin, Kathleen J; Weiss, Marianne E; Johnson, Norah; Gralton, Karen; Malin, Shelly; Klingbeil, Carol; Lerret, Stacee M; Thompson, Jamie J; Zimmanck, Kim; Kaul, Molly; Schiffman, Rachel F

2017-03-01

Parents of hospitalized children, especially parents of children with complex and chronic health conditions, report not being adequately prepared for self-management of their child's care at home after discharge. No theory-based discharge intervention exists to guide pediatric nurses' preparation of parents for discharge. To develop a theory-based conversation guide to optimize nurses' preparation of parents for discharge and self-management of their child at home following hospitalization. Two frameworks and one method influenced the development of the intervention: the Individual and Family Self-Management Theory, Tanner's Model of Clinical Judgment, and the Teach-Back method. A team of nurse scientists, nursing leaders, nurse administrators, and clinical nurses developed and field tested the electronic version of a nine-domain conversation guide for use in acute care pediatric hospitals. The theory-based intervention operationalized self-management concepts, added components of nursing clinical judgment, and integrated the Teach-Back method. Development of a theory-based intervention, the translation of theoretical knowledge to clinical innovation, is an important step toward testing the effectiveness of the theory in guiding clinical practice. Clinical nurses will establish the practice relevance through future use and refinement of the intervention. © 2017 Sigma Theta Tau International.

Child Supervision and Burn Outcome among Admitted Patients at Major Trauma Hospitals in the Gambia

Directory of Open Access Journals (Sweden)

Edrisa Sanyang

2017-07-01

Full Text Available Burn-related injuries are a significant burden in children, particularly in low- and middle-income countries (LMICs, where more than 90% of burn-related pediatric deaths occur. Lack of adult supervision of children is a major risk for pediatric burn injuries. The goal of this paper was to examine the general characteristics of burns and identify burn injury outcomes among adult-supervised children compared to those who were not supervised. The study examined burn injury and clinical characteristics among all burn patients admitted to two trauma hospitals in The Gambia, West Africa. At intake in the emergency room, the treating physician or nurse determined the need for admission based on body surface area burned (BSAB, depth of burn, and other clinical considerations such as co-occurring injuries and co-morbidities. During the study period of 1 April 2014 through 31 October 2016, 105 burn patients were admitted and data were collected by the treating physician for all of them. Information about supervision was only asked for children aged five years or less. More than half (51% of the burn patients were children under 18 years, and 22% were under 5 years. Among children under five, most (86.4% were supervised by an adult at the time of burn event. Of the 19 supervised children, 16 (84.2% had body area surface burned (BSAB of less than 20%. Two of the three children without adult supervision at the time of burn event had BSAB ≥ 20%. Overall, 59% of the patients had 20% + BSAB. Females (aOR = 1.25; 95% CI = 0.43–3.62, those burned in rural towns and villages (aOR = 2.29; 95% CI = 0.69–7.57, or burned by fire or flames (aOR = 1.47; 95% CI = 0.51–4.23 had increased odds of having a BSAB ≥ 20%, although these differences were not statistically significant. Children 0–5 years or 5–18 years (aOR = 0.04, 95% CI = 0.01–0.17; aOR = 0.07, 95% CI = 0.02–0.23, respectively were less likely to have BSAB ≥ 20% than adults. Those burned in a

Child Welfare Training in Child Psychiatry Residency: A Program Director Survey

Science.gov (United States)

Lee, Terry G.; Cox, Julia R.; Walker, Sarah C.

2013-01-01

Objective: This study surveys child psychiatry residency program directors in order to 1) characterize child welfare training experiences for child psychiatry residents; 2) evaluate factors associated with the likelihood of program directors' endorsing the adequacy of their child welfare training; and 3) assess program directors'…

Helping Your Child through Early Adolescence -- Helping Your Child Series

Science.gov (United States)

... Bibliography Acknowledgements Tips to Help Your Child through Early Adolescence No Child Left Behind Printable ... Information About... Transforming Teaching Family and Community Engagement Early Learning Helping Your Child Our mission is to promote student achievement and ...

Skull and Posterior Rib Fractures with Respiratory Failure caused by Child Abuse

Directory of Open Access Journals (Sweden)

Dzulfikar Djalil Lukmanul Hakim

2017-03-01

Full Text Available Background: Presence of multiple fractures suggests child abuse. Skull fractures rarely occurred but posterior rib fractures are commonly found and have high specificity as a radiological finding in child abuse. A respiratory failure can occur as a result of the damage to the osseous structure of the thorax that destabilizes the rib cage and impairs spontaneous breathing mechanism. Methods: A case report of a 6-month-old boy who presented with respiratory failure, multiple bilateral parietal and occipital bone fractures, and also fractures of right rib 5–8. The patient required ventilatory support for 9 days in the Pediatric Intensive Care Unit, Dr.HasanSadikin General Hospital. Results: The patient was on ventilatory support for 9 days, and was given antibiotics for 2 weeks. Next, the patient was referred to the High Care Unit (HCU after the condition was stabilized, and then referred to the ward, for treatment by the Social Pediatric Division. The patient was still having issues about his foster care. Conclusions: Recognition of presence of fractures is important in early diagnosis and treatment of child abuse.

Child Care Subsidies and Child Development

Science.gov (United States)

Herbst, Chris M.; Tekin, Erdal

2010-01-01

Child care subsidies are an important part of federal and state efforts to move welfare recipients into employment. One of the criticisms of the current subsidy system, however, is that it overemphasizes work and does little to encourage parents to purchase high-quality child care. Consequently, there are reasons to be concerned about the…

38 CFR 10.42 - Claim of child other than legitimate child.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Claim of child other than legitimate child. 10.42 Section 10.42 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUSTED COMPENSATION Adjusted Compensation; General § 10.42 Claim of child other than legitimate child. A...

The Child Health Care System in Italy.

Science.gov (United States)

Corsello, Giovanni; Ferrara, Pietro; Chiamenti, Gianpietro; Nigri, Luigi; Campanozzi, Angelo; Pettoello-Mantovani, Massimo

2016-10-01

Pediatric care in Italy has been based during the last 40 years on the increased awareness of the importance of meeting the psychosocial and developmental needs of children and of the role of families in promoting the health and well-being of their children. The pediatric health care system in Italy is part of the national health system. It is made up of 3 main levels of intervention: first access/primary care, secondary care/hospital care, and tertiary care based on specialty hospital care. This overview will also include a brief report on neonatal care, pediatric preventive health care, health service accreditation programs, and postgraduate training in pediatrics. The quality of the Italian child health care system is now considered to be in serious danger because of the restriction of investments in public health caused both by the 2008 global and national economic crisis and by a reduction of the pediatric workforce as a result of progressively insufficient replacement of specialists in pediatrics. Copyright © 2016 Elsevier Inc. All rights reserved.

Radiation protection for the parent and child in diagnostic nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Mountford, P.J. (Kent and Canterbury Hospital (UK). Dept. of Nuclear Medicine)

1991-12-01

Administration of a radiopharmaceutical to a parent or child for diagnostic purposes will result in certain specific radiation hazards, yet it can yield information vital to patient management. These hazards have been cited as a reason for the reluctance of some referring clinicians and, indeed, nuclear medicine practitioners to exploit paediatric radiopharmaceutical investigations (Piepsz et al. 1991). Ignorance of these hazards has the following consequences. Firstly, a valuable diagnostic procedure could be denied to a parent or child patient without justification, thereby compromising their management. Secondly, inappropriate recommendations could result in either excessive restrictions or an unnecessarily high radiation dose to a patient's family and to hospital staff. All members of a nuclear medicine service should be familiar with these radiation risks in order to provide appropriate guidance and to dispel any unwarranted fears. (orig.).

Health-e-Child a grid platform for european paediatrics

CERN Document Server

Skaburskas, K; Shade, J; Manset, D; Revillard, J; Rios, A; Anjum, A; Branson, A; Bloodsworth, P; Hauer, T; McClatchey, R; Rogulin, D

2008-01-01

The Health-e-Child (HeC) project [1], [2] is an EC Framework Programme 6 Integrated Project that aims to develop a grid-based integrated healthcare platform for paediatrics. Using this platform biomedical informaticians will integrate heterogeneous data and perform epidemiological studies across Europe. The resulting Grid enabled biomedical information platform will be supported by robust search, optimization and matching techniques for information collected in hospitals across Europe. In particular, paediatricians will be provided with decision support, knowledge discovery and disease modelling applications that will access data in hospitals in the UK, Italy and France, integrated via the Grid. For economy of scale, reusability, extensibility, and maintainability, HeC is being developed on top of an EGEE/gLite [3] based infrastructure that provides all the common data and computation management services required by the applications. This paper discusses some of the major challenges in bio-medical data integr...

The Ventricular Assist Device in the Life of the Child: A Phenomenological Pediatric Study.

Science.gov (United States)

van Manen, Michael A

2017-05-01

What is it like for a child to live with an artificial heart? The use of some medical therapies in children requires developmental considerations, is associated with psychosocial consequences, and calls for ethical sensitivities. A critical case is the ventricular assist device (VAD), a mechanical pump used to support the functioning of a failing heart. As a pediatric therapy, the device can be used as a temporary solution for poor heart function, a bridge to transplantation or recovery, or as a destination therapy. While the mechanical-technical operation of the VAD is well understood, the clinical-technical aspects of young people living with this device are largely unexplored. Drawing on interviews of school-aged children, the aim of this phenomenological study is to explore how a VAD may structure or condition a child's meaningful experience of their world outside the hospital. The driveline of an implanted VAD is the peripheral attachment, extruding through the skin to connect the controller-power supply. The materiality of the device may be interruptive, restrictive, and disturbing to the psycho-physical being and sense of self-identity of the child as a child. And while a child equipped with a VAD is not necessarily conspicuous among other children, the child may experience the device as an exposing presence, while living with the worry of a caregiver who takes on the role not simply of parent but of watchful health professional. A phenomenological understanding of the VAD should assist parents and caregiving health professionals knowing how to deal with specific issues arising in the life of the VAD child.

Clinical indications and determinants of the rise of cesarean section in three hospitals in rural China.

Science.gov (United States)

Qin, Cheng; Zhou, Min; Callaghan, William M; Posner, Samuel F; Zhang, Jun; Berg, Cynthia J; Zhao, Gengli

2012-10-01

This study investigated changes in cesarean delivery rate and cesarean indications in 3 county-level hospitals in rural China. Hospital delivery records in 1997 and 2003 were used to examine the reasons behind the changes. In Chengde County Hospital, the cesarean delivery rate increased from 28% in 1997 to 54% in 2003. The rate increased from 43% in 1997 to 65% in 2003 in Anxian County Hospital and Anxian Maternal and Child Health Hospital. The dramatic increase in cesarean delivery in the study hospitals was associated with a shift from more severe to mild or no clinical indications. The ratio of mild to moderate to severe hypertension increased substantially. More than half of the cephalopelvic disproportion cases were diagnosed prior to labor. The majority of nuchal cord cases were diagnosed without fetal distress. Maternal/family request was the number one cesarean indication in Anxian County Hospital and Anxian MCH Hospital in 2003. Ultrasound evidence of nuchal cord moved from the ninth ranked indication in 1997 to the second in 2003 in Chengde County Hospital.

Child protective services utilization of child abuse pediatricians: A mixed methods study.

Science.gov (United States)

Girardet, Rebecca; Bolton, Kelly; Hashmi, Syed; Sedlock, Emily; Khatri, Rachna; Lahoti, Nina; Lukefahr, James

2018-02-01

Several children's hospitals and medical schools across Texas have child abuse pediatricians (CAPs) who work closely with child protection workers to help ensure accurate assessments of the likelihood of maltreatment in cases of suspected abuse and neglect. Since the state does not mandate which cases should be referred to a CAP center, we were interested in studying factors that may influence workers' decisions to consult a CAP. We used a mixed methods study design consisting of a focus group followed by a survey. The focus group identified multiple factors that impact workers' decision-making, including several that involve medical providers. Responses from 436 completed surveys were compared to employees' number of years of employment and to the state region in which they worked. Focus group findings and survey responses revealed frustration among many workers when dealing with medical providers, and moderate levels of confidence in workers' abilities to make accurate determinations in cases involving medical information. Workers were more likely to refer cases involving serious physical injury than other types of cases. Among workers who reported prior interactions with a CAP, experiences and attitudes regarding CAPs were typically positive. The survey also revealed significant variability in referral practices by state region. Our results suggest that standard guidelines regarding CAP referrals may help workers who deal with cases involving medical information. Future research and quality improvement efforts to improve transfers of information and to better understand the qualities that CPS workers appreciate in CAP teams should improve CAP-CPS coordination. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pediatric hospital medicine core competencies: development and methodology.

