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Sample records for attend day care

  1. Day-care attendance and child development

    DEFF Research Database (Denmark)

    Bauchmüller, Robert; Gørtz, Mette; Rasmussen, Astrid Würtz

    Earlier research suggests that children’s development is shaped in their early years of life. This paper examines whether differences in day-care experiences during pre-school age are important for children’s cognitive and language development at the age of 15. The analysis is based on class...... performance at the end of elementary schooling. We assess the effects of attended types and qualities of day-care institutions on various child outcomes as measured by school grades in mathematics, science, English and Danish for the whole Danish population as well as outcomes from the 2006 PISA Denmark...... survey and a 2007 PISA Copenhagen survey. We use administrative registries to generate indicators such as child-staff ratios, child-pedagogues ratios, and the share of male staff and of staff with non-Danish origins. Furthermore, we use information on the average levels of educational attainments...

  2. Day-care attendance and child development:

    DEFF Research Database (Denmark)

    Bauchmüller, Robert; Gørtz, Mette; Rasmussen, Astrid Würtz

    performance at the end of elementary schooling. We assess the effects of attended types and qualities of day-care institutions on various child outcomes as measured by school grades in mathematics, science, English and Danish for the whole Danish population as well as outcomes from the 2006 PISA Denmark...... survey and a 2007 PISA Copenhagen survey. We use administrative registries to generate indicators such as child-staff ratios, child-pedagogues ratios, and the share of male staff and of staff with non-Danish origins. Furthermore, we use information on the average levels of educational attainments......, of total work experiences, ages and hourly wages of staff members. Those indicators show the expected correlations with children’s development outcomes, better day-care quality being linked to better child outcomes ten years later. We use rich administrative information about the children’s background...

  3. Otitis Media and the Social Behavior of Day-Care-Attending Children.

    Science.gov (United States)

    Vernon-Feagans, Lynne; And Others

    1996-01-01

    Examined the relationship between early otitis media in children attending day care and children's subsequent behavior in the day care classroom when they were well. Found that day care children with chronic otitis media in the first three years of life play alone more often and have fewer verbal interactions with peers than nonchronic children.…

  4. Comparison of motor and cognitive performance of children attending public and private day care centers

    Directory of Open Access Journals (Sweden)

    Mariana M. Santos

    2013-12-01

    Full Text Available BACKGROUND: Given that environmental factors, such as the school environment, can influence child development, more attention should be paid to the development of children attending day care centers. OBJECTIVE: Todetermine whether there are differences in the gross motor, fine motor, or cognitive performances of children between 1 and3 years-old of similar socioeconomic status attending public and private day care centers full time. METHOD: Participants were divided into 2 groups, 1 of children attending public day care centers (69 children and another of children attending private day care centers (47 children. All children were healthy and regularly attended day care full time for over 4 months. To assess cognitive, gross and fine motor performance, the Bayley Scales of Infant and Toddler Development III was used. The Mann-Whitney test was used for comparative analyses between groups of children between 13 and 24 months, 25 and 41 months, and 13 and 41 months. RESULTS: Children in public day care centers exhibited lower scores on the cognitive development scale beginning at 13 months old. The fine and gross motor performance scores were lower in children over the age of 25 months attending public centers. Maternal education was not related to the performance of children in either group. CONCLUSION: The scores of cognitive performance as well as fine and gross motor performance of children of similar socioeconomic status who attend public day care centers are lower than children attending private daycare centers.

  5. Exposure to infections through day-care attendance and risk of childhood leukaemia

    International Nuclear Information System (INIS)

    Urayama, K. Y.; Ma, X.; Buffler, P. A.

    2008-01-01

    There is growing evidence supporting a role for infections in the aetiology of childhood leukaemia. Hypotheses proposed by both Greaves and Kinlen describe childhood leukaemia to be a rare response to one or more common infections acquired through personal contacts. Previous epidemiological studies have used day-care attendance as an indicator of the increased likelihood of early and frequent exposure to infections. It is well-documented that in developed countries, exposures to common infections occur more frequently in this type of setting. Within the Northern California Childhood Leukaemia Study, the role of social contact has been assessed and a unique 'child-hours' summary measure incorporating information on the number of months attending a day-care, mean hours per week at this day-care and the number of children in the day-care setting was constructed. In this review, the previously reported day-care results have been described, showing that in non-Hispanic White children, children in the highest category of total child-hours of exposure had a reduced risk of acute lymphoblastic leukaemia (ALL), particularly common B-cell precursor ALL (c-ALL), compared with children without such exposures, with evidence of a dose-response effect. In addition, a literature review of relevant studies has been conducted, examining the relationship between day-care attendance and risk of childhood ALL. Overall, the 14 studies identified provided consistent support for this hypothesis, with the majority of studies reporting some evidence of a reduced risk. A meta-analysis is currently underway, which will provide a quantitative evaluation of the overall consistency and strength of the association between day-care attendance or social contact and risk of childhood ALL. (authors)

  6. Impact of extrinsic factors on fine motor performance of children attending day care

    Directory of Open Access Journals (Sweden)

    Carolina Corsi

    Full Text Available Abstract Objective: To assess the impact of extrinsic factors on fine motor performance of children aged 2-years old. Methods: 73 children attending public and 21 private day care centers were assessed. Day care environment was evaluated using the Infant/Toddler Environment Rating Scale-Revised Edition (ITERS-R, fine motor performance was assessed through the Bayley Scales of Infant and Toddler Development-III (BSITD-III, socioeconomic data, maternal education and time of start at the day care were collected through interviews. Spearman's correlation coefficient was calculated to assess the association between the studied variables. Results: The time at the day care was positively correlated with the children's performance in some fine motor tasks of the BSITD-III, showing that the activities developed in day care centers were important for the refinement of specific motor skills, while the overall fine motor performance by the scale was associated with maternal education and the ITERS-R scale sub-item “language and understanding”. Conclusions: Extrinsic factors such as higher maternal education and quality of day care centers are associated with fine motor performance in children attending day care.

  7. Impact of extrinsic factors on fine motor performance of children attending day care.

    Science.gov (United States)

    Corsi, Carolina; Santos, Mariana Martins Dos; Marques, Luísa de Andrade Perez; Rocha, Nelci Adriana Cicuto Ferreira

    2016-12-01

    To assess the impact of extrinsic factors on fine motor performance of children aged two years old. 73 children attending public and 21 private day care centers were assessed. Day care environment was evaluated using the Infant/Toddler Environment Rating Scale - Revised Edition (ITERS-R), fine motor performance was assessed through the Bayley Scales of Infant and Toddler Development - III (BSITD-III), socioeconomic data, maternal education and time of start at the day care were collected through interviews. Spearman's correlation coefficient was calculated to assess the association between the studied variables. The time at the day care was positively correlated with the children's performance in some fine motor tasks of the BSITD-III, showing that the activities developed in day care centers were important for the refinement of specific motor skills, while the overall fine motor performance by the scale was associated with maternal education and the ITERS-R scale sub-item "language and understanding". Extrinsic factors such as higher maternal education and quality of day care centers are associated with fine motor performance in children attending day care. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  8. [Seasonal changes of invasive pneumococcal disease in children and association with day care attendance].

    Science.gov (United States)

    Matsubara, Kousaku; Nigami, Hiroyuki; Iwata, Aya; Uchida, Yoshiko; Yamamoto, Go; Chang, Bin; Wada, Akihito

    2012-01-01

    To determine seasonal changes in the incidence of invasive pneumococcal disease (IPD) in children, we retrospectively analyzed 69 children with 72 episodes of IPD, admitted to a regional center in Kobe, Japan, between July 1994 and June 2011. IPD episodes involved occult bacteremia (n = 48), pneumonia (n = 10), meningitis (n = 10), periorbital cellulitis (n = 3), and mastoiditis (n = 1), including 3 cases of two IPD recurrences. We analyzed 5 IPD-associated factors previously documented in Europe and North Amrica with inconsistent results--1) age at onset, 2) sibling number, 3) preschool sibling number, 4) subjects' day care attendance, and 5) siblings' day care attendance. We collected information on these factors by reviewing medical charts or contacting subjects' parents or guardians by telephone. IPD peaked bimodally in April and May (n = 21) and in November and December (n = 20), decreasing prominently between July and September (n = 8). Subjects with IPD attending day care formed a significantly higher propotion during April and May than did those developing IPD during other months: 12/21 [57.1%] vs. 12/51 [23.5%], odds ratio 4.3, 95% confidence interval, 1.5-12.8; p = 0.006. Combined day care attendance among subjects with IPD and/or their siblings also differed significantly between these two groups: 17/21 [80.9%] vs. 27/51 [52.9%], odds ratio 3.8, 95% confidence interval, 1.1-12.8; p = 0.027. Not significant differences were seen in age at onset, sibling number, or preschool sibling number. In contrast, however children with IPD onset during November and December showed no significant difference in association with any of the 5 factors, compared to children with IPD onset in other months. Our findings showed a bimodal peak in IPD in children, the first and highest of which occurred in April and May and was significantly associated with day care attendance by those with IPD and/or their siblings. This first peak may, however, be related to circumstances in

  9. Respiratory Virus Detection and Clinical Diagnosis in Children Attending Day Care.

    Directory of Open Access Journals (Sweden)

    Nina Moe

    Full Text Available Respiratory viruses often have been studied in children with respiratory tract infection (RTI, but less knowledge exists about viruses in asymptomatic children. We have studied the occurrence of a broad panel of respiratory viruses in apparently healthy children attending day care, taking into account the influence of possible confounding factors, such as age, clinical signs of respiratory tract infection (RTI, location (day-care section and season.We have studied 161 children in two day-care centers, each with separate sections for younger and older children, during four autumn and winter visits over a two-year period. A total of 355 clinical examinations were performed, and 343 nasopharyngeal samples (NPS were analyzed by semi-quantitative, real-time, polymerase chain reaction (PCR tests for 19 respiratory pathogens.Forty-three percent of all NPS were PCR-positive for ≥ 1 of 13 virus species, with high species variation during visits. Rhinovirus 26% (88/343 NPS, enterovirus 12% (40/343 and parechovirus 9% (30/343 were detected in every visit, and the rates varied in relation to age, day-care section and season. Ten other viruses were detected in ≤ 3% of the NPS. Generally, viruses occurred together in the NPS. In 24% (79/331 of the clinical examinations with available NPS, the children had clear signs of RTI, while in 41% (135/331 they had mild signs, and in 35% (117/331 the children had no signs of RTI. Moreover, viruses were found in 70% (55/79 of children with clear signs of RTI, in 41% (55/135 with mild signs and in 30% (35/117 without any signs of RTI (p < 0.001.Positive PCR tests for respiratory viruses, particularly picornaviruses, were frequently detected in apparently healthy children attending day care. Virus detection rates were related to age, presence of clinical signs of RTI, location in day care and season.

  10. Viral etiology and incidence of acute gastroenteritis in young children attending day-care centers

    DEFF Research Database (Denmark)

    Rosenfeldt, Vibeke; Vesikari, Timo; Pang, Xiao-Li

    2005-01-01

    BACKGROUND: The purpose of the study was to investigate the frequency, morbidity and cause of acute gastroenteritis in children attending day-care centers in Denmark. METHODS: Children with acute diarrhea (> or =2 consecutive loose stools in 24 hours, with duration of ... 19 day-care centers, were included. Gastroenteritis viruses, group A rotavirus, sapoviruses, noroviruses and astroviruses were detected with reverse transcription-polymerase chain reaction assays. In addition, stool specimens were cultured for bacterial pathogens. Children who were brought...

  11. Patterns of gender-role behaviour in children attending traditional and non-traditional day-care centres.

    Science.gov (United States)

    Cole, H J; Zucker, K J; Bradley, S J

    1982-08-01

    Using a sex-typed free-play task and the Draw-a-Person test, the gender-role behaviour of children attending a day-care centre whose staff adhered to a "non-sexist" child-rearing philosophy was compared to the gender-role behaviour of children attending a more traditional day-care center. Parental provision of sex-typed and neutral toys and approval of cross-sex role behaviour was also assessed. On both measures, the two groups of children showed culturally typical patterns of gender-role behaviour. The parents of the two groups of children were generally similar in terms of the kinds of toys they provided and in their attitudes toward the expression of cross-sex role behaviour. Potential explanations for the inability to demonstrate effects of the "non-sexist" child-rearing philosophy were discussed.

  12. Consumption of industrialized food by infants attending child day care centers.

    Science.gov (United States)

    Toloni, Maysa Helena de A; Longo-Silva, Giovana; Konstantyner, Tulio; Taddei, José Augusto de A C

    2014-03-01

    To identify the age of introduction of petit suisse cheese and instant noodles in the diet of infants attending nurseries of public day care centers and to compare the nutritional composition of these foods with the healthy recommended diet (breast milk and salt meal) for this age, in order to estimate nutritional errors. Cross-sectional study of 366 children (from nine to 36 months old) who attended day care centers, whose mothers were interviewed about the age of introduction of those foods. The means of the nutrients indicated on the labels of the most consumed brands were considered. For the calculation of the percent composition of breast milk and salt meal, Tables of Food Composition were used. To assess the nutritional adequacy, we used the Dietary Reference Intakes by age group. The percentage of adequacy evaluation of the petit suisse cheese and the instant noodles nutritional compositions was made by comparing them with those of the human milk and the salt meal, respectively. The petit suisse cheese and the instant noodles were consumed by 89.6 and 65.3% of the children in the first year of life. The percentages of adequacy for carbohydrates were more than twice and the percentages for sodium were 20 times higher than those found in the recommended foods. Both industrialized products are inappropriate for infants, emphasizing the need for adoption of norms that can inform health professionals, educators and parents about the risks of consumption.

  13. Consumption of industrialized food by infants attending child day care centers

    Directory of Open Access Journals (Sweden)

    Maysa Helena de A. Toloni

    2014-03-01

    Full Text Available Objective: To identify the age of introduction of petit suisse cheese and instant noodles in the diet of infants attending nurseries of public day care centers and to compare the nutritional composition of these foods with the healthy recommended diet (breast milk and salt meal for this age, in order to estimate nutritional errors. Methods: Cross-sectional study of 366 children (from nine to 36 months old who attended day care centers, whose mothers were interviewed about the age of introduction of those foods. The means of the nutrients indicated on the labels of the most consumed brands were considered. For the calculation of the percent composition of breast milk and salt meal, Tables of Food Composition were used. To assess the nutritional adequacy, we used the Dietary Reference Intakes by age group. The percentage of adequacy evaluation of the petit suisse cheese and the instant noodles nutritional compositions was made by comparing them with those of the human milk and the salt meal, respectively. Results: The petit suisse cheese and the instant noodles were consumed by 89.6 and 65.3% of the children in the first year of life. The percentages of adequacy for carbohydrates were more than twice and the percentages for sodium were 20 times higher than those found in the recommended foods. Conclusions: Both industrialized products are inappropriate for infants, emphasizing the need for adoption of norms that can inform health professionals, educators and parents about the risks of consumption.

  14. Probiotics for respiratory tract infections in children attending day care centers − a systematic review

    DEFF Research Database (Denmark)

    Laursen, Rikke Pilmann; Hojsak, Iva

    2018-01-01

    Probiotics have been suggested to have a preventive effect on respiratory tract infections (RTIs), but limited evidence exist on strain-specific effects. The main aim of this systematic review and meta-analysis was to evaluate strain-specific probiotic effects on RTIs in children attending day care...... RCTs investigating specific probiotic strains or their combinations in prevention of RTIs are needed. (Table presented)...

  15. Streptococcus pneumoniae(Spn) Nasopharyngeal Carriage in Children Under 3 Years Old, Attending Day Care Centers in Argentina

    Science.gov (United States)

    Gentile, Angela; Rearte, Analía; Von Spetch, Martha; Laban, Celia; Papucci, Santiago Lopez; Badano, Andrea; Ferrario, Claudia; Pereda, Rosana; Flores, Devora; Berry, Diana; Aguilera, Alejandra; Sponton, Norma; Sorhouet, Cecilia; Napoli, Daniela; Devoto, Susana; Vizzotti, Carla

    2017-01-01

    Abstract Background In 2012 the 13-valent conjugated pneumococcal vaccine (PCV-13) was introduced in the National Immunization Program. We performed an epidemiological study to describe SPN nasopharyngeal carriage prevalence. Methods Between June to September 2015 it was performed a cross-sectional study among children Salta (North West), Trelew (South), Rosario (Centre), Buenos Aires (Capital city) and Posadas (North East)). Samples were analyzed at references hospitals of each city and isolates were submitted to the INEI “Dr. Carlos G. Malbrán “, for confirming and serotyping. We considered completed schedule 3 doses of PCV13, administrated14 days prior to enrollment. Results We included 359 toddlers, 61,6% (IC95% 56,3–66,6) were SPN carriers. Median age was 24 months, without significative difference in carriage status. Multivariate analysis showed that independently of age, sex and socioeconomic level, variables associated with carriage were: · City: Taking Salta as reference (less carriage prevalence), Rosario and Posadas were statistically associated with higher prevalence rates: OR: 3,1 (IC95% 1,3–7,1) y OR: 2,8 (IC96% 1,2–6,3) respectively · Children attending to public day care centers had higher carriage rates than those attending private ones: OR: 1,9 (IC95% 1,06–3,4) · Children sharing bedroom with 3 or more persons, were associated to mayor risk or carriage: OR: 1,7 (IC95% 1,03–2,7) We found 46 serotypes in the 221 isolates. (2 couldn’t be serotyped), 90,9% (IC95% 86,3–94,3) were non PCV 13 serotypes (most frequent were 15B, 23B and 11A). Only 7 of 46 were PCV13 serotypes. (Graphic 1) Of the 20 toddlers with PCV13 serotypes, 16 were completely vaccinated Graphic 1: S pneumoniae serotype distribution. N = 221 Conclusion Nasopharyngeal carriage of SPN was high in children < 3 years old attending day care centers. Most isolates were Non PCV13 serotypes. The independent predictors for higher prevalence rates were: 1- Children living

  16. Effects of Experimentally Imposed Noise on Task Performance of Black Children Attending Day Care Centers Near Elevated Subway Trains.

    Science.gov (United States)

    Hambrick-Dixon, Priscilla Janet

    1986-01-01

    Investigates whether an experimentally imposed 80dB (A) noise affected psychomotor, serial memory words and pictures, incidental memory, visual recall, paired associates, perceptual learning, and coding performance of five-year-old Black children attending day care centers near and far from elevated subways. (HOD)

  17. Effect of a probiotic milk product on gastrointestinal and respiratory infections in children attending day-care

    OpenAIRE

    Smerud, Hilde Kloster; Kleiveland, Charlotte Ramstad; Mosland, Anette Roll; Grave, Gisle; Birkeland, Stein-Erik

    2011-01-01

    Gastrointestinal and respiratory infections are common among children attending day-care, particularly among younger children. The aim of the present randomized, double-blind and placebo-controlled study was to investigate whether Biola, a commercial milk product with a combination of three different probiotic strains (Lactobacillus rhamnosus GG (LGG), L. acidophilus LA-5, and Bifidobacterium Bb-12) given daily to 240 children younger than 3 years, during 7 winter months of their first year i...

  18. A hand hygiene intervention to decrease infections among children attending day care centers: Design of a cluster randomized controlled trial

    NARCIS (Netherlands)

    T.P. Zomer (Tizza); V. Erasmus (Vicky); N. Vlaar (Nico); E.F. van Beeck (Ed); A. Tjon-A-Tsien (Aimée); J.H. Richardus (Jan Hendrik); H.A.C.M. Voeten (Hélène)

    2013-01-01

    textabstractBackground: Day care center attendance has been recognized as a risk factor for acquiring gastrointestinal and respiratory infections, which can be prevented with adequate hand hygiene (HH). Based on previous studies on environmental and sociocognitive determinants of caregivers'

  19. ENERGY EXPENDITURE AND INTAKE COMPARISONS IN CHILEAN CHILDREN 4-5 YEARS ATTENDING DAY-CARE CENTRES.

    Science.gov (United States)

    Salazar, Gabriela; Vásquez, Fabián; Rodríguez, Maria P; Andrade, Ana M; Anziani, Maria A; Vio, Fernando; Coward, Williams

    2015-09-01

    the doubly labelled water (DLW) method has an accuracy of 1% and within-subject precision of 5-8%, depending on subject's age and environments issues. Energy intake assessment is prone to errors (>15- 20%) depending in the method utilized. to quantify DLW methodology errors in four to five year olds that could affect the comparison with energy intake. energy expenditure (TEE, by DLW), was assessed during 14 days in 18 preschool children, who attended eight hours daily to day-care centres. Energy intake was determined by a combined method: food weighing during weekdays and recall after leaving the Centre (17h to sleep time) plus 24 h recall, during the weekend. Several assumptions affecting DLW total error were assessed to determine their influence in the comparison to energy intake (i.e. background variability, space ratio, proportion of water subject to fractionation, food quotient value). the individual mean energy expenditure was 1 373 ± 177 kcal and the energy intake (1 409 ± 161 kcal). The overall difference between intake and expenditure was 42.9 kcal/day (limits of agreement + 259.1 to -112.3 kcal/day). TEE measurement error only explained a minor quantity (2.4%), between both measurements, and the observed mean isotope dilution space was 1.030 ± 0.010 confirming the value utilized in adults studies. energy expenditure data is similar to other studies in preschool children. The small difference found between energy intake and expenditure may be attributed to the applied energy intake methodology, the homogeneous diet at care centres during the week-days and the lower DLW methodology error. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  20. Infectious Diseases in Day Care.