Science.gov (United States)

Stucky, Erin R; Ottolini, Mary C; Maniscalco, Jennifer

2010-01-01

Pediatric hospital medicine is the most rapidly growing site-based pediatric specialty. There are over 2500 unique members in the three core societies in which pediatric hospitalists are members: the American Academy of Pediatrics (AAP), the Academic Pediatric Association (APA) and the Society of Hospital Medicine (SHM). Pediatric hospitalists are fulfilling both clinical and system improvement roles within varied hospital systems. Defined expectations and competencies for pediatric hospitalists are needed. In 2005, SHM's Pediatric Core Curriculum Task Force initiated the project and formed the editorial board. Over the subsequent four years, multiple pediatric hospitalists belonging to the AAP, APA, or SHM contributed to the content of and guided the development of the project. Editors and collaborators created a framework for identifying appropriate competency content areas. Content experts from both within and outside of pediatric hospital medicine participated as contributors. A number of selected national organizations and societies provided valuable feedback on chapters. The final product was validated by formal review from the AAP, APA, and SHM. The Pediatric Hospital Medicine Core Competencies were created. They include 54 chapters divided into four sections: Common Clinical Diagnoses and Conditions, Core Skills, Specialized Clinical Services, and Healthcare Systems: Supporting and Advancing Child Health. Each chapter can be used independently of the others. Chapters follow the knowledge, skills, and attitudes educational curriculum format, and have an additional section on systems organization and improvement to reflect the pediatric hospitalist's responsibility to advance systems of care. These competencies provide a foundation for the creation of pediatric hospital medicine curricula and serve to standardize and improve inpatient training practices. (c) 2010 Society of Hospital Medicine.

Child and Family Factors Associated With Child Maltreatment in Vietnam

NARCIS (Netherlands)

Tran, N.K. (Nhu K.); van Berkel, S.R. (Sheila R.); M.H. van IJzendoorn (Rien); L.R.A. Alink (Lenneke R.A.)

2018-01-01

textabstractThis study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and

Child and Family Factors Associated With Child Maltreatment in Vietnam

OpenAIRE

Tran, N.K. (Nhu K.); van Berkel, S.R. (Sheila R.); IJzendoorn, Rien; Alink, Lenneke R.A.

2018-01-01

textabstractThis study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and the occurrence of multiple types of child maltreatment. Cross-sectional data of 1,851 secondary and high school students aged 12 to 17 years (47.3% boys) in four provinces of Northern Vietnam were ...

Fatal child abuse: a study of 13 cases of continuous abuse

Directory of Open Access Journals (Sweden)

Juhani Merikanto

2012-01-01

Full Text Available A parent who continuously physically abuses her/his child doesn’t aim to kill the child but commits an accidental filicide in a more violent outburst of anger. Fatal abuse deaths are prevented by recognition of signs of battering in time. Out of 200 examined intra-familial filicides, 23 (12% were caused by child battering and 13 (7% by continuous battering. The medical and court records of the victim and the perpetrator were examined. The perpetrator was the biological mother and the victim was male in 69 per cent of the cases. The abused children were either younger than one year or from two-and-a-half to four years old. Risk factors of the victim (being unwanted, premature birth, separation from the parent caused by hospitalization or custodial care, being ill and crying a lot and the perpetrator (personality disorder, low socioeconomic status, chaotic family conditions, domestic violence, isolation, alcohol abuse were common. The injuries caused by previous battering were mostly soft tissue injuries in head and limbs and head traumas and the battering lasted for days or even an year. The final assault was more violent and occurred when the parent was more anxious, frustrated or left alone with the child. The perpetrating parent was diagnosed as having a personality disorder (borderline, narcissistic or dependent and often substance dependence (31%. None of them were psychotic. Authorities and community members should pay attention to the change in child’s behavior and inexplicable injuries or absence from daycare. Furthermore if the parent is immature, alcohol dependent, have a personality disorder and is unable to cope with the demands the small child entails in the parent’s life, the child may be in danger.

The importance of pets’ visit in recovery of hospitalized children

Directory of Open Access Journals (Sweden)

Andreia Maria Heins Vaccari

2007-06-01

Full Text Available Objective: To understand the experience of hospitalized childrenwhen visited by animals at hospital. Methods: Descriptive andexploratory research with qualitative approach in a private pediatrichospital in the city of São Paulo, Brazil. Thirteen children aged threeto six years were enrolled. Observation of the children before,during, and after the animal’s visit, interviews, and drawings weresome of the strategies used to collect data, which were submittedto the Bardin content analysis technique. Results: Three meaningcategories were identified and showed some of the benefits of thisexperience to children “pleasant contact with the animals”; “easierinteraction with staff and with other children”; “pain and discomfortrelief”. Conclusions: Animal visits make the environment morerelaxed, improve the interaction between the child, the staff andother children thus helping sick children to be more cooperativewith hospital procedures. This is an alternative strategy for pain anddiscomfort relief. It has also been observed that this activity benefitsnot only children but also adults who care them.

Fifty Years of Burn Care at Shriners Hospitals for Children, Galveston.

Science.gov (United States)

Čapek, Karel D; Culnan, Derek M; Desai, Manubhai H; Herndon, David N

2018-03-01

More than 50 years ago, Shriners Hospitals for Children expanded their philanthropy to include care for burned children. In so doing, the effects of their work weightily expanded from rehabilitation and quality of life outcomes to include survival proper. As the first facility dedicated to the care of burned children, originally designated the Shriners Burn Institute, the Galveston hospital remains the cornerstone of this endeavor. Shriners maintains charitable pediatric hospitals, provide care irrespective of the patient's or the family's ability to pay, and promote research. The sole criterion for admission at Shriners Hospitals for Children is the determination by a surgeon at a Shriners hospital that "the child's trouble may be corrected or improved." This philanthropic effort to provide medical care for children is one expression of the human commonality recognized by Shriners. In this article, we provide some background information on how this hospital came into existence as well as a global summary of its interventions toward greater survival and more complete rehabilitation of burned children. Based on the findings presented herein, we assert that there is less suffering and less loss of life due to childhood burns today than in previous years. We attribute much of this improvement to the simple voluntary collective decision by Shriners to provide alms for burned children.

Children with Sickle-Cell Anemia: Parental Relations, Parent-Child Relations, and Child Behavior.

Science.gov (United States)

Evans, Robert C.; And Others

1988-01-01

Investigated the influence of a child with sickle-cell anemia on parental affiliation, parent-child relationships, and parents' perception of their child's behavior. In the sickle-cell group, parents' interpersonal relationship suffered; parent-child relationship and child behavior correlated significantly; and single-parent families estimated…

After a child's acquired brain injury (ABI): An ethnographic study of being a parent.

Science.gov (United States)

Rashid, Marghalara; Goez, Helly R; Caine, Vera; Yager, Jerome Y; Joyce, Anthony S; Newton, Amanda S

2016-11-30

To explore the meanings associated with being a parent of a child with an aquired brain injury (ABI). An ethnographic study was conducted with parents of children aged 3 to 10 years who had acquired a severe brain injury. Purposeful sampling was used to recruit parents from the Glenrose Rehabilitation Hospital in Edmonton, Alberta. Data collection involved participant observation, fieldwork and semi-structured interviews. Field notes and interviews transcriptions were analysed using a thematic analysis framework and informed by symbolic interactionism theory. Six parent dyads (mothers and fathers) and 4 mothers participated in the study.Parents' meanings of `parenting' a child with severe brain injury were shaped by the injury, wide range of familial dynamics, and interactions. Six main themes related to parental meanings emerged from our data: (1) Getting `back to normal'; (2) Relying on a support system; (3) Worrying something bad may happen after the injury; (4) Going through a range of emotions following the injury; (5) Changing family dynamics after the injury; and (6) Ongoing performativity. Parents' meanings of `parenting' a child are extensively impacted by their child's functioning after the ABI. Having a greater appreciation of these experiences may be beneficial for medical professionals.

``Battered child`` syndrome; Das ``Battered-Child``-Syndrom

Energy Technology Data Exchange (ETDEWEB)

Elsner, K.; Merk, J.; Sokiranski, R. [Ulm Univ. (Germany). Abt. Diagnostische Radiologie

1997-10-01

Synonyms for the `battered child` syndrome (BCS) are terms describing the physical and body aspects of the process, such as `child abuse`, or `non-accidental injury`. These are to be distinguished from the psychic aspects and abuse, emotional and bodily neglect, and sexual abuse. Most cases are one or another combination of these aspects. Radiology is the essential method for giving proof of such abuses, identifying the signs of maltreatment in a medical record, or for disproving suspected abuse. (orig./AJ) [Deutsch] Als Synonym fuer das `Battered-Child`-Syndrom (BCS) stehen die Begriffe der koerperlichen-/physikalischen-Kindesmisshandlung, im angelsaechsischen Sprachraum die Begriffe `Child Abuse` und `Nonaccidental Injury`. Vom Syndrom abzugrenzen sind die seelische Misshandlung, die seelische und koerperliche Vernachlaessigung, und der sexuelle Missbrauch. Kombinationsformen sind nicht selten. Bei der Diagnostik des Syndroms spielt die Radiologie eine entscheidende Rolle. So hilft der Einsatz adaequater Untersuchungsmethoden, den Tatbestand der Misshandlung zu identifizieren und zu dokumentieren, aber auch einen Verdacht zu widerlegen. (orig./AJ)

[Fear of child/family in pediatric intensive care units: what is the nurse's role?].

Science.gov (United States)

Machado, Cidália; Sousa, Pedro Jácome

2007-01-01

The fear is considered a negative emotion, lived with apprehension, uncertainty and a sense of threat or danger to the personal integrity (Torres & Guerra, 2003). It is often associated with hospitalization of the chid/family, and may be the cause to start an emotional crisis due to the separation from environment and the usual routines, the loss of independence and autonomy, and also due to be with strange people (Bicho, 2006; Festas 1994; Freitas &Freitas, 2005; Hockenberry, 2006). Hospitalization in a Pediatric Intensive Care Unit (PICU) may worsen an already existing crisis not only for the given reasons but also because the child may be in life danger. The environment "aggressive"and stressant characteristic of these units also contributes to this situation. To minimize the fear and his negative effects, the nurse has an important role to play. Because of his/her activities and function he/she is the closest health care professional to the child/family, and therefore in a better position to establish a relationship of trust and empathy that will minimize such effects, as well as to the interventions best suited to achieve this objective.

Informant Discrepancies in Assessing Child Dysfunction Relate to Dysfunction Within Mother-Child Interactions

OpenAIRE

De Los Reyes, Andres; Kazdin, Alan E.

2006-01-01

Examined whether mother-child discrepancies in perceived child behavior problems relate to dysfunctional interactions between mother and child and stress in the mother. Participants included 239 children (6–16 years old; 58 girls, 181 boys) referred for oppositional, aggressive, and antisocial behavior, and their mothers. Mother-child discrepancies in perceived child behavior problems were related to mother-child conflict. Moreover, maternal stress mediated this relationship. The findings sug...

Exploring the controversy in child abuse pediatrics and false accusations of abuse.

Science.gov (United States)

Gabaeff, Steven C

2016-01-01

There is a controversy in child abuse pediatrics between an established corps of child abuse pediatricians aligned with hospital colleagues and law enforcement, and a multi-specialty challenger group of doctors and other medical professionals working with public interest lawyers. The latter group questions the scientific validity of the core beliefs of child abuse pediatricians and believes that there are a substantial number of false accusations of abuse occurring. An unproven primary hypothesis, crafted around 1975 by a small group of pediatricians with an interest in child abuse, lies at the foundation of child abuse pediatrics. With no scientific study, it was hypothesized that subdural hemorrhage (SDH) and retinal hemorrhage (RH) were diagnostic of shaking abuse. That hypothesis became the so-called "shaken baby syndrome." Through the period 1975-1985, in a coordinated manner, these child abuse specialists coalesced under the American Academy of Pediatrics and began working with district attorneys and social workers, informing them of the ways in which their hypothesis could be applied to prosecutions of child abuse and life-altering social service interventions. In a legal context, using then-prevailing evidentiary rules which treated scientific expert testimony as valid if it was "generally accepted" in the field, they represented falsely that there was general acceptance of their hypothesis and therefore it was valid science. As the ability to convict based on this unproven prime hypothesis (SDH and RH equals abuse) increased, some defense attorneys were professionally compelled by their own doubts to reach out to experts from other fields with experience with SDH and RH, trauma, and biomechanics, for second opinions. Medical and legal challenges to the established thinking soon emerged, based on both old and new evidenced-based literature. As the intensity of the controversy increased, the probability of false accusation became more apparent and the need

Parent-child aggression: association with child abuse potential and parenting styles.

Science.gov (United States)

Rodriguez, Christina M

2010-01-01

The present investigation predicted that greater use of corporal punishment as well as physical maltreatment would be associated with child abuse potential and selected parenting styles. Three independent studies were examined, two with community samples and a third with a clinical at-risk sample of parents. Parents across all studies anonymously completed the Child Abuse Potential Inventory, the Parent-Child Conflict Tactics Scale to assess physical discipline and maltreatment, as well as the Parenting Scale to measure dysfunctional parenting styles. Findings support that overall parent-child aggression, as well as physical maltreatment behaviors specifically, were associated with child abuse potential. Parent-child aggression was also related to dysfunctional parenting styles, particularly an overreactive, authoritarian parenting style. Permissive parenting was also identified as potentially associated with physical maltreatment, although the findings regarding such lax parenting styles are less clear. Intriguing findings emerged regarding the connection of psychological aggression to both child abuse potential and dysfunctional parenting style. Child abuse potential was also associated with dysfunctional parenting style, particularly harsh, overreactive approaches. Recommendations for future study with at-risk samples and additional research on permissive parenting and psychological aggression are discussed.

Mother-Child Positivity and Negativity: Family-Wide and Child-Specific Main Effects and Interactions Predict Child Adjustment

Science.gov (United States)

Oliver, Bonamy R.; Pike, Alison

2018-01-01

Links between positive and negative aspects of the parent-child relationship and child adjustment are undisputed. Scholars recognize the importance of parental differential treatment (PDT) of siblings, yet, less is known about PDT in the context of the shared (family-wide) parent-child relationship climate, or about the extent to which positivity…

Child and Family Factors Associated With Child Maltreatment in Vietnam.

Science.gov (United States)

Tran, Nhu K; van Berkel, Sheila R; van IJzendoorn, Marinus H; Alink, Lenneke R A

2018-04-01

This study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and the occurrence of multiple types of child maltreatment. Cross-sectional data of 1,851 secondary and high school students aged 12 to 17 years (47.3% boys) in four provinces of Northern Vietnam were obtained using self-report questionnaires. Results indicated that the likelihood of emotional abuse, witnessing parental conflict, and experiencing multiple types of child maltreatment during lifetime increased with age. Boys had a higher risk than girls on lifetime sexual abuse, and past year and lifetime physical abuse. Living in a single parent family was the risk factor related to most types of child maltreatment including lifetime sexual abuse, neglect, and multiple types of child maltreatment, and both past year and lifetime witnessing parental conflict. Interestingly, low socioeconomic status (SES) and parental unemployment were associated with a decreased risk on experiencing emotional abuse in the past year and during lifetime, respectively. "Tiger parenting," a parenting style observed frequently in East Asian parents, may be more common in families with high SES and might explain this finding. This study highlights the importance of prioritizing single parent families in parenting programs and implementing child maltreatment interventions early because of the risk on child maltreatment increased with age. More research on emotional abuse and "Tiger parenting" in Vietnam could clarify the association of emotional abuse with high SES and parental employment. Finally, the underlying mechanisms of the risk factors in Vietnam should be studied more to inform interventions.

Multiple perpetrator rape among girls evaluated at a hospital-based child advocacy center: seven years of reviewed cases.

Science.gov (United States)

Edinburgh, Laurel; Pape-Blabolil, Julie; Harpin, Scott B; Saewyc, Elizabeth

2014-09-01

The aim of this study was to describe contextual events, abuse experiences, and disclosure processes of adolescents who presented to a hospital-based Child Advocacy Center for medical evaluation and evidentiary collection as indicated after experiencing multiple perpetrator rape during a single event (n=32) and to compare these findings to a group of single perpetrator sexual assaults (n=534). This study used a retrospective mixed-methods design with in-depth, forensic interviews and complete physical examinations of gang-raped adolescents. Patients ranged from 12 to 17 years (M=14 years). Girls who experienced multiple perpetrator rape during a single event were more likely to have run away, to have drunk alcohol in the past month, and to have participated in binge drinking in the past 2 weeks. Acute presentation of these victims were rare but 30% had hymenal transections and 38% had sexually transmitted infections (STIs). Forensic interviews revealed alcohol was a common weapon used by offenders, and its use resulted in victims experiencing difficulty in remembering and reporting details for police investigation or physical and mental health care. Most victims were raped at parties they attended with people they thought they could trust, and they felt let down by witnesses who could have helped but did not intervene. Although relatively rare, multiple perpetrator rape during a single event is a type of severe sexual assault experience and has significant risks for deleterious health outcomes. These victims require health care by trained providers to diagnose physical findings, treat STIs, screen for trauma, and support victims. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

A Critical Review of Child Labour in Nigeria and The Case for Child Entrepreneurship

Directory of Open Access Journals (Sweden)

Mike Akpa AjaNwachuku

2016-12-01

Full Text Available Nigeria and the world over condemn forced or exploitative labour of a child, for the obvious reason of the adverse physical, psychological, mental and emotional effect of it on children. What is condemned is not child labour per se, but child forced or exploitative labour. This paper analyses the condemnable child forced or exploitative labour, distinguishes it from the accepted child labour and makes a case for the advancement from child labour to child entrepreneurship. It posits that the advancement to child entrepreneurship shall enable the Nigerian child to contribute their bit to the financial wellbeing of their family and the economic development of Nigeria.

Unusual Presentation of Dengue Fever; A child with acute myocarditis

Directory of Open Access Journals (Sweden)

Moaz Aslam

2016-02-01

Full Text Available Dengue fever (DF is an acute febrile illness that follows a self-limiting course. However, some patients suffer from complications, including myocarditis, due to the involvement of other organs. A child presented at the Aga Khan University Hospital in Karachi, Pakistan, in June 2013 with a high-grade fever, malaise and epigastric pain radiating to the chest. Positive DF antigen and immunoglobulin M assays confirmed the diagnosis of DF. Persistent bradycardia with low blood pressure led to further cardiac investigations which showed a decreased ejection fraction and raised serum cardiac enzymes, indicating myocardial damage. With supportive care and use of inotropes, the spontaneous normalisation of cardiac enzyme levels and ejection fraction was observed. The child was discharged five days after admission. This case highlights the importance of identifying myocarditis in DF patients suffering from cardiac symptoms that are not explained by other potential aetiologies. Awareness, early suspicion and supportive care are essential to ensure favourable outcomes.

Office of Child Care

Science.gov (United States)

... for Children & Families Office of Child Care By Office Administration for Native Americans (ANA) Administration on Children, ... about the Child Care Rule > What is the Office of Child Care (OCC)? The Office of Child ...

The daily life in the context of illness and hospitalization: what say the accompanying mothers of children diagnosed with neoplasia?

Directory of Open Access Journals (Sweden)

Camila Rebeca Vieira de Almeida

2016-04-01

Full Text Available Introduction: Daily life is a complex, multidimensional and processual phenomenon, in which all people are included; it measures the succession of human life, and is the constituent basis of life, promoting the direction (s of the continuity of existence. Among the childhood diseases, cancer is noted for its high incidence and impact on the lives and daily life of the child and their parents or guardians, being common for children with cancer and their caregivers to experience hospitalization. Objective: Considering the importance and impact of daily living for health hand well-being, we aimed to uncover the meanings of the hospital routine experience for mothers of children diagnosed with cancer. Method: This is a qualitative research with phenomenological content analysis; from the application of semi-structure interviews with nine mothers, in a Public Hospital. Results: The results revealed that the hospital routine can be permeated by physical discomfort, anguish; fears, uncertainties, difficulties in adapting to the rules, environment and hospital procedures; by nostalgia, isolation from people, contexts and meaningful occupations; and tasks linked to the child care. However, people can (re think the daily life through occupational experiences and supportive relationships between caregivers, which may contribute to the perception of well-being and learning resulting from this experience. Conclusion: Therefore, this experience and the way it can interfere with the health and well-being of people should receive attention from occupational therapists in hospitals.

Child Care Subsidy Use and Child Development: Potential Causal Mechanisms

Science.gov (United States)

Hawkinson, Laura E.

2011-01-01

Research using an experimental design is needed to provide firm causal evidence on the impacts of child care subsidy use on child development, and on underlying causal mechanisms since subsidies can affect child development only indirectly via changes they cause in children's early experiences. However, before costly experimental research is…

Realising the child's best interests: lessons from the Child Justice ...

African Journals Online (AJOL)

... Act to refine the Schools Act with regard to serious matters of school discipline and to ensure its proper alignment with the constitutional imperatives regarding the best-interests-of-the-child right. Keywords: School discipline; child justice; the best interests of the child; children's rights; education law; restorative justice ...

Kindergarten Child Care Experiences and Child Achievement and Socioemotional Skills

Science.gov (United States)

Claessens, Amy

2012-01-01

Young children's experiences outside of both home and school are important for their development. As women have entered the labor force, child care has become an increasingly important context for child development. Child care experiences prior to school entry have been well-documented as important influences on children's academic and…

Do no more harm: the psychological stress of the medical examination for alleged child sexual abuse.

Science.gov (United States)

Marks, Susan; Lamb, Robyn; Tzioumi, Dimitra

2009-03-01

Currently, there is some controversy that the medical examination following allegations of child sexual abuse may further traumatise the child. Access for children to appropriate care may be hindered if decisions about referral are influenced by personal beliefs, rather than by recognition of the potential health and psychological benefits of the assessment. We aimed to study the expectations and emotional responses of children and their parents to the medical examination. We conducted a prospective quantitative and qualitative study at the Children's Hospital at Westmead. Participants completed questionnaires pre-examination and post-examination, including Children's Anxiety and Pain Scales. Clinicians recorded a Genital Examination Distress Scale and a questionnaire about potentially prognostic variables. Parents found the medical examination significantly less stressful than they had anticipated. They highlighted the importance of being involved in the process, the child's reaction, staff attitudes and the doctor's explanations. Although most parents expected that the medical would be stressful for their child, this did not correlate with the children's reports of feeling scared beforehand. Increased parental and child distress were significantly associated with the child being 12 years or older. The type of abuse was not significantly linked to any of the parent or child self-reports. Our findings indicate that the medical examination is not as stressful as expected and support the recommendation that timely medical assessment by appropriately trained professionals should be offered for all children following allegations of sexual abuse.

Child labour in Bhutan : the challenges of implementing child rights in Bhutan

OpenAIRE

Chhetri, Kishore Kumar

2011-01-01

This dissertation attempts to contextualize the practice of child labour in Bhutan by examining various socio-economic and cultural aspects. By reviewing the United Nations Convention on the Rights of the Child, this dissertation looks into the policies, Acts and strategies adopted by the Royal Government of Bhutan in reducing child labour. It describes various characteristics of child labour in Bhutan. It also provides an analysis of domestic child labour in the country. The study is mo...

The two-child limit for Universal Credit and Child Tax Credit

OpenAIRE

MACHIN, Richard

2017-01-01

Richard Machin explores the background to, and likely impact of, the two-child limit on the child element in Universal Credit and the Child Tax Credit, which was introduced by the Welfare Reform and Work Act 2016

Increasing maternal healthcare use in Rwanda: implications for child nutrition and survival.

Science.gov (United States)

Pierce, Hayley; Heaton, Tim B; Hoffmann, John

2014-04-01

Rwanda has made great progress in improving maternal utilization of health care through coordination of external aid and more efficient health policy. Using data from the 2005 and 2010 Rwandan Demographic and Health Surveys, we examine three related questions regarding the impact of expansion of health care in Rwanda. First, did the increased use of health center deliveries apply to women across varying levels of education, economic status, and area of residency? Second, did the benefits associated with being delivered at a health center diminish as utilization became more widespread? Finally, did inequality in child outcomes decline as a result of increased health care utilization? Propensity score matching was used to address the selectivity that arises when choosing to deliver at a hospital. In addition, the regression models include a linear model to predict child nutritional status and Cox regression to predict child survival. The analysis shows that the largest increases in delivery at a health center occur among less educated, less wealthy, and rural Rwandan women. In addition, delivery at a health center is associated with better nutritional status and survival and the benefit is not diminished following the dramatic increase in use of health centers. Finally, educational, economic and residential inequality in child survival and nutrition did not decline. Copyright © 2014 Elsevier Ltd. All rights reserved.

Job satisfaction and turnover intent among hospital social workers in the United States.

Science.gov (United States)

Pugh, Greg L

2016-08-01

Feelings of job satisfaction and turnover intentions among social workers affect work quality for both social workers and the people for whom they provide services. Existing literature on job satisfaction among hospital social workers is limited, and is overly focused on issues of compensation. There is job satisfaction research with hospital nurses available for comparison. Other informative social work research on job satisfaction and turnover exists in mental health and generally, across settings. Research on turnover intent in social work is primarily from child welfare settings and may not generalize. The literature notes gaps and contradictions about predictors of job satisfaction and turnover intent. Using a large national dataset of hospital social workers, this research clarifies and fills gaps regarding hospital social workers, and explores how Herzberg's theory of work can clarify the difference between sources of job dissatisfaction and job satisfaction. Findings include hospital social workers reporting high job satisfaction and that demographics do not contribute to the predictive models. The findings do support centralized social work departments and variety in the job functions of hospital social workers, and are consistent with the theoretical framework.

Does participation in preventive child health care at the general practitioner minimise social differences in the use of specialist care outside the hospital system?

DEFF Research Database (Denmark)

Mårtensson, Solvej; Hansen, KH; Olsen, KR

2012-01-01

INTRODUCTION: The primary purposes of preventive child health care in Denmark are to help ensure a healthy childhood and to create preconditions for a healthy adult life. The aim of this study is to examine whether participation in age-appropriate preventative child health care affects...... the number of contacts with a specialist in 2006 was related to participation in preventive child health care between 2002 and 2005. To control for the potential effect of difference in GP behaviour the data were analysed using a multilevel Poisson model linking each child to the GP with whom he or she...... was listed. RESULTS: If the children attended any preventive child health care visits, they had the same probability of contact with a specialist regardless of the parents' income. However, children from low-income families not participating in any preventive care had a lower probability of contact...

Does Social Labelling Encourage Child Schooling and Discourage Child Labour in Nepal?