    Science.gov (United States)

    Sleator, Esther K.

    Discussed in this publication are infectious illnesses for which children attending day care appear to be at special risk. Also covered are the common cold, some infectious disease problems receiving media attention, and some other annoying but not serious diseases, such as head lice, pinworms, and contagious skin conditions. Causes,…

  1. Everyday practice and unnoticed professional competence in day care work

    DEFF Research Database (Denmark)

    Ahrenkiel, Annegrethe; Warring, Niels; Nielsen, Birger Steen

    In Denmark more than 9 out 10 children attend day care centers that are publicly funded and regulated. The main part of employees, the social educators, at day care centers have attended a 3½ years educational programme with both theoretical and practical elements. Nevertheless it has been hard...... for the social educators to get recognition for their professional competencies and the societal importance of their work. Neoliberal governance has imposed a lot of demands for documentation, evaluation etc., and a growing focus on children’s learning in day care centers has resulted in national goals...... hand it can tend to underestimate the value of a large part of their work which is embedded in what in the paper will be explored as unnoticed professional competences. Building on empirical results from research in day care centers based on mixed methods (observations, interviews and action research...

  2. Freqüência à creche e outros condicionantes do estado nutricional infantil Attendance at day-care centers and other conditioning factors in child nutritional status

    Directory of Open Access Journals (Sweden)

    Marina Vieira da Silva

    1998-06-01

    Full Text Available O estudo descreve o estado nutricional de 2 096 pré-escolares atendidos nos 27 Centros Educacionais e Creches do município de Piracicaba, estado de São Paulo. Observa-se que 5,1% das crianças apresentam déficit de altura/idade (escore ZAI The study describes the nutritional status of 2 096 preschool children attending 27 Educational Centers and Day-Care Centers in Piracicaba, state of São Paulo. Five point one percent of the children are observed to present a height/age deficit (score HAZ<-2.0 and a proportion of 1.2 with weight/height deficit (score WHZ<-2.0. The results reveal that per capita income, mother schooling, type of sewage, type of housing and attendance time at are the variables that cause impact on the HAZ score of the children.The positive association detected between attendance time at and -Z score of height for age stresses the importance of these investments as means to protect children, mainly against chronic malnutrition, as basic care with health, feeding and hygiene is associated with education. The day-care center also provides the participation of mothers in the work market, which is very important in poor families in order to increase family income.

  3. A hand hygiene intervention to decrease infections among children attending day care centers: design of a cluster randomized controlled trial.

    Science.gov (United States)

    Zomer, Tizza P; Erasmus, Vicki; Vlaar, Nico; van Beeck, Ed F; Tjon-A-Tsien, Aimée; Richardus, Jan Hendrik; Voeten, Hélène A C M

    2013-06-03

    Day care center attendance has been recognized as a risk factor for acquiring gastrointestinal and respiratory infections, which can be prevented with adequate hand hygiene (HH). Based on previous studies on environmental and sociocognitive determinants of caregivers' compliance with HH guidelines in day care centers (DCCs), an intervention has been developed aiming to improve caregivers' and children's HH compliance and decrease infections among children attending DCCs. The aim of this paper is to describe the design of a cluster randomized controlled trial to evaluate the effectiveness of this intervention. The intervention will be evaluated in a two-arm cluster randomized controlled trial among 71 DCCs in the Netherlands. In total, 36 DCCs will receive the intervention consisting of four components: 1) HH products (dispensers and refills for paper towels, soap, alcohol-based hand sanitizer, and hand cream); 2) training to educate about the Dutch national HH guidelines; 3) two team training sessions aimed at goal setting and formulating specific HH improvement activities; and 4) reminders and cues to action (posters/stickers). Intervention DCCs will be compared to 35 control DCCs continuing usual practice. The primary outcome measure will be observed HH compliance of caregivers and children, measured at baseline and one, three, and six months after start of the intervention. The secondary outcome measure will be the incidence of gastrointestinal and respiratory infections in 600 children attending DCCs, monitored over six months by parents using a calendar to mark the days their child has diarrhea and/or a cold. Multilevel logistic regression will be performed to assess the effect of the intervention on HH compliance. Multilevel poisson regression will be performed to assess the incidence of gastrointestinal and respiratory infections in children attending DCCs. This is one of the first DCC intervention studies to assess HH compliance of both caregivers and

  4. [Organisational factors associated with the repetition of infections among children in Parisian day-care setting].

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    Delour, M; Caparros, N; Rufat, P; Desplanques, L; Bonnefoi, M-C; Patris, S; Brodin, M

    2006-09-01

    This study analyzes the organisational factors linked with episodes of infections in children attending child day-care setting in Paris. A sample of children who attended parisian municipal child day-care setting, stratified on the type and the size of the day-care setting, was achieved. This cohort was followed from September 2000 to June 2001. We compared the risk of repeated infections according to the type of day-care setting (family day-care or day-care centre), and for the day-care centre according to the size (60 places) and the structure of groups (mixing age groups or not). The events studied were the occurrence of at least: 6 episodes of any infection, 2 otitis, 2 gastroenteritis, 2 conjunctivitis or 5 upper respiratory tract infections. Nine hundred and ninety-three children were included in this study. The 878 children attending a day-care centre had a significant higher risk of infections compare to children in family day-care (RR = 2.92[1.58-5.38]) except for gastroenteritis and conjunctivitis. This relationship between the type of day-care setting and the repeated infections was especially shown for children younger than 1 year. The mixing of ages only increased the risk of conjunctivitis (RR = 1.98[1.15-3.42]). No significant relationship between the size of the day care centre and the repetition of every studied infection was found. This study strengthens the orientation of the more vulnerable children towards the family day-care centers.

  5. Fermented Milk Consumption and Common Infections in Children Attending Day-Care Centers: A Randomized Trial.

    Science.gov (United States)

    Prodeus, Andrey; Niborski, Violeta; Schrezenmeir, Juergen; Gorelov, Alexander; Shcherbina, Anna; Rumyantsev, Alexander

    2016-11-01

    This multicenter, double-blind, randomized, placebo-controlled clinical trial investigated the effect of a fermented milk product containing the Lactobacillus casei National Collection of Microorganisms and Cell Cultures (CNCM) I-1518 strain on respiratory and gastrointestinal common infectious diseases (CIDs) in children attending day-care centers in Russia. Children ages 3 to 6 years received 100 g of a fermented milk product (n = 300) or a control product (n = 299) twice daily for 3 months, followed by a 1-month observation period. The primary outcome was the incidence of CIDs during the product consumption period. There was no significant difference in the incidence of CIDs between the groups (N = 98 with fermented milk product vs N = 93 with control product). The overall number of CIDs (and no severe cases at all) in both study groups and in all 12 centers, however, was unexpectedly low resulting in underpowering of the study. No differences were found between the groups in the duration or severity of disease, duration of sick leave from day-care centers, parental missed working days, or in quality-of-life dimensions on the PedsQL questionnaire (P > 0.05).There was, however, a significantly lower incidence of the most frequently observed CID, rhinopharyngitis, in children consuming the fermented milk product compared with those consuming the control product (N = 81 vs N = 100, relative risk 0.82, 95% confidence interval 0.69-0.96, P = 0.017) when considering the entire study period. Although no other significant differences were shown between the fermented milk and control product groups in this study, lower incidence of rhinopharyngitis may indicate a beneficial effect of this fermented milk product.

  6. Daily consumption of foods and nutrients from institutional and home sources among young children attending two contrasting day-care centers in Guatemala City.

    Science.gov (United States)

    Vossenaar, M; Jaramillo, P M; Soto-Méndez, M-J; Panday, B; Hamelinck, V; Bermúdez, O I; Doak, C M; Mathias, P; Solomons, N W

    2012-12-01

    Adequate nutrition is critical to child development and institutions such as day-care centers could potentially complement children's diets to achieve optimal daily intakes. The aim of the study was to describe the full-day diet of children, examining and contrasting the relative contribution of home-derived versus institutional energy and nutrient sources. The present comparison should be considered in the domain of a case-study format. The diets of 33, 3-6 y old children attending low-income day-care centers serving either 3 or a single meal were examined. The home-diet was assessed by means of 3 non-consecutive 24-hr recalls. Estimated energy and nutrient intakes at the centers and at home were assessed and related to Recommended Nutrient Intakes (RNI). Nutrient densities, critical densities and main sources of nutrients were computed. We observed that in children attending the day-care center serving three meals, home-foods contributed less than half the daily energy (47.7%) and between 29.9% and 53.5% of daily nutrients. In children receiving only lunch outside the home, energy contribution from the home was 83.9% and 304 kcal lower than for children receiving 3 meals. Furthermore, between 59.0% and 94.8% of daily nutrients were provided at home. Daily energy, nutrient intakes and nutrient densities were well above the nutrient requirements for this age group, and particularly high for vitamin A. The overall dietary variety was superior in the situation of greater contribution of home fare, but overall the nutrient density and adequacy of the aggregate intakes did not differ in any important manner.

  7. Mobile phones improve antenatal care attendance in Zanzibar

    DEFF Research Database (Denmark)

    Lund, Stine; Nielsen, Birgitte B; Hemed, Maryam

    2014-01-01

    BACKGROUND: Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns' survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality...... of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during...... included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome...

  8. Group Prenatal Care Attendance: Determinants and Relationship with Care Satisfaction.

    Science.gov (United States)

    Cunningham, Shayna D; Grilo, Stephanie; Lewis, Jessica B; Novick, Gina; Rising, Sharon Schindler; Tobin, Jonathan N; Ickovics, Jeannette R

    2017-04-01

    Objectives Group prenatal care results in improved birth outcomes in randomized controlled trials, and better attendance at group prenatal care visits is associated with stronger clinical effects. This paper's objectives are to identify determinants of group prenatal care attendance, and to examine the association between proportion of prenatal care received in a group context and satisfaction with care. Methods We conducted a secondary data analysis of pregnant adolescents (n = 547) receiving group prenatal care in New York City (2008-2012). Multivariable linear regression models were used to test associations between patient characteristics and percent of group care sessions attended, and between the proportion of prenatal care visits that occurred in a group context and care satisfaction. Results Sixty-seven groups were established. Group sizes ranged from 3 to 15 women (mean = 8.16, SD = 3.08); 87 % of groups enrolled at least five women. Women enrolled in group prenatal care supplemented group sessions with individual care visits. However, the percent of women who attended each group session was relatively consistent, ranging from 56 to 63 %. Being born outside of the United States was significantly associated with higher group session attendance rates [B(SE) = 11.46 (3.46), p = 0.001], and women who received a higher proportion of care in groups reported higher levels of care satisfaction [B(SE) = 0.11 (0.02), p prenatal care as possible in a group setting, as well as value-based reimbursement models and other incentives to encourage more widespread adoption of group prenatal care.