Science.gov (United States)

Chakrabarty, Sayan; Grote, Ulrike; Luchters, Guido

2011-01-01

This paper explores the determinants of child labour vis-a-vis child schooling. It further examines the influence of non-governmental organisations (NGOs) which are engaged in social labelling, on the incidence of child labour and schooling trade-off. The empirical results show that the probability of child schooling increases as well as child…

Prosthetic Oral Rehabilitation of a Child With S-ECC: A Case Report with Histopathologic Analysis.

Science.gov (United States)

Tannure, P N; Moraes, G G; Borba, McU; Abrahão, A; Andrade, Mtrc; Fidalgo, Tks

2015-01-01

The aim of this case report is to describe the treatment planning of a young child with severe early childhood caries (S-ECC) as well as the prosthetic rehabilitation technique. A 3-year-old female child was referred to the pediatric dentistry clinic with the chief complaint of tooth pain, difficulty in eating and recurrent hospitalizations caused by dental infections. The mother reported intermittent episodes of fever and recurrent swelling of child's face. The girl presented angular cheilitis and was referred to a dietitian. The treatment plain consisted on a behavior changes in oral hygiene habits, exodontias of all primary teeth and oral rehabilitation with a prosthesis. The extracted teeth with periapical lesions were submitted to histopathologic analysis (hematoxilin and eosin staining) and revealed an inflammatory infiltrate. The aesthetic requirement of children with S-ECC has been a challenge to pediatric dentists. In the present case, the oral rehabilitation provided for the children better aesthetic, nutrition, phonation, and functional conditions.

Early child health in Lahore, Pakistan: IV. Child care practices.

Science.gov (United States)

Zaman, S; Jalil, F; Karlberg, J

1993-08-01

Child care practices and hygiene measures were studied at 6 months of age in a longitudinally followed cohort of 1476 infants born between September 1984 to March 1987 in four socio-economically different areas in and around Lahore, Pakistan. Although, 76-98% of the mothers looked after their infants during health and 96-98% during a diarrhoeal illness, child care practices and hygiene measures differed significantly between the four areas. During a diarrhoeal episode, the mothers from the upper middle class took timely medical help, fed ample food and Oral Rehydration Salts (ORS) to the sick infants and provided uncontaminated food to them in clean surroundings. The mothers from the village and the periurban slum took their sick child, mostly after the second day of illness, to a doctor, but preferred home remedies. Fourteen percent of the mothers in the village and 6% in the periurban slum did not seek any medical help at all. One-third of the families, from these two areas, fed food to children 12 hours after cooking; the surroundings of the child were dirty with large numbers of flies present throughout the year, though the food was commonly kept covered with a lid. We constructed a simple measure of the surroundings of the child, rated as dirty, medium or clean; it was found to be associated to both parental illiteracy and child growth, but not with housing standard. The main conclusion is that any attempt to improve child-care practices and the hygienic environment for the child, should focus on maternal literacy and simple health messages.

Sexual murderers with adult or child victims: are they different?

Science.gov (United States)

Spehr, Aranke; Hill, Andreas; Habermann, Niels; Briken, Peer; Berner, Wolfgang

2010-09-01

This study investigates characteristics differentiating sexually motivated murderers targeting child victims (CV; n = 35) from those with only adult victims (AV; n = 100). In the initial phase, psychiatric court reports were evaluated using standardized instruments (SCID-II, PCL-R, HCR-20, SVR-20, Static-99). In the second phase, data on duration of detention and reconviction rates were obtained from German federal criminal records. The CV group showed more often diagnostic criteria of pedophilia (43% vs. 4%) and less often alcohol abuse and drug dependency (31% vs. 55%), sexual dysfunctions (9% vs. 29%) and narcissistic personality disorder (0% vs. 13%). No significant differences were found regarding PCL-R and total risk assessment scores. Child victim perpetrators were more likely to have committed acts of sexual child abuse before the sexual homicide (46% vs. 16%) but were less likely to have committed rape or sexual assault (17% vs. 42%) or caused bodily injury (26% vs. 50%). The CV group was detained more frequently in forensic psychiatric hospitals (59% vs. 26%), but the two groups showed the same rates of release and reconviction for sexual (22% for both groups), nonsexual violent (CV 25% vs. AV 15%) and nonviolent offenses (CV 63% vs. AV 59%). Although well-known differences between nonhomicidal sexual child abusers and rapists were replicated in this study on sexual homicide perpetrators, the groups showed more similarities than differences. The high prevalence of violence and antisocial personality disorder in both groups seem to be important risk factors for committing a (sexual) homicide and might have outweighed other differences.

Overprotective parenting and child anxiety: the role of co-occurring child behavior problems.

Science.gov (United States)

Gere, Martina K; Villabø, Marianne A; Torgersen, Svenn; Kendall, Philip C

2012-08-01

The relationship between overprotective parenting and child anxiety has been examined repeatedly because theories emphasize its role in the maintenance of child anxiety. No study has yet tested whether this relationship is unique to child anxiety, by controlling for commonly co-occurring behavior problems within the same children. The current study examined 190 children (age 7-13, 118 [corrected] boys) referred to mental health clinics and their parents. Results revealed that significant correlations between overprotective parenting and child anxiety symptoms disappear after controlling for co-occurring child behavior symptoms. It appears that overprotection is not uniquely related to child anxiety. Furthermore, overprotective parenting was significantly and uniquely related to child behavior symptoms. Researchers and practitioners need to consider co-occurring child behavior problems when working with the parents of anxious children. Copyright © 2012 Elsevier Ltd. All rights reserved.

Teaching HIV/AIDS through a Child-to-Child Approach: A Teacher's Perspective

Science.gov (United States)

Mwebi, Bosire Monari

2012-01-01

This paper draws from a larger study conducted in Kenya, which was a narrative inquiry into a teacher's experiences of teaching the HIV/AIDS curriculum using a child-to-child approach. The two major research questions of this study were: 1) What are the experiences of a teacher teaching the HIV/AIDS curriculum using a child-to-child curriculum…

Predictors of mother-child interaction quality and child attachment security in at-risk families.

Science.gov (United States)

De Falco, Simona; Emer, Alessandra; Martini, Laura; Rigo, Paola; Pruner, Sonia; Venuti, Paola

2014-01-01

Child healthy development is largely influenced by parent-child interaction and a secure parent-child attachment is predictively associated with positive outcomes in numerous domains of child development. However, the parent-child relationship can be affected by several psychosocial and socio-demographic risk factors that undermine its quality and in turn play a negative role in short and long term child psychological health. Prevention and intervention programs that support parenting skills in at-risk families can efficiently reduce the impact of risk factors on mother and child psychological health. This study examines predictors of mother-child interaction quality and child attachment security in a sample of first-time mothers with psychosocial and/or socio-demographic risk factors. Forty primiparous women satisfying specific risk criteria participated in a longitudinal study with their children from pregnancy until 18 month of child age. A multiple psychological and socioeconomic assessment was performed. The Emotional Availability Scales were used to measure the quality of emotional exchanges between mother and child at 12 months and the Attachment Q-Sort served as a measure of child attachment security at 18 months. Results highlight both the effect of specific single factors, considered at a continuous level, and the cumulative risk effect of different co-occurring factors, considered at binary level, on mother-child interaction quality and child attachment security. Implication for the selection of inclusion criteria of intervention programs that support parenting skills in at-risk families are discussed.

Predictors of mother-child interaction quality and child attachment security in at-risk families

Directory of Open Access Journals (Sweden)

Simona eDe Falco

2014-08-01

Full Text Available Child healthy development is largely influenced by parent-child interaction and a secure parent-child attachment is predictively associated with positive outcomes in numerous domains of child development. However, the parent-child relationship can be affected by several psychosocial and socio-demographic risk factors that undermine its quality and in turn play a negative role in short and long term child psychological health. Prevention and intervention programs that support parenting skills in at-risk families can efficiently reduce the impact of risk factors on mother and child psychological health. This study examines predictors of mother-child interaction quality and child attachment security in a sample of first-time mothers with psychosocial and/or socio-demographic risk factors. Forty primiparous women satisfying specific risk criteria participated in a longitudinal study with their children from pregnancy until 18 month of child age. A multiple psychological and socioeconomic assessment was performed. The Emotional Availability Scales were used to measure the quality of emotional exchanges between mother and child at 12 months and the Attachment Q-Sort served as a measure of child attachment security at 18 months. Results highlight both the effect of specific single factors, considered at a continuous level, and the cumulative risk effect of different co-occurring factors, considered at binary level, on mother-child interaction quality and child attachment security. Implication for the selection of inclusion criteria of intervention programs that support parenting skills in at-risk families are discussed.

Individual and hospital-specific factors influencing medical graduates' time to medical specialization.

Science.gov (United States)

Johannessen, Karl-Arne; Hagen, Terje P

2013-11-01

Previous studies of gender differences in relation to medical specialization have focused more on social variables than hospital-specific factors. In a multivariate analysis with extended Cox regression, we used register data for socio-demographic variables (gender, family and having a child born during the study period) together with hospital-specific variables (the amount of supervision available, efficiency pressure and the type of teaching hospital) to study the concurrent effect of these variables on specialty qualification among all 2474 Norwegian residents who began specialization in 1999-2001. We followed the residents until 2010. A lower proportion of women qualified for a specialty in the study period (67.9% compared with 78.7% of men, p specialization qualification (p specialization: working at university hospitals (regional) or central hospitals was associated with a reduction in the time taken to complete the specialization, whereas an increased patient load and less supervision had the opposite effect. Multivariate analysis showed that the smaller proportion of women who qualified for a specialty was explained principally by childbirth and by the number of children aged under 18 years. Copyright © 2013 Elsevier Ltd. All rights reserved.

MEASUREMENT OF FATHER-CHILD ROUGH-AND-TUMBLE PLAY AND ITS RELATIONS TO CHILD BEHAVIOR.

Science.gov (United States)

Stgeorge, Jennifer; Freeman, Emily

2017-11-01

Although there is increasing evidence of paternal influence on child outcomes such as language and cognition, researchers are not yet clear on the features of father-child play that are most valuable in terms of child development. Physical play such as rough and tumble play (RTP) is a favored type of father-child play in Western societies that has been linked to children's socioemotional competence. It is important, therefore, to determine the implications of this play for child development. In this review and meta-analysis, associations between father-child physical play and child behavior were examined. The review also focused on study methods. Sixteen studies are reviewed, N = 1,521 father-child dyads, 35% boys. Study characteristics such as definitions of physical play, play settings, play measures, and coding were examined. The meta-analysis found weak to moderate population effects for links between father-child physical play and child aggression, social competence, emotional skills, and self-regulation. Research investigating the effect of father-child physical play on children's development will be improved when definitions clearly identify the nature of play, settings facilitate boisterous play, and measures include frequency and quality of play interactions. This play shows promise as an enhancer of positive father-child relationships and a catalyst for child development. © 2017 Michigan Association for Infant Mental Health.

Reiki training for caregivers of hospitalized pediatric patients: A pilot program☆

Science.gov (United States)

Kundu, Anjana; Dolan-Oves, Rebecca; Dimmers, Martha A.; Towle, Cara B.; Doorenbos, Ardith Z.

2013-01-01

To explore the feasibility of a Reiki therapy-training program for the caregivers of pediatric medical or oncology inpatients, at a large pediatric hospital, a series of Reiki training classes were offered by a Reiki Master. At completion of the training, an interview was conducted to elicit participant’s feedback regarding the effectiveness and feasibility of the training program. Seventeen of the 18 families agreed to participate. Most families (65%) attended three Reiki training sessions, reporting that Reiki benefitted their child by improving their comfort (76%), providing relaxation (88%), and pain relief (41%). All caregivers identified becoming an active participant in their child’s care as a major gain from participation in the Reiki training. A hospital-based Reiki training program for caregivers of hospitalized pediatric patients is feasible and can positively impact patients and their families. More rigorous research regarding the benefits of Reiki in the pediatric population is needed. PMID:23337565

45 CFR 98.20 - A child's eligibility for child care services.

Science.gov (United States)

2010-10-01

..., ethnic background, sex, religious affiliation, or disability; (2) Limit parental rights provided under... 45 Public Welfare 1 2010-10-01 2010-10-01 false A child's eligibility for child care services. 98.20 Section 98.20 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD...

Child health, child education.

Science.gov (United States)

Rao, A R

1989-06-01

Although child survival programs may help to increase the life span of poor children in developing countries such as India, the quality of life will remain unchanged unless the value of involving children in health education efforts is recognized. The primary health care strategy seeks to involve children and communities in making decisions and taking actions to improve their health. Children can be engaged in the learning process through activities such as helping to care for younger siblings, educating children of their own age who are not attending school, and spreading preventive health messages to their homes and communities. Numerous studies have confirmed that children are easily motivated to play such roles and have the desire to transfer their knowledge to others; however, it is essential that health education messages are appropriate for the level of the child. Specific messages with tested effectiveness in child-to-child programs include accident prevention, dental hygiene, neighborhood hygiene, use of oral rehydration in cases of diarrhea, recognition of signs of major illness, care of sick children, use of play and mental stimulation to enhance children's development, and the making of toys and games to aid growth. Children can further be instructed to identify peers with sight and hearing problems as well as those with nutritional deficiencies. In the Malvani Project in Bombay, children are given responsibility for the health care of 3-4 families in their neighborhood. In the NCERT Project in New Delhi, children are organizing artistic exhibitions and plays to convey health messages to their peers who are not in school. Also in New Delhi, the VHAI Project has enlisted children in campaigns to prevent diarrhea and dehydration, smoking, and drug use.