  9. Assessment of global motor performance and gross and fine motor skills of infants attending day care centers.

    Science.gov (United States)

    Souza, Carolina T; Santos, Denise C C; Tolocka, Rute E; Baltieri, Letícia; Gibim, Nathália C; Habechian, Fernanda A P

    2010-01-01

    To analyze the global motor performance and the gross and fine motor skills of infants attending two public child care centers full-time. This was a longitudinal study that included 30 infants assessed at 12 and 17 months of age with the Motor Scale of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). This scale allows the analysis of global motor performance, fine and gross motor performance, and the discrepancy between them. The Wilcoxon test and Spearman's correlation coefficient were used. Most of the participants showed global motor performance within the normal range, but below the reference mean at 12 and 17 months, with 30% classified as having "suspected delays" in at least one of the assessments. Gross motor development was poorer than fine motor development at 12 and at 17 months of age, with great discrepancy between these two subtests in the second assessment. A clear individual variability was observed in fine motor skills, with weak linear correlation between the first and the second assessment of this subtest. A lower individual variability was found in the gross motor skills and global motor performance with positive moderate correlation between assessments. Considering both performance measurements obtained at 12 and 17 months of age, four infants were identified as having a "possible delay in motor development". The study showed the need for closer attention to the motor development of children who attend day care centers during the first 17 months of life, with special attention to gross motor skills (which are considered an integral part of the child's overall development) and to children with suspected delays in two consecutive assessments.

  10. Day Care Work as the Creation of Coherence in Everyday Life

    DEFF Research Database (Denmark)

    Ahrenkiel, Annegrethe

    2010-01-01

    of kindergarten teachers: confronting neoliberal regulation”, is that a great deal of the work of kindergarten teachers is oriented towards creating coherence in the every life of children and their families. But this central function is threatened by neoliberal forms to the regulation of work in day care......Day care institutions serve a central function in modern society; not least because taking care of children is a prerequisite for parent’s participation in the labour market. This is certainly the case in Denmark, where 90 % of children attend day care institutions. In this sense, day care...... institutions are a prerequisite for a sus-tainable everyday life in modern society. Without day care for children it is not possible for families to create a coherent everyday life. At the same time, life in day care institutions shares a lot of similarities with everyday life. It is extremely important...

  11. Children's hand hygiene behaviour and available facilities: an observational study in Dutch day care centres.

    Science.gov (United States)

    van Beeck, A H Elise; Zomer, Tizza P; van Beeck, Eduard F; Richardus, Jan Hendrik; Voeten, Helene A C M; Erasmus, Vicki

    2016-04-01

    Children attending day care centres are at increased risk of infectious diseases, in particular gastrointestinal and respiratory infections. Hand hygiene of both caregivers and children is an effective prevention measure. This study examined hand hygiene behaviour of children attending day care centres, and describes hygiene facilities at day care centres. Data were collected at 115 Dutch day care centres, among 2318 children cared for by 231 caregivers (August to October 2010). Children's hand hygiene behaviour was observed and data on hand hygiene facilities of the day care centres collected by direct unobtrusive observation. National guidelines indicate hand hygiene is required before eating, after toilet use and after playing outside. Among 1930 observed hand hygiene opportunities for children, overall adherence to hand hygiene guidelines was 31% (95% CI: 29-33%). Adherence after both toilet use and playing outside was 48%. Hands were less frequently washed before eating, where guideline adherence was 15%. In 38% of the playrooms there was no soap within reach of children and 17% had no towel facilities. In over 40% of the playrooms, appropriate hand hygiene facilities for children were lacking. Adequate hand washing facilities were available for children in only half of the participating day care centres in our study and children washed their hands in only 15-48% of the occasions defined by official guidelines. More attention is needed to hand hygiene of children attending day care centres in the prevention of infectious diseases. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  12. Age at introduction of ultra-processed food among preschool children attending day-care centers.

    Science.gov (United States)

    Longo-Silva, Giovana; Silveira, Jonas Augusto C; Menezes, Rísia Cristina Egito de; Toloni, Maysa Helena de Aguiar

    To identify the age of introduction of ultra-processed food and its associated factors among preschool children. Cross-sectional study carried out from March to June 2014 with 359 preschool children aged 17 to 63 months attending day-care centers. Time until ultra-processed food introduction (outcome variable) was described by the Kaplan-Meier analysis, and the log-rank test was used to compare the survival functions of independent variables. Factors associated with ultra-processed food introduction were investigated using the multivariate Cox proportional hazards model. The results were shown as hazard ratios with their respective 95% confidence intervals. The median time until ultra-processed food introduction was six months. Between the 3rd and 6th months, there is a significant increase in the probability of introducing ultra-processed food in the children's diet; and while the probability in the 3rd month varies from 0.15 to 0.25, at six months the variation ranges from 0.6 to 1.0. The final Cox proportional hazards model showed that unplanned pregnancy (1.32 [1.05-1.65]), absence of prenatal care (2.50 [1.02-6.16]), and income >2 minimum wages (1, 50 [1.09-2.06]) were independent risk factors for the introduction of ultra-processed food. Up to the 6th month of life, approximately 75% of preschool children had received one or more ultra-processed food in their diet. In addition, it was observed that the poorest families, as well as unfavorable prenatal factors, were associated with early introduction of ultra-processed food. Copyright © 2017. Published by Elsevier Editora Ltda.

  13. [Nutritional status in preschoolers attending a public day-care center in Valencia, Venezuela].

    Science.gov (United States)

    Real, Sara Irene del; Jaeger, Armando Sánchez; Barón, María Adela; Díaz, Nayka; Solano, Liseti; Velásquez, Emma; López, Jesús

    2007-09-01

    With the purpose of evaluating nutritional status in a group of preschoolers attending a public day care center in Valencia, Venezuela (2002), a research was made for social stratus, anthropometric variables; weight, height and arm circumference, hemoglobin, seric retinol, presence of parasitosis and food consumption, as well as the mother's educational level. The program SPSS 11.0 and the t Student, ANOVA Post Hoc from Bonferroni and Fisher (p education, while only 9.8% of the mothers in poverty had reached that level. According to the Z values (H/A, W/H and AC/H), high percentages under -1.00 were observed (27.3%, 25.6% and 24.5%, respectively). The W/H and AC/H of children of mothers studying in a university presented discrepancies when compared with children of mothers with a primary educational level. A 25.9% of anemia was presented, and there were differences between anemic and non-anemic groups for H/A and AC/H. Protozoaries were observed in 61.0%, helmintos in 16.9% and both in 22.1%. There was a 2.6 times higher risk of presenting nutritional deficiency for AC/H in the group found with parasites. An adequate consumption of energy and iron was found, with an excessive consumption of proteins and vitamin A. It is concluded that there exists a nutritional risk evaluated through hematologic parameters, the presence of parasitosis and social stratus.

  14. Training traditional birth attendants on the WHO Essential Newborn Care reduces perinatal mortality.

    Science.gov (United States)

    Garcés, Ana; McClure, Elizabeth M; Hambidge, Michael; Krebs, Nancy F; Mazariegos, Manolo; Wright, Linda L; Moore, Janet; Carlo, Waldemar A

    2012-05-01

    To evaluate the impact of birth attendant training using the World Health Organization Essential Newborn Care (ENC) course among traditional birth attendants, with a particular emphasis on the effect of acquisition of skills on perinatal outcomes. Population-based, prospective, interventional pre-post design study. 11 rural clusters in Chimaltenango, Guatemala. Health care providers. This study analyzed the effect of training and implementation of the ENC health care provider training course between September 2005 and December 2006. The primary outcome measure was the rate of death from all causes in the first seven days after birth in fetuses/infants ≥1500g. Secondary outcome measures were overall rate of stillbirth, rate of perinatal death, which included stillbirths plus neonatal deaths in the first seven days in fetuses/infants ≥1500g. Perinatal mortality decreased from 39.5/1000 pre-ENC to 26.4 post-ENC (RR 0.72; 95%CI 0.54-0.97). This reduction was attributable almost entirely to a decrease in the stillbirth rate of 21.4/1000 pre-Essential Newborn Care to 7.9/1000 post-ENC (RR 0.40; 95%CI 0.25-0.64). Seven-day neonatal mortality did not decrease (18.3/1000 to 18.6/1000; RR 1.05; 95%CI 0.70-1.57). Essential Newborn Care training reduced stillbirths in a population-based controlled study with deliveries conducted almost exclusively by traditional birth attendants. Scale-up of this intervention in other settings might help assess reproducibility and sustainability. © Published [2012]. This article is a U.S. Government work and is in the public domain in the USA. Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Attending National Library Legislative Day: Why Is It Important?

    Science.gov (United States)

    Young, Robyn

    2009-01-01

    Prior to this year, the National Library Legislative Day never really held much importance for the author as a school library media specialist. However, this feeling changed after she attended her first National Library Legislative Day in May of 2008. The goal of this day is to allow everyday practicing professionals to speak with their national…

  16. The impact of a pre-hospital medical response unit on patient care and emergency department attendances.

    LENUS (Irish Health Repository)

    Deasy, C

    2012-02-03

    A rapid response team was instigated in Cork to improve prehospital care and reduce unnecessary Emergency Department (ED) visits. This consisted of a Specialist Registrar (SpR) in Emergency Medicine and a Paramedic who attended all "999" calls in a designated rapid response vehicle on the allotted study days. Two hundred and sixty-three patients were seen on designated days between Jan 2004 and March 2006. Presentations seen included; road traffic accident (23%) collapse (12%), fall (10%) and seizure (8%). The majority of calls were to houses (36%). The most common medical intervention was intravenous cannulation (25%). Intravenous medications were administered in 21% of these patients--morphine sulphate was the most common drug given. It was possible to safely discharge 31% of patients on scene. In our experience skilled Emergency Medicine doctors attending at scene could provide advanced care and reduce ambulance transportation and patient attendance.

  17. Effects of Adult Day Care on Daily Stress of Caregivers: A Within-Person Approach

    Science.gov (United States)

    Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Savla, Jyoti; Molenaar, Peter C. M.