[Practices of nursing staff in the process of preterm baby hospital discharge].

Science.gov (United States)

Schmidt, Kayna Trombini; Terassi, Mariélli; Marcon, Sonia Silva; Higarashi, Ieda Harumi

2013-12-01

The objective of this study was to identify the strategies used by the nursing team in the neonatal unity care of a school-hospital during the preparation of the family for the premature baby discharge. It is a descriptive study with qualitative approach. The data was collected between March and June 2011, by means of observation and semi-structured interviews. From the discourse analysis two categories appeared: Orientations and professional strategies in preparing the family for the premature baby hospital discharge and Difficulties and potentialities in the neonatal attention space. The main strategy mentioned was the family early insertion in the caring process and the stressed difficulty was the parents' absence during the child's hospital staying. The potentialities and limitations pointed out in this study revealed that the assistance process is dynamic, asking for constant correction and adequacies to effectively and wholly care for the premature baby and its family.

Child Neglect in the Military Community: Are We Neglecting the Child?

Science.gov (United States)

1995-04-01

absent a state statute, charges for child neglect under clauses 1 and 2, disorders or neglects to the prejudice of good order and discipline, may not...DOarMRET ROCIuCsiz KMW nuavmm Mr B2ID urn "LA NrOC DO CUMAE•N LOAN DOCUMENT CHILD NEGLECT IN THE MILITARY COMMUNITY: ARE WE NEGLECTING THE CHILD ? A Thesis...M. Schenck United States Army 43D JUDGE ADVOCATE OFFICER GRADUATE COURSE April 1995 Published: 148 Mil. L. Rev. 1 (1995). CHILD NEGLECT IN THE

The Process of Parents' Decision-Making to Discharge Their Child against Medical Advice (DAMA: A grounded theory study

Directory of Open Access Journals (Sweden)

Nikbakht Nasrabadi Alireza

2016-05-01

Full Text Available Discharge against medical advice (DAMA refers to the phenomenon that patient or the patient’s surrogate decides to leave the hospital before the attending physician confirms the patient is discharged. Children are much more vulnerable to such discharges. This process occurs with different mechanisms that identifying them can be helpful in reducing this phenomenon. We aimed to explore the process of parents' decision-making to discharge their child against medical advice. In-depth, semi-structured interviews were conducted with 10 fathers, 10 mothers, 6 nurses and 3 physician assistants and the data were collected to the point of saturation. Grounded theory methodology was adopted for data collection and analysis. The results of qualitative analysis in the field of the parents' decisionmaking on the DAMA revealed 4 main themes: "lack of family-centered care", "disruption of the parenting process", "distrust to the medical team and center" and "psychological strategy of shirk responsibility for child care and treatment ". By providing family-centered care, adopting measures to empowering the families, developing the trust of parents to the health care team and developing a discharge plan from the beginning of children hospitalization with the cooperation of health care team and parents and considering all factors such as child's special health condition and parent's health related perceptions and beliefs, children will not be discharged against medical advice and will experience better outcomes.

Child maltreatment and cannabis use in young adulthood: a birth cohort study.

Science.gov (United States)

Mills, Ryan; Kisely, Steve; Alati, Rosa; Strathearn, Lane; Najman, Jake M

2017-03-01

To investigate whether: (1) child maltreatment is associated with life-time cannabis use, early-onset cannabis use, daily cannabis use and DSM-IV cannabis abuse in young adulthood; and (2) behaviour problems, tobacco use and alcohol use at age 14 are associated with cannabis use. Birth cohort using linked government agency child protection data to define exposure to child maltreatment. The Mater-University of Queensland Study of Pregnancy in Brisbane, Australia. Of the original cohort of 7223 mother and child pairs, obtained from consecutive presentations for prenatal care at a hospital serving a cross-section of the community, 3778 (52.3%) of the young people participated at age 21 years. Exposure to child maltreatment was established by substantiated government agency reports. Cannabis outcomes were by self-report questionnaire and Composite International Diagnostic Interview (CIDI)-Auto at age 21. Associations were adjusted for a range of potential confounders. Additional adjustment was carried out for variables measured at age 14-youth behaviour problems [Achenbach Child Behavior Checklist (CBCL)], tobacco use and alcohol use. After adjustment, substantiated child maltreatment was associated with any life-time cannabis use [odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.08-2.39], cannabis use prior to age 17 (OR = 2.47, 95 % CI = 1.67-3.65), daily cannabis use (OR = 2.68, 95% CI = 1.49-4.81) and DSM-IV cannabis abuse/dependence (OR = 1.72, 95% CI = 1.07-2.77). Externalizing behaviour and tobacco and alcohol use at age 14 were associated significantly with almost all cannabis outcomes (P maltreated are more likely to go on to use cannabis before the age of 17, use cannabis as an adult, use cannabis daily and meet DSM-IV criteria for cannabis dependence. Externalizing behaviour in adolescence appears partly to mediate the association with adult cannabis use. © 2016 Society for the Study of Addiction.

Improving child nutrition at the village level.

Science.gov (United States)

Stanfield, J P

1981-01-01

The decision was made about 12 years ago in the Department of Pediatrics and Child Health of Makerere University to see if childhood malnutrition could be cured and prevented in a rural area of Uganda, surrounding a small 10-bedded maternity center some 20 miles north of Kampala. The staff included 2 midwives and another midwife who had had training in health visiting, and a community development foreman. There were weekly visits from the Church of Uganda Mengo Hospital by a doctor and sister and a similar visit from an agricultural assistant from Makerere University Department of Agriculture. A small shelter was built on the grounds of the maternity center for the purpose of conducting antenatal and children's clinics. From the beginning the intention was to involve the community, and this was done through the local pastor and the community development foreman assisted by the midwife with health-visiting experience. A local club was formed, and members decided to start by improving and cleaning the local sources of water. At the clinic infants and children were weighed and seen every fortnight until they had been immunized, and thereafter at any time their mothers were anxious about them. Any child who showed early signs of faltering in weight or of clinical malnutrition was followed by a midwife health visitor from the large children's clinic. The mothers were taught about mixing the food to give the children adequate calories and protein. The principles which appeared to be significant in the improvement of child nutrition at the village level were the following: identification; involvement of mothers; communication with the people; involvement of influential persons; indoctrination; integration in village life; and staff effectiveness.

Funding child rearing: child allowance and parental leave.

Science.gov (United States)

Walker, J R

1996-01-01

This article proposes two financing plans to address what the author identifies as the two primary concerns in the child care field: (1) a child allowance for poor and near-poor households to address the child care problems of low-income families, and (2) a program of voluntary parental leave, available to all parents at child birth or adoption, to ensure the adequacy of infant care. The child allowance plan would cover the first three children in families up to 175% of the poverty level (more than 22 million children) at an annual cost of $45 billion. The author suggests that the allowance could be financed by redirecting funds from existing income support (for example, Aid to Families with Dependent Children), tax credit, and tax deduction programs. Financing the parental leave program would require new revenues, generated by an employee-paid increase in payroll tax totaling 3.5%. Each employee's contributions would create a parental leave account (PLA). Families could use the funds in these accounts to cover the cost of a one-year leave from work after the birth or adoption of a child. If families did not have enough dollars in their accounts to cover the cost of the leave, the federal government would extend a low-interest loan to them, which they would have to pay back. The amount individuals receive through Social Security would be adjusted upward or downward according to the balances in their parental leave accounts at retirement. The author suggests that both proposals would help parents balance work and family obligations and protect parental freedom of choice over the care and upbringing of their children.

Care ethics in hospitalized child: a perspective for nursing

Directory of Open Access Journals (Sweden)

Benedita Maria Rêgo Deusdará Rodrigues

2014-10-01

Full Text Available Objetivo: Apreender quais são os aspectos éticos que norteiam o cuidado prestado pelo enfermeiro à criança hospitalizada. Método: Estudo qualitativo com enfoque na fenomenologia sociológica de Alfred Schutz. Foram entrevistados 10 enfermeiros lotados nas unidades de internação de um hospital municipal, localizado na cidade do Rio de Janeiro, em 2011. A entrevista fenomenológica pautou-se na questão: Quais os aspectos éticos que norteiam o seu cuidado a criança hospitalizada?   Resultados: A análise das falas possibilitou a apreensão de duas categorias discutidas à luz da fenomenologia sociológica que são: Respeito à privacidade da criança e Respeito à família da criança hospitalizada. Conclusões: O estudo permitiu o entendimento de que as ações do enfermeiro no que diz respeito à ética no cuidado à criança hospitalizada perpassam pelo reconhecimento da família como elemento indispensável na assistência de enfermagem. Aponta a necessidade de repensar sobre as práticas em saúde, como um modo ético de cuidar. Descritores: Ética, Saúde da criança, Cuidados de enfermagem.

Identifying Child-Staff Ratios That Promote Peer Skills in Child Care

Science.gov (United States)

Iluz, Reli; Adi-Japha, Esther; Klein, Pnina S.

2016-01-01

Research Findings: Early child care policy and practice are grounded in a growing understanding of the importance of the first years of life. In earlier studies, associations between child-staff ratios and peer skills yielded inconsistent findings. The current study used data from the National Institute of Child Health and Human Development Study…

Animal livestock and the risk of hospitalized diarrhoea in children under 5 years in Vietnam.

Science.gov (United States)

Thiem, Vu Dinh; Schmidt, Wolf-Peter; Suzuki, Motoi; Tho, Le Huu; Yanai, Hideki; Ariyoshi, Koya; Anh, Dang Duc; Yoshida, Lay-Myint

2012-05-01

To investigate the association between environmental exposure to livestock and incidence of diarrhoea among Vietnamese children. A population-based cohort of 353,525 individuals, living in 75,828 households in Khanh Hoa Province, Vietnam, with baseline data covering geo-referenced information on demography, socio-economic status and household animals was investigated. Geographic information system was applied to calculate the density of livestock. The data were linked to hospitalized diarrhoea cases of children under 5 years recorded at two hospitals treating patients from the area as inpatients in the study area. Overall, 3116 children with diarrhoea were hospitalized during the study period. The incidence of diarrhoea hospitalization was 60.8/1000 child-years. Male gender, age Vietnam. Public health interventions to reduce childhood diarrhoea burden should focus on well-recognized causes such as sanitation, personal hygiene, access to adequate clean water supply and vaccination. © 2012 Blackwell Publishing Ltd.

Association between maternal depressive symptoms with child malnutrition or child excess weight

Directory of Open Access Journals (Sweden)

Thais Feres Moreira Lima

Full Text Available Abstract Objectives: to verify associations between maternal depressive symptoms with child malnutrition or child excess weight. Methods: prospective study with data from the BRISA prenatal cohort in São Luís, Brazil, obtained from the 22nd to the 25th week of gestation (in 2009 and 2010 and, later, when children were aged 12 to 32 months (in 2010 and 2012. Maternal depressive symptoms were identified using the Center for Epidemiologic Studies Depression Scale (CES-D and the Edinburgh Postnatal Depression Scale (EPDS. For the excess weight evaluation, BMI z-score for age > +2 was used. For measuring child malnutrition, height z-score for age < -2 was used. The confounding factors were identified using a directed acyclic graph in DAGitty software. Results: we did not find associations between maternal depressive symptoms with child malnutrition or child excess weight. The prevalence of maternal depressive symptoms was 27.6% during gestation and 19.8% in the second or third year of the child's life. The malnutrition rate was 6% and the excess weight rate was 10.9%. Conclusions: no associations between maternal depressive symptoms in prenatal or in the second or third year of the child's life and child malnutrition or excess weight were detected.

Maternal ratings of child health and child obesity, variations by mother's race/ethnicity and nativity.

Science.gov (United States)

Baker, Elizabeth H; Altman, Claire E

2015-05-01

We examined whether indicators of child health, focusing on obesity, are associated with maternal ratings of child health (MRCH) and its variation by mother's ethnicity/nativity, focusing on Hispanics. The early childhood longitudinal study, kindergarten cohort kindergarten-eighth grade waves (n = 48,814) and nested general linear mixed modeling are used to examine excellent MRCH. The only indicator of child health that varies by mother's ethnicity/nativity for MRCH is child obesity. Child obesity did not influence MRCH for foreign-born Hispanic mothers, especially among less acculturated mothers, though significant differences among immigrants by acculturation were not found. However, among native-born white, black, and Hispanic mothers child obesity was associated with a lower likelihood of excellent MRCH even after controls for socioeconomic characteristics, family characteristics, and other indicators of child health are included. MRCH reflect not only child's actual health, but also the mother's perception of what contributes to poor child health. Our findings suggest that less acculturated foreign-born Hispanic mothers are less likely to associate child obesity with poor child health. Cultural orientations that prefer heavier children or are unlikely to associate child obesity with poor child health may contribute to the higher levels of obesity found among their children.

Is there any place for spontaneous healing in deep palmar burn of the child?