    2011-01-01

    Objectives. This article examined exposure to and appraisal of care-related stressors associated with use of adult day services (ADS) by family caregivers of individuals with dementia. Methods. Using a within-person withdrawal design (A-B-A-B), we compared caregivers’ exposure to and appraisal of behavior problems on days their relative attended and did not attend ADS. Participants were 121 family caregivers enrolling a relative with dementia in an ADS program. Daily assessments were obtained prior to the person's attending ADS for the first time and after 1 and 2 months of attendance on days the person attended and did not attend ADS. Results. Total exposure to stressors and stress appraisals decreased significantly over time on ADS days compared with non-ADS days. Most of this difference was accounted by the time the person with dementia was away from the caregiver, but there were also significant reductions in behavioral problems during the evening and improved sleep immediately following ADS use. Discussion. ADS use lowered caregivers’ exposure to stressors and may improve behavior and sleep for people with dementia on days they have ADS. The study highlights how a within-person design can identify the effects of an intermittent intervention, such as ADS. PMID:21642593

  18. Postpartum care attendance at a rural district hospital in Zambia

    NARCIS (Netherlands)

    J. Lagro (Joep); A. Liche (Agnes); J. Mumba (John); R. Ntebeka (Ruth); J. van Roosmalen (Jos)

    2006-01-01

    textabstractPostpartum care is an important tool in both preventive and promotive maternal health care. We studied the postpartum care attendance rate in 540 women who delivered at a district hospital in Zambia. Forty-two percent of the women attended postpartum care within six weeks of delivery.

  19. High blood lead levels are associated with lead concentrations in households and day care centers attended by Brazilian preschool children.

    Science.gov (United States)

    da Rocha Silva, Júlia Prestes; Salles, Fernanda Junqueira; Leroux, Isabelle Nogueira; da Silva Ferreira, Ana Paula Sacone; da Silva, Agnes Soares; Assunção, Nilson Antonio; Nardocci, Adelaide Cassia; Sayuri Sato, Ana Paula; Barbosa, Fernando; Cardoso, Maria Regina Alves; Olympio, Kelly Polido Kaneshiro

    2018-08-01

    A previous study observed high blood lead levels (BLL) in preschool children attending 50 day care centers (DCC) in São Paulo, Brazil. To identify whether lead levels found in both homes and DCC environments are associated with high blood lead levels. Children attending 4 DCCs, quoted here as NR, VA, PS and PF, were divided into two groups according to BLL: high exposure (HE: ≥13.9 μg/dL; 97.5 percentile of the 2013 year sample) and low exposure (LE: 600 μg/g, whereas such levels were observed in 77.1% of NR playground measurements. In VA DCC, 22% and 23% of the measurements in the building and in the playgrounds had levels higher than 600 μg/g, respectively. The percentage of high lead levels in the children's houses of the LE group was 5.9% (95% CI: 4.3-7.6%) and 13.2 (95% CI: 8.3-18.0%) in the HE group. Moreover, a significant association was found between high BLLs and lead levels found both in households and DCCs (p < 0.001). Most of the high lead measurements were found in tiles and playground equipment. Lead exposure estimated from the DCCs, where children spend about 10 h/day, can be as relevant as their household exposure. Therefore, public authorities should render efforts to provide a rigorous surveillance for lead-free painting supplies and for all objects offered to children. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Knowledge, attitude and practice of oral health promoting factors among caretakers of children attending day-care centers in Kubang Kerian, Malaysia: A preliminary study

    Directory of Open Access Journals (Sweden)

    Mani S

    2010-06-01

    Full Text Available Background and Aim: The role of caretakers at day-care centers has become more imperative in promoting oral health care in children since many new mothers opt to work outside their homes, leaving their children at day-care centers. The aim of this study is to assess the knowledge, attitude and practice of oral health promoting factors among secondary caretakers of children attending day-care centers. Settings and Design: This was a cross-sectional exploratory study conducted among secondary caretakers in Kubang Kerian, Malaysia. Materials and Methods: Thirty-four caretakers fulfilling the inclusion and exclusion criteria participated in the study. The data were collected using a self-administered questionnaire addressing various aspects of knowledge, attitude and practice of oral health in children. Analysis was done using SPSS version 12.0. Results: The knowledge of factors causing dental caries was found to be good among majority of the caretakers, but the concepts of transmissibility of caries and effect of hidden sugars were not evident. Seventy one percent did not know that frequent bottle feeding could cause tooth decay. Attitudes seemed to be governed by the cultural practices of the region rather than the knowledge obtained. The knowledge was not translated to practice adequately. Giving sweetened liquid in bottles was practiced by 53% of the caretakers. Conclusion: Implementation of nursery-based oral health promotion programs for secondary caretakers is needed to counteract early childhood caries.

  1. Mobile phones improve antenatal care attendance in Zanzibar: a cluster randomized controlled trial

    Science.gov (United States)

    2014-01-01

    Background Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns’ survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during pregnancy. Methods This study was an open label pragmatic cluster-randomised controlled trial with primary healthcare facilities in Zanzibar as the unit of randomisation. 2550 pregnant women (1311 interventions and 1239 controls) who attended antenatal care at selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome measure was four or more antenatal care visits during pregnancy. Secondary outcome measures were tetanus vaccination, preventive treatment for malaria, gestational age at last antenatal care visit, and antepartum referral. Results The mobile phone intervention was associated with an increase in antenatal care attendance. In the intervention group 44% of the women received four or more antenatal care visits versus 31% in the control group (OR, 2.39; 95% CI, 1.03-5.55). There was a trend towards improved timing and quality of antenatal care services across all secondary outcome measures although not statistically significant. Conclusions The wired mothers’ mobile phone intervention significantly increased the proportion of women receiving the recommended four antenatal care

  2. Infection Control in Child Day Care Centres : Development and evaluation of a hand hygiene intervention

    NARCIS (Netherlands)

    T.P. Zomer (Tizza)

    2015-01-01

    markdownabstract__Abstract__ Children attending child day care centres are at increased risk of acquiring gastrointestinal and respiratory infections compared to children cared for at home. Hand hygiene is known to be an effective measure to prevent infections. However, compliance with hand

  3. Food Consumption and Nutrient Intake by Children Aged 10 to 48 Months Attending Day Care in The Netherlands

    NARCIS (Netherlands)

    Goldbohm, R.A.; Rubingh, C.M.; Lanting, C.L.; Joosten, K.F.M.

    2016-01-01

    The diet of young children is an important determinant of long-term health effects, such as overweight and obesity. We analyzed two-day food consumption records from 1526 young children (10–48 months old) attending 199 daycare centers across The Netherlands. Data were observed and recorded in

  4. Risk Factors for Wheezing, Eczema and Rhinoconjunctivitis in the Previous 12 Months among Six-Year-Old Children in Himeji City, Japan: Food Allergy, Older Siblings, Day-Care Attendance and Parental Allergy History

    Directory of Open Access Journals (Sweden)

    Fumitake Kurosaka

    2011-01-01

    Conclusions: Among Japanese children, food allergy and parents' history of allergy are risk factors for WP, ES or RS. However, early day-care attendance and presence of older siblings might be protective factors against RS. Infections in early life may affect the prevalence of rhinoconjunctivitis in six-year-old children.

  5. Reasons for non-attendance at a day hospital for people with enduring mental illness: the clients' perspective.

    Science.gov (United States)

    McGonagle, I M; Gentle, J

    1996-01-01

    This paper describes a research project which aimed to discover the reasons clients give for failing to attend a mental health day hospital. There was concern that this service provision, for people with enduring mental illness, had a high level of non-attendance and therefore might not be meeting the needs of the people for whom it is targeted. Over a period of 6 months 36 people failed to attend, despite assessment and apparent agreement to attend. Of the 36, 14 agreed to talk about their reasons for not attending. An open interview format was used which enabled the clients to talk in depth about their experiences, which they felt led to the decision to stop attending. Content analysis of the interview data resulted in the identification of common themes. Main findings suggest a lack of partnership in decisions on choice of therapy, particularly the emphasis on groupwork, which 86% found unhelpful. Other main factors for non-attendance were a lack of an individual approach to care, not being listened to, and a lack of warmth from the staff. Recommendations for future practice are given, with particular attention to the need to develop a partnership with clients aimed at meeting individual needs.

  6. Association of a full-day vs part-day preschool intervention with school readiness, attendance, and parent involvement.

    Science.gov (United States)

    Reynolds, Arthur J; Richardson, Brandt A; Hayakawa, Momoko; Lease, Erin M; Warner-Richter, Mallory; Englund, Michelle M; Ou, Suh-Ruu; Sullivan, Molly

    2014-11-26

    Early childhood interventions have demonstrated positive effects on well-being. Whether full-day vs part-day attendance improves outcomes is unknown. To evaluate the association between a full- vs part-day early childhood program and school readiness, attendance, and parent involvement. End-of-preschool follow-up of a nonrandomized, matched-group cohort of predominantly low-income, ethnic minority children enrolled in the Child-Parent Centers (CPC) for the full day (7 hours; n = 409) or part day (3 hours on average; n = 573) in the 2012-2013 school year in 11 schools in Chicago, Illinois. The Midwest CPC Education Program provides comprehensive instruction, family-support, and health services from preschool to third grade. School readiness skills at the end of preschool, attendance and chronic absences, and parental involvement. The readiness domains in the Teaching Strategies GOLD Assessment System include a total of 49 items with a score range of 105-418. The specific domains are socioemotional with 9 items (score range, 20-81), language with 6 items (score range, 15-54), literacy with 12 items (score range, 9-104), math with 7 items (score, 8-60), physical health with 5 items (score range, 14-45), and cognitive development with 10 items (score range, 18-90). Full-day preschool participants had higher scores than part-day peers on socioemotional development (58.6 vs 54.5; difference, 4.1; 95% CI, 0.5-7.6; P = .03), language (39.9 vs 37.3; difference, 2.6; 95% CI, 0.6-4.6; P = .01), math (40.0 vs 36.4; difference, 3.6; 95% CI, 0.5-6.7; P = .02), physical health (35.5 vs 33.6; difference, 1.9; 95% CI, 0.5-3.2; P = .006), and the total score (298.1 vs 278.2; difference, 19.9; 95% CI, 1.2-38.4; P = .04). Literacy (64.5 vs 58.6; difference, 5.9; 95% CI, -0.07 to 12.4; P = .08) and cognitive development (59.7 vs 57.7; difference, 2.0; 95% CI, -2.4 to 6.3; P = .38) were not significant. Full-day preschool graduates also had higher

  7. Mercury Poisoning at a Home Day Care Center - Hillsborough County, Florida, 2015.

    Science.gov (United States)

    Tewell, Mackenzie; Spoto, Samantha; Wiese, Michael; Aleguas, Alfred; Peredy, Tamas

    2017-05-05

    On November 12, 2015, the Florida Poison Information Center Tampa notified the Florida Department of Health in Hillsborough County of a boy aged 3 years with a urine mercury level of 79 μg/L (normal broken sphygmomanometer (blood pressure monitor) at the home day care center attended by the child.

  8. Work stress among nursing home care attendants in Taiwan: a questionnaire survey.

    Science.gov (United States)

    Hsu, Hui-Chuan; Kung, Yuan-Wei; Huang, Hsiao-Chien; Ho, Pei-Yu; Lin, Ya-Ying; Chen, Wen-Shin

    2007-07-01

    Care attendants constitute the main workforce in nursing homes, but their heavy workload, low autonomy, and indefinite responsibility result in high levels of stress and may affect quality of care. However, few studies have focused of this problem. The aim of this study was to examine work-related stress and associated factors that affect care attendants in nursing homes and to offer suggestions for how management can alleviate these problems in care facilities. We recruited participants from nine nursing homes with 50 or more beds located in middle Taiwan; 110 care attendants completed the questionnaire. The work stress scale for the care attendants was validated and achieved good reliability (Cronbach's alpha=0.93). We also conducted exploratory factor analysis. Six factors were extracted from the work stress scale: insufficient ability, stressful reactions, heavy workload, trouble in care work, poor management, and working time problems. The explained variance achieved 64.96%. Factors related to higher work stress included working in a hospital-based nursing home, having a fixed schedule, night work, feeling burden, inconvenient facility, less enthusiasm, and self-rated higher stress. Work stress for care attendants in nursing homes is related to human resource management and quality of care. We suggest potential management strategies to alleviate work stress for these workers.

  9. Impact of training of traditional birth attendants on the newborn care.

    Science.gov (United States)

    Satishchandra, D M; Naik, V A; Wantamutte, A S; Mallapur, M D

    2009-01-01

    To study the impact of training of Traditional Birth Attendants (TBAs) on the Newborn care in resource poor setting in rural area. A community based study in the Primary Health Center (PHC) area was conducted over one year period between March 2006 to February 2007. The study participants were 50 Traditional Birth Attendants (TBAs)who conduct home deliveries in the PHC area. Training was conducted for two days which included topics on techniques of conducting safe delivery and newborn care practices. Pre-test evaluation regarding knowledge and practices about newborn care was done. Post-test evaluation was done at first month (early) and at fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi- square test with Yates's correction and Fischer's exact test. Pre-test evaluation showed that, knowledge and practices about newborn care services provided by the previously trained TBAs and untrained TBAs were poor. Early and late post-test evaluation showed that, there was a progressive improvement in the newborn care provided by both the groups. Preintervention period (one year prior to the training) and postintervention period (one year after the training) showed that, there was a statistically significant (p<0.05) reduction in the perinatal deaths (11 to 3) and neonatal deaths (10 to 2) among the deliveries conducted by TBAs after the training. Training programme for TBAs with regular reinforcements in the resource poor setting will not only improve the quality of newborn care but also reduces perinatal deaths.

  10. Day Care Centers

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of day care centers for 50 states and Washington D.C. and Puerto Rico. The dataset only includes center based day care locations...

  11. Automobile Accidents Attended by Mobile Emergency Care Service

    Directory of Open Access Journals (Sweden)

    Ana Virgínia Gomes Barros

    2017-05-01

    Full Text Available Background: Automobile accidents are increasing every day and are becoming a serious public health problem due to the high morbidity and mortality rate. The goal of the current study was to characterise the traffic accidents attended by the Mobile Emergency Care Service (MECS in Ibiara, PB. Methods: This exploratory, descriptive, documentary study adopted a quantitative approach and analysis of data. The population consisted of all victims of traffic accidents attended by MECS in the city of Ibiara, PB, from June 2015 to June 2016. The following variables were studied: age, gender, time and day of the week the accident occurred, nature of the incident, substance ingested by the victim, wearing personal protective equipment (PPE or not, the anatomical lesions on the victim and the body regions hit during the accident. Results: The sample consisted of 49 accident victims, and the majority (81.6% were male, predominately 30 to 59 years. Events occurring at night (63.3% and during the week (65.3% predominated. The most frequent type of accident was motorcycle fall (71.4%, with almost half having consumed alcohol (46.9% and most not wearing PPE (77.6%. The regions of the body most affected were the lower limbs (67.3% and upper limbs (53.1%. Conclusion: The main factor/cause of these accidents was due to imprudence and violation of traffic laws, highlighting the need to invest in traffic education policies, to direct campaigns for the prevention of traffic accidents, as well as expand the surveillance of traffic laws by authorities.

  12. Desempenho motor de lactentes frequentadores de berçários em creches públicas Motor performance of infants attending the nurseries of public day care centers

    Directory of Open Access Journals (Sweden)

    Letícia Baltieri

    2010-09-01

    Full Text Available OBJETIVO: Analisar o desempenho motor axial, apendicular e global e sua correlação com as características neonatais, familiares e de tempo de exposição à creche em crianças com idade entre 12-24 meses, frequentadoras de creches públicas. MÉTODOS: Estudo transversal com 40 lactentes (idade média 14,3±2,4 meses frequentadores de creches públicas. Os participantes foram avaliados quanto ao desempenho motor com a Bayley Scales of Infant and Toddler Development-III, a qual possibilita análise do desempenho motor e comparação dos domínios motores axial e apendicular. Foram coletados dados neonatais, familiares e de exposição à creche e pesquisou-se a correlação destes fatores ao desempenho motor. Foi utilizado o teste t pareado para comparar médias e a correlação de Pearson. RESULTADOS: O desempenho motor do grupo esteve, em média, abaixo da referência, com 22,5% das crianças classificadas como suspeitas de atraso nos desempenhos axial e global, contrastando com nenhuma no domínio apendicular. A comparação axial e apendicular apontou diferença significativa, com desempenho axial aquém do apendicular, além de 35% do grupo ter apresentado discrepância significativa entre esses domínios. Não foi encontrada correlação linear entre os domínios motores avaliados e as variáveis neonatais, familiares e de exposição à creche. CONCLUSÕES: O desempenho motor global do grupo esteve abaixo da média de referência, com desempenho motor axial inferior ao apendicular e importante discrepância entre esses. Recomenda-se atenção às habilidades motoras axiais e às oportunidades de exploração que o ambiente em creches pode propiciar, especialmente no decorrer dos dois primeiros anos de vida.OBJECTIVE: To analyze gross, fine and global motor performance and its correlation with neonatal and familial variables and day care exposure among children between 12-24 months of age attending public day care centers. METHODS: This

  13. Prevention of Fatherhood Disorders--Accompanying Early Father-Child Interaction in Day-Care Centers

    Science.gov (United States)

    Lamour, Martine; Letronnier, Paulette

    2003-01-01

    Over the last fifteen years, increasing numbers of fathers have been attending medical or day-care centers for young children, traditionally "reserved" for mothers and babies. Thus the professionals who work there are able to take an active part in the "co-construction of the fathers" by accompanying their emerging fatherhood. The…

  14. Day Care: Other Countries.

    Science.gov (United States)

    Hjartarson, Freida; And Others

    This collection of 5 bilingual papers on day care programs in foreign countries (China, the Soviet Union, and 3 Scandinavian countries) is part of a series of papers on various aspects of day care published by the Canadian Department of Health and Welfare. Each paper is presented in both English and French. Paper I considers day care services in…

  15. Oral health status and treatment needs of children and young adults attending a day centre for individuals with special health care needs

    Directory of Open Access Journals (Sweden)

    Akindayomi Yinka

    2008-10-01

    Full Text Available Abstract Background The oral health condition of individuals with special health care needs have been reported in literature to be influenced by various sociodemographic factors, including living conditions and severity of impairment. This study was carried out to determine the oral health status and treatment needs of children and young adults attending a day institution for those with special needs. Methods This study was carried out as part of an oral health screening program organized by the institution and consent was obtained from parents and guardians before the screening. All information was supplied by the parents during the screening using a questionnaire completed by the dentist. Oral examination was carried out on all consenting subjects in attendance on the days of screening in the school clinic with parents and teachers in attendance, using standard World Health Organisation oral health indices to assess dental caries, oral hygiene status, malocclusion and other oral health parameters. Results Fifty-four subjects aged 3–26 years (mean 12.28 ± 6.82 years and comprising 72.2% males and 27.8% females participated in the study. Over 90% were from parents of high and middle level educational background. Thirty-six (66.7% were caries free, with a mean dmft score of 0.7 ± 1.77 and mean DMFT score of 0.4 ± 1.44 with no significant difference across gender (p = 0.5 and parents' educational status (p = 0.43. The mean OHI-S of the total population in this study was 1.36 ± 0.16. Females had a mean score of 0.88 ± 1.10 while males had a mean score of 1.55 ± 1.24 with no significant difference (p = 0.6. Twenty-five (46.3% had good oral hygiene, 17 (31.5% had fair oral hygiene and 12 (22.2% had poor oral hygiene, with no significant difference across gender (p = 1.11 and age groups (p = 0.07. Fifteen (27.8% had gingivitis with no significant difference across age groups (p = 0.17. Forty-five (83.3% had Angle's class I malocclusion, 6

  16. [Infectious diseases and use of health care resources in children less than 2 years-old who attend kindergarten].

    Science.gov (United States)

    Domínguez Aurrecoechea, B; Fernández Francés, M; Ordóñez Alonso, M Á; López Vilar, P; Pérez Candás, J I; Merino Ramos, L; Aladro Antuña, A; Fernández López, F J; Pérez López, A M

    2015-09-01

    Parents often ask paediatricians for advice about the best way to care for their children. There are discrepancies in the literature on this subject. The objective of this study is to evaluate the influence of attending kindergartens on the risk of acute infections and the use of health care resources in children less than 24 months. A prospective longitudinal study was conducted on two cohorts of children 0-24 months (born between 1 January and 30 September 2010), who were grouped according to whether they attended kindergarten or not, and were usually seen in 33 pediatric clinics of the Principality of Asturias Public Health Service. A total of 975 children were studied, of whom 43.7% attended a kindergarten at 24 months. Attending kindergarten increases the risk of pneumonia by 131%, recurrent wheezing by 69%, bronchitis by 57%, and otitis media by 64%. Early exposure to kindergarten increases the risk of pneumonia from 2.31 to 2.81, and the mean emergency room visits from 1 to 2.3. The mean antibiotic cycle is 1.7 in children who do not go to kindergarten, 3.4 if started within the first 6 months, and 2 if they start at 18 months. Day-care attendance is a risk factor of infectious diseases that increases if attending kindergartens from an early age. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  17. Critical Care Nurses' Reasons for Poor Attendance at a Continuous Professional Development Program.