Science.gov (United States)

Chateau, J; Guillot, M; Zevounou, L; Braye, F; Foyatier, J-L; Comparin, J-P; Voulliaume, D

2017-06-01

Child palm burns arise by contact and are often deep. The singular difficulty of such a disease comes from the necessity of the child growth and from the potential occurrence of constricted scars. In order to avoid sequelae, the actual gold standard is to practice an early excision of the burn, followed by a skin graft. The aim of this study is to evaluate the results of spontaneous healing combined with rehabilitation versus early skin grafting and rehabilitation concerning the apparition of sequelae. We performed a retrospective study in two burn centers and one rehabilitation hospital between 1995 and 2010. Eighty-seven hands have been included in two groups: one group for spontaneous healing and the other group for excision and skin grafting. Every child benefited from a specific rehabilitation protocol. The two main evaluation criteria were the duration of permanent splint wearing and the number of reconstructive surgery for each child. The median follow-up duration is about four years. The two groups were comparable. For the early skin grafting group, the splint wearing duration was 1/3 longer than for the spontaneous healing group. Concerning the reconstructive surgery, half of the grafted hands needed at least one procedure versus 1/5 of spontaneous healing hands. Our results show the interest of spontaneous healing in palmar burn in child, this observation requires a specific and intense rehabilitation protocol. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Extended child and caregiver benefits of behavior-based child contingency learning games.

Science.gov (United States)

Dunst, Carl J; Raab, Melinda; Trivette, Carol M; Wilson, Linda L; Hamby, Deborah W; Parkey, Cindy

2010-08-01

Findings from 2 studies of the relationship between response-contingent child behavior and child, caregiver-child, and caregiver behavior not directly associated with child contingency learning are described. The participants were 19 children with significant developmental delays and their mothers in 1 study and 22 children with significant developmental delays and their teachers in the second study. Caregivers engaged the children in learning games characterized by behavior-based contingencies for 15 weeks. Research staff observed the children and their caregivers in everyday routines and activities and rated child and caregiver behavior while the children and caregivers were not playing the games. Results from both studies showed that the degree of response-contingent responding during the games was related to child and caregiver behavior, not the focus of the contingency learning opportunities afforded the children. Implications for practice are described.

Thoracic solitary pedunculated osteochondroma in a child: a case report

Directory of Open Access Journals (Sweden)

Wali Z

2013-10-01

Full Text Available Zubair Wali,1 Khalid I Khoshhal21Department of Orthopedic Surgery, King Fahd Hospital, Almadinah Almunawwarah, Saudi Arabia; 2Department of Orthopedic Surgery, College of Medicine, Taibah University, Almadinah Almunawwarah, Saudi ArabiaObjective: This case report describes the rare presentation of a thoracic pedunculated osteochondroma in a child, arising from the lamina of the fourth thoracic vertebra.Clinical features: A 7-year-old girl was referred for the evaluation of a swelling in her back. The patient was suffering from atraumatic, progressive painless back swelling, of approximately 2 years duration. The physical examination showed a healthy child, with a well-defined mass, about 4 × 6 cm, located around the midline of the upper thoracic spine. No clinical signs of hereditary multiple exostoses were detected. Plain radiographs and computerized tomography were suggestive of a pedunculated osteochondroma arising from the lamina of the fourth thoracic vertebra.Intervention and outcome: The patient underwent surgical excision of the mass. The pathologist confirmed the diagnosis. Follow up for 2 years did not show any evidence of clinical or radiological recurrence.Conclusion: The current report describes a rare case and the management of a solitary pedunculated osteochondroma arising from the lamina of the fourth thoracic vertebra in a child below the age of 10 years.Keywords: benign tumors, hereditary multiple exostoses, spine column tumors, thoracic vertebra

Predictors of Hospitalization among Children on ART in Ethiopia: a Cohort study.

Science.gov (United States)

Haileamlak, Abraham; Hagos, Tesfalem; Abebe, Workeabeba; Abraham, Loko; Asefa, Henok; Teklu, Alula M

2017-02-01

Substantial progress has been made in the management of pediatric HIV infection in Ethiopia with the implementation of mother-to-child-prevention programs. Since the introduction of HAART in 2005, mortality among HIV-infected children has reduced while the rate of hospitalization was expected to rise. The purpose of this study, therefore, was to assess predictors of hospitalization in children on ART in seven university referral hospitals in Ethiopia. A prospective cohort study design was employed on children age 0-18 years as part of a multisite observational study. ART-experienced eligible and ART-naïve children with HIV/AIDS were enrolled into the Advanced Clinical Monitoring (ACM) till December 31, 2012 were included. From the database, information on hospitalization and other independent variables were extracted. Analysis was done using both SPSS for Windows version 16.0 and STATA. Descriptive analyses and modeling was done using logistic regression. Of the 405 children on ART (174 experienced, 231 naive), 86 (20.7%) were hospitalized for various reasons; two children were excluded since they were hospitalized for unrelated conditions (appendicitis and burn). Fifty one (60.7%) of the eighty four admitted children were hospitalized in the first six months of ART initiation. Of the independent variables, only the presence of opportunistic infections and duration on ART were significantly associated with hospitalization both on bi-variable and multivariable analyses (P-value ART increased by one month, the risk of hospitalization decreased by 5.4%, which is statistically significant (P hospitalized increased by 35.2% (P = 0.002). Of the individual opportunistic infections, pneumonia was found to be the only predictor of hospitalization (P-value = 0.002). This study showed that nearly two-third of the hospitalization was within 6 months of initiation of ART; and presence of OI and duration on ART were the only predictors of hospitalization.

Maternal Mental Representations of the Child and Mobile Phone Use During Parent-Child Mealtimes.

Science.gov (United States)

Radesky, Jenny; Leung, Christy; Appugliese, Danielle; Miller, Alison L; Lumeng, Julie C; Rosenblum, Katherine L

2018-05-01

Qualities of the parent-child relationship have not been explored as predictors of parent mobile device use during parent-child activities. In 195 mother-child dyads enrolled in an ongoing cohort study, maternal mental representations of their child (ability to reflect on their child's characteristics, emotional state, and their parenting role) were evaluated through the Working Model of the Child Interview (WMCI), a validated semistructured interview. WMCI scale scores were examined as predictors of active maternal mobile device use during parent-child eating encounters (videotaped home mealtimes and a structured laboratory-based protocol) in multivariate logistic regression models. Children were aged 5.9 years (SD: 0.7), mothers were aged 31.5 years (SD: 7.4), and 73.3% of mothers were of white non-Hispanic race/ethnicity. During the family mealtime, 47 (24.1%) mothers actively used a mobile device at least once, whereas during the structured eating protocol, 44 (22.6%) mothers used a device. Controlling for maternal race/ethnicity, education level, and child's sex, WMCI subscales were associated with device use during home mealtimes (higher Child Difficulty) and the eating protocol (higher Child Difficulty and lower Richness of Perceptions and Caregiving Sensitivity). Maternal mental representations of their child were significantly associated with using mobile devices during eating encounters. More research studies are needed to understand directionality and longer-term associations between mobile device use and parent-child relationship characteristics.

Preschool Child Care and Child Well-being in Germany

DEFF Research Database (Denmark)

Kaiser, Micha; Bauer, Jan M.

Because the value of preschool child care is under intensive debate among both policymakers and society in general, this paper analyzes the relation between preschool care and the well-being of children and adolescents in Germany. It also examines differences in outcomes based on child...... socioeconomic background by focusing on the heterogeneous effects for migrant children. Our findings, based on data from the German Health Interview and Examination Survey of Children and Adolescents, suggest that children who have experienced child care have a slightly lower well-being overall. For migrant...

Child-Visiting and Domestic Abuse.

Science.gov (United States)

Shepard, Melanie

1992-01-01

Explains problems with child visiting in cases of domestic abuse. Data on domestic abuse, child care concerns, and child adjustment problems were collected from 25 mothers and 22 fathers at a child visiting program serving separated and abusive families. Psychological abuse of mothers correlated with child adjustment problems. (BB)

Effects of nurse-led child- and parent-focused violence intervention on mentally ill adult patients and victimized parents: A randomized controlled trial.

Science.gov (United States)

Sun, Gwo-Ching; Hsu, Mei-Chi

2016-08-01

Child-to-parent violence is an often hidden serious problem for parental caregivers of mentally ill adult children who experience violence toward them. To date, the comprehensive dyadic parent-adult child intervention to manage child-to-parent violence is scarce. To evaluate the effect of Child- and Parent-focused Violence Program, an adjunctive intervention involved with both violent adult children with mental illness and their victimized biological parent (parent-adult child dyads) on violence management. Open-label randomized controlled trial. A psychiatric ward in a teaching hospital and two mental hospitals in Southern Taiwan. Sixty-nine patients aged ≥20 years, with thought or mood disorders, having violent behavior in the past 6 months toward their biological parent of either gender were recruited. The violent patients' victimized biological parents who had a major and ongoing role in provision of care to these patients, living together with and being assaulted by their violent children were also recruited. The parent-adult child dyads were selected. The intervention was carried out from 2011 to 2013. The parent-adult child dyads were randomly assigned to either the experimental group (36 dyads), which received Child- and Parent-focused Violence Intervention Program, or to the control group (33 dyads), which received only routine psychiatric care. The intervention included two individualized sessions for each patient and parent, separately, and 2 conjoint sessions for each parental-child dyad for a total of 6 sessions. Each session lasted for at least 60-min. Data collection was conducted at 3 different time frames: pre-treatment, post-treatment, and treatment follow-up (one month after the completion of the intervention). Occurrence of violence prior to intervention was comparable between two groups: 88.9% (n=32) parents in the experimental group versus 93.9% (n=31) in the control group experienced verbal attack, and 50% (n=18) versus 48.5% (n=16

What's Going on with This Child? Child Study for the 21st Century

Science.gov (United States)

Jones, Allison; Cossentino, Jacqueline

2017-01-01

Allison Jones and Jacqueline Cossentino have taken the term child study to describe the work they do with children experiencing challenges. Their approach to child study attempts to change the typical question of "What is wrong with this child?" to "What is going on with this child?" They have created a system by which they try…

Maternal intimate partner violence exposure, child cortisol reactivity and child asthma.

Science.gov (United States)

Bair-Merritt, Megan H; Voegtline, Kristin; Ghazarian, Sharon R; Granger, Douglas A; Blair, Clancy; Johnson, Sara B

2015-10-01

Psychosocial stressors like intimate partner violence (IPV) exposure are associated with increased risk of childhood asthma. Longitudinal studies have not investigated the role of hypothalamic-pituitary-adrenal (HPA) axis reactivity (and associated alterations in cortisol release) in the child IPV exposure-asthma association. We sought to investigate this association, and to assess whether this relationship differs by child HPA reactivity. This secondary analysis used longitudinal cohort data from the Family Life Project. Participants included 1,292 low-income children and mothers; maternal interview and child biomarker data, including maternal report of IPV and child asthma, and child salivary cortisol obtained with validated stress reactivity paradigms, were collected when the child was 7, 15, 24, 35, and 48 months. Using structural equation modeling, maternal IPV when the child was 7 months of age predicted subsequent reports of childhood asthma (B=0.18, p=.002). This association differed according to the child's HPA reactivity status, with IPV exposed children who were HPA reactors at 7 and 15 months of age--defined as a ≥10% increase in cortisol level twenty minutes post peak arousal during the challenge tasks and a raw increase of at least .02μg/dl--being significantly at risk for asthma (7 months: B=0.17, p=.02; 15 months: B=0.17, p=.02). Our findings provide support that children who are physiologically reactive are the most vulnerable to adverse health outcomes when faced with environmental stressors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt.

Science.gov (United States)

Hoytema van Konijnenburg, Eva M M; Diderich, Hester M; Teeuw, Arianne H; Klein Velderman, Mariska; Oudesluys-Murphy, Anne Marie; van der Lee, Johanna H

2016-03-01

To improve identification of child maltreatment, a new policy ('Hague protocol') was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care for children. If so, these children are referred to the Reporting Center for Child Abuse and Neglect (RCCAN), for assessment and referrals to support services. An adapted, hospital-based version of this protocol ('Amsterdam protocol') was implemented in another region. Children are identified in the same manner, but, instead of a RCCAN referral, they are referred to the pediatric outpatient department for an assessment, including a physical examination, and referrals to services. We compared results of both protocols to assess how differences between the protocols affect the outcomes on implementation, detection of child maltreatment and referrals to services. Furthermore, we assessed social validity and results of a screening physical examination. We included 212 families from the Amsterdam protocol (cohort study with reports by pediatric staff and parents) and 565 families from the Hague protocol (study of RCCAN records and telephone interviews with parents). We found that the RCCAN identified more maltreatment than pediatric staff (98% versus at least 51%), but referrals to services were similar (82% versus 80% of the total sample) and parents were positive about both interventions. Physical examination revealed signs of maltreatment in 5%. We conclude that, despite the differences, both procedures can serve as suitable methods to identify and refer children at risk for maltreatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Observed parent-child feeding dynamics in relation to child body mass index and adiposity.