    Science.gov (United States)

    Viljoen, Myra; Coetzee, Isabel; Heyns, Tanya

    2016-12-01

    Society demands competent and safe health care, which obligates professionals to deliver quality patient care using current knowledge and skills. Participation in continuous professional development programs is a way to ensure quality nursing care. Despite the importance of continuous professional development, however, critical care nurse practitioners' attendance rates at these programs is low. To explore critical care nurses' reasons for their unsatisfactory attendance at a continuous professional development program. A nominal group technique was used as a consensus method to involve the critical care nurses and provide them the opportunity to reflect on their experiences and challenges related to the current continuous professional development program for the critical care units. Participants were 14 critical care nurses from 3 critical care units in 1 private hospital. The consensus was that the central theme relating to the unsatisfactory attendance at the continuous professional development program was attitude. In order of importance, the 4 contributing priorities influencing attitude were communication, continuous professional development, time constraints, and financial implications. Attitude relating to attending a continuous professional development program can be changed if critical care nurses are aware of the program's importance and are involved in the planning and implementation of a program that focuses on the nurses' individual learning needs. ©2016 American Association of Critical-Care Nurses.

  18. Dientamoeba fragilis is more prevalent than Giardia duodenalis in children and adults attending a day care centre in Central Italy

    Directory of Open Access Journals (Sweden)

    Crotti D.

    2005-06-01

    Full Text Available Giardia duodenalis is a well recognised enteropathogen, while Dientamoeba fragilis is rarely detected and consequently it is not recognised as an important human pathogen. In 2002-2003, a survey has been carried out on enteroparasites in faecal samples of outpatients attending a day care centre in the town of Perugia (Central Italy. To improve the detection level, at least three samples from each patient were collected at different days and within two hours from defecation. The coproparasitological examination has been carried out by direct microscopic examination, faecal concentration, and Giemsa and modified Ziehl-Nielsen stainings of faecal smears. The genotypes of Giardia duodenalis isolates were determined by PCR of the β-giardin gene. Of 1,989 enrolled people (966 children, 1,023 adults, 165 persons (8.3%; 153 adults, 15.0%; 12 children, 1.2%, were positive for parasites, but only 112 adults (73.2% of those infected and eight children (66.7% of those infected harboured D. fragilis and G. duodenalis. Both the Assemblages A and B were detected in 18 G. duodenalis isolates examined at the β-giardin gene. The higher prevalence of D. fragilis infections than that of G. duodenalis is probably related to the method used, a procedure, which is rarely followed in laboratories for the diagnosis of enteric parasites. These epidemiological data suggest that when faecal samples are examined after a period of time and without Giemsa staining, most D. fragilis infections goes undetected.

  19. Self care activities among patients with diabetes attending a tertiary ...

    African Journals Online (AJOL)

    Self care activities among patients with diabetes attending a tertiary care hospital in Mangalore Karnataka, India. ... Conclusions: Self‑care practices were found to be unsatisfactory in almost all aspects except for blood sugar monitoring and treatment adherence. As these practices are essential for prevention of ...

  20. Green Care Farms: An Innovative Type of Adult Day Service to Stimulate Social Participation of People With Dementia

    NARCIS (Netherlands)

    Bruin, de S.R.; Stoop, A.; Molema, C.C.M.; Vaandrager, L.; Hop, P.J.W.M.; Baan, C.A.

    2015-01-01

    Objective: To explore the value of day services at green care farms (GCFs) in terms of social participation for people with dementia. Method: Semi-structured interviews were conducted with people with dementia who attended day services at a GCF (GCF group, n = 21), were on a waiting list (WL) for

  1. [Psychosocial aspects associated with excessive attendance in primary care paediatric clinics].

    Science.gov (United States)

    Martín Martín, Raquel; Sánchez Bayle, Marciano; Teruel de Francisco, Carmen

    2018-04-20

    Hyper-attendance is a significant problem in paediatric Primary Care clinics. The aim of our study was to analyse the level of attendance in these clinics and its relationship with certain psychosocial aspects of the families attending them. Observational descriptive study was conducted using questionnaires collected during a period of 6months, as well as recording the frequency of attendance in the previous 6months. A total of 346 questionnaires of children between 6months and 13years of age belonging to 2 urban Primary Care clinics in Madrid were completed. The raw data was analysed, and comparisons between groups and multivariate analysis were performed. The mean number of consultations in the last 6months, of the total included in the study, was 3.06 in the Primary Care centre, and 0.77 in the emergency services. It was considered over-frequent for those who had attended the Primary Care health centre 6 or more times in this period (>p90), of which there were 33 children (9.53%). In the multivariate analysis, the variables related to being frequent users of Primary Care clinics were: the presence of high level of anxiety in the parents (OR=5.50; 95%CI: 2.49-12.17, P<.0001), and the age of the children (OR=0.73; 95%CI: 0.58-0.91, P=.005). The model presented an area under the curve of 0.761 (95%CI: 0.678-0.945, P<.0001). The frequency of visits in paediatric Primary Care clinics is directly related to the high level of anxiety of the parents, and inversely to the age of the children. It would be advisable to detect and, if possible, intervene in cases of high parental anxiety in order to try to reduce the over-frequency in the paediatric primary health care. Copyright © 2018. Publicado por Elsevier España, S.L.U.

  2. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Science.gov (United States)

    2010-01-01

    ... veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... adequate veterinary care. (a) Each research facility shall have an attending veterinarian who shall provide adequate veterinary care to its animals in compliance with this section: (1) Each research facility shall...

  3. Childhood diarrhoea in Danish day care centres could be associated with infant colic, low birthweight and antibiotics

    DEFF Research Database (Denmark)

    Hebbelstrup Jensen, B.; Röser, D.; Utoft Andreassen, Bente

    2016-01-01

    and low birthweight. Methods A dynamic one-year follow-up cohort study comprising 179 children from 36 day care centres was conducted from September 2009 to July 2013 in Copenhagen, Denmark. Questionnaires were sent to the children's parents or legal guardians every two months for a year, requesting......Aim Diarrhoea is very common in children attending day care centres. The aim of this study was to examine certain predisposing risk factors for an association with diarrhoea, including foreign travel, treatment with antibiotics, having household pets, infant colic, bottle feeding, using a pacifier...... the risk of diarrhoea in Danish children in day care centres. ©2015 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd....

  4. Effectiveness of fortification of drinking water with iron and vitamin C in the reduction of anemia and improvement of nutritional status in children attending day-care centers in Belo Horizonte, Brazil.

    Science.gov (United States)

    Rocha, Daniela da Silva; Capanema, Flávio Diniz; Netto, Michele Pereira; de Almeida, Carlos Alberto Nogueira; Franceschini, Sylvia do Carmo Castro; Lamounier, Joel Alves

    2011-12-01

    Because of the high prevalence of iron-deficiency anemia in Brazil, individual control measures tend to be ineffective, and fortification of foods with iron is considered the most effective method to fight anemia. To evaluate the effectiveness of fortification of drinking water with iron and vitamin C in the reduction of anemia in children in day-care centers in Belo Horizonte, Brazil. This before-and-after study evaluated 318 children aged 6 to 74 months. Identification data and data on socioeconomic variables were collected; anthropometric and biochemical measurements were performed before and after 5 months of fortification of water with 5 mg of elemental iron and 50 mg of ascorbic acid per liter. The fortified water was used for drinking and cooking at the day-care center. Wilcoxon's nonparametric test was used to evaluate the differences in continuous variables, and McNemar's test was used to compare the prevalence rates of anemia. The prevalence of anemia decreased significantly from 29.3% before fortification to 7.9% at the end of the study, with a significant increase in hemoglobin levels. Reductions in the prevalence rates of stunting and underweight were observed. Fortification of water with iron and vitamin C significantly reduced the prevalence of anemia and improved nutritional status among children attending day-care centers.

  5. Factors associated with late antenatal care attendance in selected ...

    African Journals Online (AJOL)

    Background: Despite antenatal care services being provided free of charge or sometimes at a minimal cost in Zambia, only 19% of women attend antenatal care by their fourth month of pregnancy, as recommended by World Health Organization (WHO). An estimated 21% of pregnant women in urban and 18% in rural ...

  6. Antenatal Care and Skilled Birth Attendance in Three Communities ...

    African Journals Online (AJOL)

    Antenatal Care and Skilled Birth Attendance in Three Communities in Kaduna State, Nigeria. ... Most importantly, safer delivery options that would be acceptable in communities where women traditionally birth at home need to be explored (Afr. J. Reprod. Health 2010; 14[3]: 89-96). Key words: Antenatal care, skilled birth ...

  7. Can the theory of planned behavior help explain attendance to follow-up care of childhood cancer survivors?

    Science.gov (United States)

    Baenziger, Julia; Roser, Katharina; Mader, Luzius; Christen, Salome; Kuehni, Claudia E; Gumy-Pause, Fabienne; Tinner, Eva Maria; Michel, Gisela

    2018-06-01

    Childhood cancer survivors are at high risk for late effects. Regular attendance to long-term follow-up care is recommended and helps monitoring survivors' health. Using the theory of planned behavior, we aimed to (1) investigate the predictors of the intention to attend follow-up care, and (2) examine the associations between perceived control and behavioral intention with actual follow-up care attendance in Swiss childhood cancer survivors. We conducted a questionnaire survey in Swiss childhood cancer survivors (diagnosed with cancer aged theory of planned behavior-related predictors (attitude, subjective norm, perceived control), intention to attend follow-up care, and actual attendance. We applied structural equation modeling to investigate predictors of intention, and logistic regression models to study the association between intention and actual attendance. Of 299 responders (166 [55.5%] females), 145 (48.5%) reported attending follow-up care. We found that subjective norm, ie, survivors' perceived social pressure and support (coef = 0.90, P < 0.001), predicted the intention to attend follow-up; attitude and perceived control did not. Perceived control (OR = 1.58, 95%CI:1.04-2.41) and intention to attend follow-up (OR = 6.43, 95%CI:4.21-9.81) were positively associated with attendance. To increase attendance, an effort should be made to sensitize partners, friends, parents, and health care professionals on their important role in supporting survivors regarding follow-up care. Additionally, interventions promoting personal control over the follow-up attendance might further increase regular attendance. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Knowledge Attitude and Practice Towards Skilled Care Attendance ...

    African Journals Online (AJOL)

    response rate was 851 (91.8%) of the sample size. ... Conclusion: The study revealed that skilled care attendance at birth is still very low as compared to other ... Introduction. Maternal Mortality in Eritrea is one of the highest in the world.