Science.gov (United States)

Johnson, C M; Henderson, M S; Tripicchio, G; Rozin, P; Heo, M; Pietrobelli, A; Berkowitz, R I; Keller, K L; Faith, M S

2018-04-01

Restrictive feeding is associated with child overweight; however, the majority of studies used parent-report questionnaires. The relationship between child adiposity measures and directly observed parent and child behaviours were tested using a novel behavioural coding system (BCS). Data from 109 children, participants in a twin study and their mothers, were analyzed. Parent-child dyads were video-recorded twice in the laboratory, while children ate ad libitum from a buffet lunch. Mother and child behaviours were assessed using the BCS. Height, body weight and body fat were directly measured for each child. Associations between child adiposity measures and average BCS behaviour (i.e. pooled across visits) were tested using partial correlations adjusting for child age. Regarding discouragement prompts, child body mass index (BMI) z-score was significantly associated with a greater rate of total discouragements (per minute, min -1 ), nonverbal discouragements (min -1 ) and temporary (delay) discouragements (min -1 ) (p < 0.05). Child percent body fat was associated with greater nonverbal discouragements (min -1 ). Regarding encouragement prompts, child BMI z-score was significantly associated with a greater rate of total encouragements (min -1 ), nonverbal encouragements (min -1 ) and reward encouragements (min -1 ). Child BMI z-score and percent body fat were both positively associated with greater maternal health encouragements (min -1 ). Associations with encouragement to eat prompts were no longer significant when accounting for the dependence among twins (being part of the same family). Heavier children received greater maternal discouragements to eat and, with qualifications, encouragements to eat. The role of nonverbal parenting cues warrants further research regarding child eating regulation and obesity. © 2017 World Obesity Federation.

Does the gender of parent or child matter in child maltreatment in China?

Science.gov (United States)

Cui, Naixue; Xue, Jia; Connolly, Cynthia A; Liu, Jianghong

2016-04-01

Child maltreatment is a public health problem worldwide, and China is no exception. However, the pattern of child maltreatment remains unknown, including whether the gender of children and their parents has an impact on the occurrence of maltreatment. This study aims at examining the rates and frequency of child maltreatment, including physical abuse, psychological abuse and neglect perpetrated by mothers and fathers. We also test whether the interaction between parents' gender and their child's gender affects the occurrence of child maltreatment in China. 997 children from the China Jintan Child Cohort Study participated in the present study and reported their maltreatment experience perpetrated by their mothers and fathers using the questionnaire, Parent-Child Conflict Tactics Scale (CTSPC_CA). Generalized linear model analyses show that boys were more likely than girls to report physical abuse, and, in particular, boys were more likely than girls to be physically abused by their fathers. On the other hand, mothers were more likely than fathers to exhibit psychological aggression and use corporal punishment for both boys and girls. There was no difference based on the child's or parent's gender in the occurrence of neglect. The findings present empirical evidence that enhances the understanding of the pattern of child maltreatment in China, provide implications for social workers and health professionals to identify children at risk of child maltreatment, and shed light on future research studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Implementing a pediatric obesity care guideline in a freestanding children's hospital to improve child safety and hospital preparedness.

Science.gov (United States)

Porter, Renee M; Thrasher, Jodi; Krebs, Nancy F

2012-12-01

Medical and surgical care of children with severe obesity is complicated and requires recognition of the problem, appropriate equipment, and safe management. There is little literature describing patient, provider, and institutional needs for the severely obese pediatric patient. Nonetheless, the limited data suggest 3 broad categories of needs unique to this population: (a) airway management, (b) drug dosing and pharmacology, and (c) equipment and infrastructure. We describe an opportunity at the Children's Hospital Colorado to better prepare and optimize care for this patient population by creation of a Pediatric Obesity Care Guideline that focused on key areas of quality and safety. Copyright © 2012 Elsevier Inc. All rights reserved.

CDC Kerala 14: Early child care practices at home among children (2-6 y) with autism--a case control study.

Science.gov (United States)

George, Babu; Padmam, M S Razeena; Nair, M K C; Leena, M L; Russell, Paul Swamidhas Sudhakar

2014-12-01

To compare early child care practices at home as possible risk factors among children between 2 and 6 y of age with autism and a control group of normal children without any symptom of autism, presenting at the well-baby/immunization clinic. This case control study was undertaken at the autism clinic of CDC Kerala, comparing possible risk factors for autism among 143 children between 2 and 6 y with autism as per CARS criteria and a control group of 200 normal children of the same age from well-baby/immunization clinic of SAT hospital. The data was collected using a structured pre-piloted questionnaire, which included 11 questions administered by the same senior social scientist, on early child care practices at home that have been universally considered as important for child development. On multivariate analysis on early child care practices at home as possible risk factors for autism, it was observed that statistically significant high odds ratios were present for (i) no outings (OR = 3.36; 95% CI: 1.39-8.16; p 0.007); (ii) child does not play with children of same age (OR = 19.57; 95% CI: 9.50-40.32); (iii) do not tell stories/sing songs to the child (OR = 3.21; 9 % CI: 1.61-6.41); and (iv) breastfeeding duration nil/ early child care practices at home, specifically breastfeeding duration nil/ child does not play with children of same age, do not tell stories/sing songs to the child and no outings for the child are possible risk factors for autism.

Pet dogs and child physical activity: the role of child-dog attachment.

Science.gov (United States)

Gadomski, A M; Scribani, M B; Krupa, N; Jenkins, P

2017-10-01

Dog ownership has been associated with increased physical activity in children which in turn may mitigate childhood obesity. To measure the association between child-dog attachment and child physical activity and screen time. Cross-sectional study including 370 children (ages 4-10) who had pet dogs in the home. Parents completed the DartScreen, a web-based screener, before a well-child visit. Screener domains included child body mass index (BMI), physical activity, screen time and dog-related questions. The Companion Animal Bonding Scale (CABS) was used to measure child attachment to the dog. Clinic nurses weighed and measured the children. Associations between CABS, BMI z-score, screen time and physical activity were estimated. CABS was strongly associated with time spent being active with the dog (F = 22.81, p dog is associated with increased child physical activity. © 2016 World Obesity Federation.

Role of male partners in the prevention of mother-to-child HIV transmission

Directory of Open Access Journals (Sweden)

Osoti A

2014-07-01

Full Text Available Alfred Osoti,1–3 Hannah Han,4 John Kinuthia,1,5 Carey Farquhar3,4,6 1Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya; 2Department of Obstetrics and Gynecology, AIC Kijabe Hospital, Kijabe, Kenya; 3Department of Epidemiology, 4Department of Global Health, University of Washington, Seattle, USA; 5Department of Obstetrics and Gynecology, Kenyatta National Hospital, Nairobi, Kenya; 6Department of Medicine, University of Washington, Seattle, USA Abstract: There is emerging evidence that in resource-limited settings with a high human immunodeficiency virus (HIV burden, male partner involvement in prevention of mother-to-child HIV transmission (PMTCT is associated with improved uptake of effective interventions and infant HIV-free survival. There is also increasing evidence that male partner involvement positively impacts non-HIV related outcomes, such as skilled attendance at delivery, exclusive breastfeeding, uptake of effective contraceptives, and infant immunizations. Despite these associations, male partner involvement remains low, especially when offered in the standard antenatal clinic setting. In this review we explore strategies for improving rates of antenatal male partner HIV testing and argue that the role of male partners in PMTCT must evolve from one of support for HIV-infected pregnant and breastfeeding women to one of comprehensive engagement in prevention of primary HIV acquisition, avoidance of unintended pregnancies, and improved HIV-related care and treatment for the HIV-infected and uninfected women, their partners, and children. Involving men in all components of PMTCT has potential to contribute substantially to achieving virtual elimination of mother-to-child HIV transmission; promoting partner-friendly programs and policies, as well as pursuing research into numerous gaps in knowledge identified in this review, will help drive this process. Keywords: male involvement, limited-resource settings

Child labour in developing countries

OpenAIRE

Dvořáková, Pavla

2014-01-01

Child labour in developing countries Abstract This bachelor thesis deals with the child labour and its occurence in developing countries. The main aim is to present the basic view of this problem. The term of child labour relies here on Convention on the Rights of the Child and conventions of International Labour Organization. There are several types of child labour, in which children appear most, including the worst forms of child labour. Every type includes description of activities perform...

Illicit drug exposure in patients evaluated for alleged child abuse and neglect.

Science.gov (United States)

Oral, Resmiye; Bayman, Levent; Assad, Abraham; Wibbenmeyer, Lucy; Buhrow, Jakob; Austin, Andrea; Bayman, Emine O

2011-06-01

Substantiation of drug exposure in cases with alleged maltreatment is important to provide proper treatment and services to these children and their families. A study performed at University of Iowa Hospitals and Clinics showed that 30% of pediatric patients with burn injuries, which were due to child maltreatment, were also exposed to illicit drugs. The children presenting to the University of Iowa Hospitals and Clinics with alleged maltreatment have been tested for illicit substances since 2004. The objective of this study was to analyze the presence of illicit drug exposure in the pediatric subpopulation admitted to pediatric inpatient and outpatient units for an evaluation for abuse/neglect. The study design is a retrospective chart review. Using hospital databases, every pediatric chart with a child abuse/neglect allegation was retrieved. The association between risk factors and clinical presentation and illicit drug test result was assessed. Excel and SAS were used for statistical analysis. Institutional review board approval was obtained to conduct this study. Six hundred sixty-five charts met study inclusion criteria for child abuse/neglect allegation. Of those, 232 cases were tested for illicit drugs between 2004 and 2008 per the testing protocol. Thirty-four cases (14.7%) tested positive on a drug test. Positive test rates based on clinical presentation were 28.6% (18/63) in neglect cases, 16.1% (5/31) in cases with soft tissue injuries, 14.3% (4/28) in burn injuries, 10.0% (2/20) in cases with sexual abuse, 7.1% (2/28) in cases with fractures, and 4.8% (3/62) in abusive head trauma cases. There were long-term abuse findings in 129 children (55.6%). Logistic regression analysis revealed that positive drug testing was most significantly associated with clinical symptoms suggesting physical abuse or neglect versus sexual abuse (odds ratio [OR] = 6.70; 95% confidence interval [CI], 1.26-35.49; P = 0.026), no or public health insurance versus those with

The effects of interactive music therapy on hospitalized children with cancer: a pilot study.

Science.gov (United States)

Barrera, Maru E; Rykov, Mary H; Doyle, Sandra L

2002-01-01

The use of music therapy with children in health settings has been documented, but its effectiveness has not yet been well established. This pilot study is a preliminary exploration of the effectiveness of interactive music therapy in reducing anxiety and increasing the comfort of hospitalized children with cancer. Pre- and post-music therapy measures were obtained from children (N = 65) and parents. The measures consisted of children's ratings of mood using schematic faces, parental ratings of the child's play performance, and satisfaction questionnaires completed by parents, children and staff. There was a significant improvement in children's ratings of their feelings from pre- to post-music therapy. Parents perceived an improved play performance after music therapy in pre-schoolers and adolescents but not in school-aged children. Qualitative analyses of children's and parents' comments suggested a positive impact of music therapy on the child's well-being. These preliminary findings are encouraging and suggest beneficial effects of interactive music therapy with hospitalized pediatric hematology/oncology patients. In future studies replicating these findings should be conducted in a randomized control trial. Copyright 2002 John Wiley & Sons, Ltd.

[Sexual child abuse: correlation between medical certificates' conclusions and judiciary sanctions].

Science.gov (United States)

Soumah, M M; Bah, H; Mbaye, I; Fall, M C; Yetognon, C; Sow, M L

2005-01-01

Sexual child abuse, comprises of indecency attitudes and physical misbehaviours, directed towards children are dominated by rape. The objective of our study was to assess in sexual child abuse the relation between the conclusion of medical certificates and court decision. It is a retrospective study carried out from 1994 to 1998 on the clerk's office correctional repertories in Dakar regional court. An overall number of 79 cases of child abuse were collected in 5 years period. Children under 18 years old of of both sex, were concerned. Data found were correlated with a review of requisition cases received by the of gynaecology and obstetrics clinic of Aristide Dantec Hospital. This facilitates the establishement of the relationship between the offences and the pronounced sanctions, as well as the initial medical certificate and these sanctions. The sanctions were severe whenever rape had been retained. Some cases were disqualified in indecent assault and were judged as such. The judge decision, which follow the medical certificate conclusions in 11 cases out of 14 shows the importance and reliability of this medical document. All files reviewed at the medical and legal level were incomplete. The difficulty of the materiality of the rape and the psychological consequences in the long run and especially HIV infection should invite to a multidisciplinary, specialized and organized management of sexual child abuse. This study has shown the importance of a correct and complete drafting of the medical certificate, to enable the establishment by the judge the materiality of the facts.

Non-cognitive Child Outcomes and Universal High Quality Child Care

DEFF Research Database (Denmark)

Datta Gupta, Nabanita; Simonsen, Marianne

2010-01-01

universal preschool programs and family day care vis-à-vis home care. We find that, compared to home care, being enrolled in preschool at age three does not lead to significant differences in child outcomes at age seven no matter the gender or the mother's level of education. Family day care, on the other...... hand, seems to significantly deteriorate outcomes for boys whose mothers have a lower level of education. Finally, longer hours in non-parental care lead to poorer child outcomes.......Exploiting a rich panel data child survey merged with administrative records along with a pseudoexperiment generating variation in the take-up of preschool across municipalities, we provide evidence of the effects on non-cognitive child outcomes of participating in large scale publicly provided...

The Ventricular Assist Device in the Life of the Child: A Phenomenological Pediatric Study

Science.gov (United States)

van Manen, Michael A.

2017-01-01

What is it like for a child to live with an artificial heart? The use of some medical therapies in children requires developmental considerations, is associated with psychosocial consequences, and calls for ethical sensitivities. A critical case is the ventricular assist device (VAD), a mechanical pump used to support the functioning of a failing heart. As a pediatric therapy, the device can be used as a temporary solution for poor heart function, a bridge to transplantation or recovery, or as a destination therapy. While the mechanical-technical operation of the VAD is well understood, the clinical-technical aspects of young people living with this device are largely unexplored. Drawing on interviews of school-aged children, the aim of this phenomenological study is to explore how a VAD may structure or condition a child’s meaningful experience of their world outside the hospital. The driveline of an implanted VAD is the peripheral attachment, extruding through the skin to connect the controller-power supply. The materiality of the device may be interruptive, restrictive, and disturbing to the psycho-physical being and sense of self-identity of the child as a child. And while a child equipped with a VAD is not necessarily conspicuous among other children, the child may experience the device as an exposing presence, while living with the worry of a caregiver who takes on the role not simply of parent but of watchful health professional. A phenomenological understanding of the VAD should assist parents and caregiving health professionals knowing how to deal with specific issues arising in the life of the VAD child. PMID:28682718

The relations of child adiposity with parent-to-child and parent-to-parent hostility.

Science.gov (United States)

Lorber, Michael F; White-Ajmani, Mandi L; Dixon, Denise; Slep, Amy M S; Heyman, Richard E

2017-11-01

Investigate (1) the association of child adiposity with parent-to-child and parent-to-parent hostility, (2) the mediation of these associations by dietary behaviours and (3) moderation by gender. One hundred thirty-five couples with 6- to 14-year-old children completed measures of emotional and physical aggression, overreactive discipline and child diet. Parent-to-parent hostility was also coded from laboratory observations. Child adiposity was a combination of body mass index and waist-to-hip ratio. Mother-to-child hostility was associated with child adiposity. This association was concentrated in boys and was not significantly explained by child dietary factors. Mother-to-father hostility was not significantly associated with boys' or girls' adiposity. Girls' adiposity was not significantly associated with family hostility. Fathers' hostility was not linked to child adiposity. This is the first study to take a family-level approach to understanding the relation of hostility to child adiposity by examining relations among adiposity and both mothers' and fathers' hostility directed toward one another and toward their children. Our findings highlight the potential role played by mothers' emotional hostility in boys' adiposity and suggest that, if this role is further substantiated, mother-son emotional hostility may be a promising target for the prevention of child obesity.

The Influence of Parenting Style and Child Temperament on Child-Parent-Dentist Interactions.

Science.gov (United States)

Aminabadi, Naser Asl; Deljavan, Alireza Sighari; Jamali, Zahra; Azar, Fatemeh Pournaghi; Oskouei, Sina Ghertasi

2015-01-01

This study aimed to investigate the interaction between parenting style and child's temperament as modulators of anxiety and behavior in children during the dental procedure. Healthy four- to six-year-olds (n equals 288), with carious primary molars scheduled to receive amalgam fillings were selected. The Primary Caregivers Practices Report was used to assess the parenting style, and the Children's Behavior Questionnaire-Very Short Form was used to evaluate child temperament. Children were managed using common behavior management strategies. Child behavior and anxiety during the procedure were assessed using the Frankl behavior rating scale and the verbal skill scale, respectively. Spearman's correlation coefficient was used to examine the correlation among variables. Authoritative parenting style was positively related to positive child's behavior (Pauthoritative parenting style on the effortful control trait (Pparent style on the child negative affectivity (PParenting style appeared to mediate child temperament and anxiety, and was related to the child's behavior. Parenting style should be considered in the selection of behavior guidance techniques.

Insatiable insecurity: maternal obesity as a risk factor for mother-child attachment and child weight.

Science.gov (United States)

Keitel-Korndörfer, Anja; Sierau, Susan; Klein, Annette M; Bergmann, Sarah; Grube, Matthias; von Klitzing, Kai

2015-01-01

Childhood obesity has become a rising health problem, and because parental obesity is a basic risk factor for childhood obesity, biological factors have been especially considered in the complex etiology. Aspects of the family interaction, e.g., mother-child attachment, have not been the main focus. Our study tried to fill this gap by investigating whether there is a difference between children of obese and normal weight mothers in terms of mother-child attachment, and whether mother-child attachment predicts child's weight, in a sample of 31 obese and 31 normal weight mothers with children aged 19 to 58 months. Mother-child attachment was measured with the Attachment Q-Set. We found that (1) children of obese mothers showed a lower quality of mother-child attachment than children of normal weight mothers, which indicates that they are less likely to use their mothers as a secure base; (2) the attachment quality predicted child`s BMI percentile; and (3) the mother-child attachment adds incremental validity to the prediction of child's BMI beyond biological parameters (child's BMI birth percentile, BMI of the parents) and mother's relationship status. Implications of our findings are discussed.

Authoritarian Child Rearing, Parental Locus of Control, and the Child's Behavior Style.

Science.gov (United States)

Janssens, Jan M. A. M.

1994-01-01

Examined relationships among childrearing, parental locus of control about childrearing, and child's behavior style. Found that parents who perceived their child's behavior as either externalizing or internalizing had a weak internal locus of control and were more authoritarian. Perceived externalizing child behavior was positively related to…

Psychosocial implications of pediatric surgical hospitalization.

Science.gov (United States)

Lerwick, Julie L

2013-08-01

The prevalence of childhood surgical illness and injury requiring hospitalization suggests the need for implementation of an applied intervention to decrease levels of anxiety in these patients. When psychological concerns are not addressed in the present moment, potential for long-term negative psychological effects occur. To respond to the psychosocial needs of pediatric surgical patients it is important to understand foundational stages of development. Age is not always directly correlated with developmental stage and attunement to this subtle differentiation is essential. Some medical facilities offer services to pediatric surgical patients that include education about upcoming procedures as well as medical play which offers the opportunity to express emotions correlated with the hospitalization experience. This approach is directive in nature and controls the process of making sense of the medical environment. An alternative is Child Centered Play Therapy (CCPT) which creates an outlet for any emotions the children choose to express. CCPT offers comprehensive mental health care through a developmentally-appropriate, undirected intervention carried out by a mental health therapist and has been shown to reduce perceived and actual psychological trauma, anxiety, and behavioral issues in children preparing for surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

Voices from the field: how do child protection practitioners in the Northern Territory operationalise child neglect?

OpenAIRE

Flaherty, Annette Clare

2017-01-01

This study set out to understand how child protection practitioners in the Northern Territory operationalise child neglect. It did so firstly because child neglect is a major reason such concerns are referred to the child protection service in the Northern Territory. Child neglect cases comprise 28 per cent of all substantiated child maltreatment cases in Australia, and 50 per cent in the Northern Territory (AIHW 2011). Secondly, as outlined in the Literature Review, child negl...

Spleen removal - child - discharge

Science.gov (United States)

... Get your child treated for any bites, especially dog bites, right away. Let your child's doctor know ... Call your health care provider if: Your child's temperature is 101°F (38.3°C) or higher. ...

Child protection and the development of child abuse pediatrics in New York City.

Science.gov (United States)

Palusci, Vincent J

2017-11-01

The history of child abuse pediatrics reflects the development of medicine as a profession influenced by social movements reacting to poverty, economic exploitation, and child maltreatment. As physicians began to specialize in caring for children, egregious cases led them to recognize children were affected by special medical problems and diseases which were compounded by poor conditions and abuse and neglect. They developed the fields of pediatrics and child abuse pediatrics to advocate for their needs in courts and communities. Using a history of prominent physicians and cases, the objectives of this article are to: (1) rediscover the founding of pediatrics in NYC in the context of the environment which served as the setting for its development; (2) highlight our early understanding of the medical issues surrounding child maltreatment, with advocacy and forensic medicine becoming a growing part of medical care for children; and (3) explore the development of child abuse pediatrics in light of prominent physicians making major contributions to child protection. Timelines show the early interplay among social problems, publicized cases, private and governmental agencies, and the development of child abuse pediatrics. The article concludes with potential lessons to be learned and further questions about this interplay of child protection systems and the development of child abuse pediatrics. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

[Estimating child mortality using the previous child technique, with data from health centers and household surveys: methodological aspects].

Science.gov (United States)

Aguirre, A; Hill, A G

1988-01-01

2 trials of the previous child or preceding birth technique in Bamako, Mali, and Lima, Peru, gave very promising results for measurement of infant and early child mortality using data on survivorship of the 2 most recent births. In the Peruvian study, another technique was tested in which each woman was asked about her last 3 births. The preceding birth technique described by Brass and Macrae has rapidly been adopted as a simple means of estimating recent trends in early childhood mortality. The questions formulated and the analysis of results are direct when the mothers are visited at the time of birth or soon after. Several technical aspects of the method believed to introduce unforeseen biases have now been studied and found to be relatively unimportant. But the problems arising when the data come from a nonrepresentative fraction of the total fertile-aged population have not been resolved. The analysis based on data from 5 maternity centers including 1 hospital in Bamako, Mali, indicated some practical problems and the information obtained showed the kinds of subtle biases that can result from the effects of selection. The study in Lima tested 2 abbreviated methods for obtaining recent early childhood mortality estimates in countries with deficient vital registration. The basic idea was that a few simple questions added to household surveys on immunization or diarrheal disease control for example could produce improved child mortality estimates. The mortality estimates in Peru were based on 2 distinct sources of information in the questionnaire. All women were asked their total number of live born children and the number still alive at the time of the interview. The proportion of deaths was converted into a measure of child survival using a life table. Then each woman was asked for a brief history of the 3 most recent live births. Dates of birth and death were noted in month and year of occurrence. The interviews took only slightly longer than the basic survey

Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis.

Science.gov (United States)

Ouma, Paul O; Maina, Joseph; Thuranira, Pamela N; Macharia, Peter M; Alegana, Victor A; English, Mike; Okiro, Emelda A; Snow, Robert W

2018-03-01

Timely access to emergency care can substantially reduce mortality. International benchmarks for access to emergency hospital care have been established to guide ambitions for universal health care by 2030. However, no Pan-African database of where hospitals are located exists; therefore, we aimed to complete a geocoded inventory of hospital services in Africa in relation to how populations might access these services in 2015, with focus on women of child bearing age. We assembled a geocoded inventory of public hospitals across 48 countries and islands of sub-Saharan Africa, including Zanzibar, using data from various sources. We only included public hospitals with emergency services that were managed by governments at national or local levels and faith-based or non-governmental organisations. For hospital listings without geographical coordinates, we geocoded each facility using Microsoft Encarta (version 2009), Google Earth (version 7.3), Geonames, Fallingrain, OpenStreetMap, and other national digital gazetteers. We obtained estimates for total population and women of child bearing age (15-49 years) at a 1 km 2 spatial resolution from the WorldPop database for 2015. Additionally, we assembled road network data from Google Map Maker Project and OpenStreetMap using ArcMap (version 10.5). We then combined the road network and the population locations to form a travel impedance surface. Subsequently, we formulated a cost distance algorithm based on the location of public hospitals and the travel impedance surface in AccessMod (version 5) to compute the proportion of populations living within a combined walking and motorised travel time of 2 h to emergency hospital services. We consulted 100 databases from 48 sub-Saharan countries and islands, including Zanzibar, and identified 4908 public hospitals. 2701 hospitals had either full or partial information about their geographical coordinates. We estimated that 287 282 013 (29·0%) people and 64 495 526 (28·2

Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis

Directory of Open Access Journals (Sweden)

Paul O Ouma, MSc

2018-03-01

Full Text Available Summary: Background: Timely access to emergency care can substantially reduce mortality. International benchmarks for access to emergency hospital care have been established to guide ambitions for universal health care by 2030. However, no Pan-African database of where hospitals are located exists; therefore, we aimed to complete a geocoded inventory of hospital services in Africa in relation to how populations might access these services in 2015, with focus on women of child bearing age. Methods: We assembled a geocoded inventory of public hospitals across 48 countries and islands of sub-Saharan Africa, including Zanzibar, using data from various sources. We only included public hospitals with emergency services that were managed by governments at national or local levels and faith-based or non-governmental organisations. For hospital listings without geographical coordinates, we geocoded each facility using Microsoft Encarta (version 2009, Google Earth (version 7.3, Geonames, Fallingrain, OpenStreetMap, and other national digital gazetteers. We obtained estimates for total population and women of child bearing age (15–49 years at a 1 km2 spatial resolution from the WorldPop database for 2015. Additionally, we assembled road network data from Google Map Maker Project and OpenStreetMap using ArcMap (version 10.5. We then combined the road network and the population locations to form a travel impedance surface. Subsequently, we formulated a cost distance algorithm based on the location of public hospitals and the travel impedance surface in AccessMod (version 5 to compute the proportion of populations living within a combined walking and motorised travel time of 2 h to emergency hospital services. Findings: We consulted 100 databases from 48 sub-Saharan countries and islands, including Zanzibar, and identified 4908 public hospitals. 2701 hospitals had either full or partial information about their geographical coordinates. We estimated that 287

The Role of Distance and Quality on Facility Selection for Maternal and Child Health Services in Urban Kenya.

Science.gov (United States)