  9. The KIzSS network, a sentinel surveillance system for infectious diseases in day care centers: study protocol

    Directory of Open Access Journals (Sweden)

    Enserink Remko

    2012-10-01

    Full Text Available Abstract Background Day care-associated infectious diseases are widely recognized as a public health problem but rarely studied. Insights into their dynamics and their association with the day care setting are important for effective decision making in management of infectious disease control. This paper describes the purpose, design and potential of our national multi-center, day care-based sentinel surveillance network for infectious diseases (the KIzSS network. The aim of the KIzSS network is to acquire a long-term insight into the syndromic and microbiological aspects of day care-related infectious diseases and associated disease burden and to model these aspects with day care setting characteristics. Methods/design The KIzSS network applies a prospective cohort design, following day care centers rather than individual children or staff members over time. Data on infectious disease symptoms and related morbidity (children and staff, medical consumption, absenteeism and circulating enteric pathogens (children are collected on a daily, weekly or monthly basis. Every two years, a survey is performed to assess the characteristics of participating day care centers. Discussion The KIzSS network offers a unique potential to study infectious disease dynamics in the day care setting over a sustained period of time. The created (biodatabases will help us to assess day care-related disease burden of infectious diseases among attending children and staff and their relation with the day care setting. This will support the much needed development of evidence-based and pragmatic guidelines for infectious disease control in day care centers.

  10. The effect of early child care attendance on childhood asthma and wheezing: A meta-analysis.

    Science.gov (United States)

    Swartz, Alicia; Collier, Tina; Young, Chelsea Anne; Cruz, Eddie; Bekmezian, Arpi; Coffman, Janet; Celedon, Juan; Alkon, Abbey; Cabana, Michael D

    2018-04-09

    Research evidence offers mixed results regarding the relationship between early child care attendance and childhood asthma and wheezing. A meta-analysis was conducted to synthesize the current research evidence of the association between early child care attendance and the risk of childhood asthma and wheezing. Peer reviewed studies published from 1964-January 2017 were identified in MEDLINE, CINAL, and EMBASE using MeSH headings relevant to child care and asthma. Two investigators independently reviewed the selected articles from this search. All relevant articles that met our inclusion criteria were selected for further analysis. Data were extracted from studies that had sufficient data to analyze the odds of asthma or wheezing among children who attended child care. The meta-analysis of 32 studies found that (1) early child care attendance is protective against asthma in children 3-5 years of age but not for children with asthma 6 years of age or older. (2) Early child care attendance increases the risk of wheezing among children 2 years of age or younger, but not the risk of wheezing for children over 2 years of age. This meta-analysis shows that early child care attendance is not significantly associated with the risk of asthma or wheeze in children 6 years of age or older.

  11. Evaluation of Service Station Attendant-Auto Care Project.

    Science.gov (United States)

    Cress, Ronald J.

    The project described offers an approach to providing occupational skills to socially and educationally handicapped youth, specifically the skills necessary for a service station attendant in driveway salesmanship and auto care. The 10-page evaluation report presents project goals and objectives with evaluation data (represented graphically) and…

  12. Day Care Legal Handbook: Legal Aspects of Organizing and Operating Day Care Programs.

    Science.gov (United States)

    Aikman, William F.

    This guide for providers of day care services presents information on business regulations and other legal considerations affecting for-profit and not-for-profit day care programs. Three basic topics covered are: (1) choosing the type of organization (sole proprietorship, partnership or corporation), (2) forming the organization, and (3) operating…

  13. Caring too much? Lack of public services to older people reduces attendance at work among their children.

    Science.gov (United States)

    Gautun, Heidi; Bratt, Christopher

    2017-06-01

    The need to provide care for older people can put a strain on their adult children, potentially interfering with their work attendance. We tested the hypothesis that public care for older people (nursing homes or home care services) would moderate the association between having an older parent in need of care and reduced work attendance among the adult children. The analysis used data from a survey of Norwegian employees aged 45-65 ( N  = 529). Institutional care for older people in need of care (i.e. nursing homes) was associated with improved work attendance among their children-their daughters in particular. Data also indicated a moderating effect: the link between the parents' reduced health and reduced work attendance among the children was weaker if the parent lived in a nursing home. However, the results were very different for home-based care: data indicated no positive effects on adult children's work attendance when parents received non-institutionalised care of this kind. Overall, the results suggest that extending public care service to older people can improve their children's ability to combine work with care for parents. However, this effect seems to require the high level of care commonly provided by nursing homes. Thus, the current trend towards de-institutionalising care in Europe (and Norway in particular) might hamper work attendance among care-giving adult children, women in particular. Home care services to older people probably need to be extended if they are intended as a real alternative to institutional care.

  14. Perceived oral health, oral self-care habits and dental attendance ...

    African Journals Online (AJOL)

    Perceived oral health, oral self-care habits and dental attendance among pregnant women in Benin-City, Nigeria. ... Results: The majority of the respondents (81.7%) rated their oral health as excellent/good using the global oral health rating scale. Seventy one percent of the respondents did not change their oral self-care ...

  15. Clinical characteristics of persistent frequent attenders in primary care: case–control study

    OpenAIRE

    Patel, Shireen; Kai, Joe; Atha, Christopher; Avery, Anthony; Guo, Boliang; James, Marilyn; Malins, Samuel; Sampson, Christopher James; Stubley, Michelle; Morriss, Richard K.

    2015-01-01

    Background. Most frequent attendance in primary care is temporary, but persistent frequent attendance is expensive and may be suitable for psychological intervention. To plan appropriate intervention and service delivery, there is a need for research involving standardized psychiatric interviews with assessment of physical health and health status.\\ud \\ud Objective. To compare the mental and physical health characteristics and health status of persistent frequent attenders (FAs) in primary ca...

  16. AIDS Risk Among Students Attending Seventh-day Adventist Schools in North America.

    Science.gov (United States)

    Hopkins, Gary L.; Hopp, Joyce W.; Marshak, Helen P. Hopp; Neish, Christine; Rhoads, Gayle

    1998-01-01

    Surveys of students attending Seventh-Day Adventist (SDA) high schools assessed sexual and drug-use behaviors that placed them at risk for contracting or transmitting HIV. Comparison of the results with data from the Youth Risk Behavior Survey indicated that SDA students had lower rates of sexual intercourse and substance use. Parental…

  17. Child-care attendance and common morbidity: evidence of association in the literature and questions of design

    Directory of Open Access Journals (Sweden)

    Barros Aluísio J. D.

    1999-01-01

    Full Text Available Papers on child-care attendance as a risk factor for acute respiratory infections and diarrhea were reviewed. There was great variety among the studies with regard to the design, definition of exposure and definition of outcomes. All the traditional epidemiological study designs have been used. The studies varied in terms of how child-care attendance in general was defined, and for different settings. These definitions differed especially in relation to the minimum time of attendance required. The outcomes were also defined and measured in several different ways. The analyses performed were not always appropriate, leading to sets of results of uneven quality, and composed of different measures of association relating different exposures and outcomes, that made summarizing difficult. Despite that, the results reported were remarkably consistent. Only two of the papers reviewed failed to show some association between child-care attendance and increased acute respiratory infections, or diarrhea. On the other hand, the magnitude of the associations reported varied widely, especially for lower respiratory infections. Taken together, the studies so far published provide evidence that children attending child-care centers, especially those under three years of age, are at a higher risk of upper respiratory infections, lower respiratory infections, and diarrhea. The studies were not consistent, however, in relation to attendance at child-care homes. Children in such settings were sometimes similar to those in child-care centers, sometimes similar to those cared for at home, and sometimes presented an intermediate risk.

  18. The association between demographic and oral health-related quality of life factors and dental care attendance among underprivileged older people.

    Science.gov (United States)

    Zini, Avi; Vered, Yuval; Sgan-Cohen, Harold D

    2011-06-01

    In order to identify whether demographic and oral health-related quality of life factors are associated with dental care attendance among an underprivileged older population, a comparison was performed between people who have and have not attended dental care. A cross-sectional purposive sample of 344 older underprivileged people comprised the study population. The dependent variable was dental care attendance. The 14-item version of the Oral Health Impact Profile index (OHIP-14) was used as the independent variable, together with other social and general variables, using a structured interview. The variables that were significantly associated with dental care attendance were family status (not married, the highest attendance), dwelling location (living at home, the highest attendance), caregiver (family member, the highest attendance), place of birth (Western countries, the highest attendance) and income (pension, the highest attendance). Sex, welfare support, functional ability, education, age and OHIP-14 were not associated with dental care attendance. Attending dental care was not associated with oral health-related quality of life measured by OHIP-14. Several socioeconomic variables were strongly associated. © 2010 The Authors. Australasian Journal on Ageing © 2010 ACOTA.

  19. Decision-making in job attendance within health care--a qualitative study.

    Science.gov (United States)

    Tveten, K M; Morken, T

    2016-04-01

    Musculoskeletal complaints are considered a major cause of sickness absence, particularly in areas such as the health sector. However, little is known about the personal decision-making process for self-certified sickness absence. To explore female health care workers' thoughts and experiences about work attendance when experiencing musculoskeletal symptoms. A qualitative study using individual, semi-structured, in-depth interviews with eight female health care workers was performed. Questions were related to factors influencing the decision to attend work and decision-making when facing the dilemma of attending work when experiencing musculoskeletal symptoms. The data were analysed according to the systematic text condensation. Subjects reported a high threshold before calling in sick. Self-certified sickness absence was not a strategy for coping with musculoskeletal symptoms as participants chose to be physically active and work part-time rather than taking sickness absence. Making decisions about attending work fostered conflicting norms, as women faced a dilemma between feeling guilt towards colleagues and patients and taking care of their own health. The findings highlight the complexity of managing work when experiencing musculoskeletal symptoms, and the dilemmas faced by those affected. The importance of work environment factors and the fact that some women feel compelled to work part-time in order to prioritize their own health require further consideration. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Iowa Family Day Care Handbook. Second Edition.

    Science.gov (United States)

    Pinsky, Dorothy; And Others

    The Iowa Family Day Care Handbook is designed as an aid for persons entering the business of providing home day care as well as for those persons already in the field. Topics include advantages and disadvantages of family day care for children, parents and providers; getting started in family day care; and a list and description of records that…

  1. Emergency department attendance patterns during Ramadan.

    Science.gov (United States)

    Butt, Taimur; Khan, Hameed Ullah; Ahmed, Israr; Eldali, Abdelmoneim

    2016-01-01

    Patient attendance in the emergency department (ED) is inherently variable and unpredictable. Resources might be better allocated if use of the ER could be predicted during the month of fasting (Ramadan), healthy adult Muslims do not eat or drink from dawn to sunset and in the Middle East, social activities occur mostly during night. There is no published data that has reported changes in local ED attendance pattern during Ramadan. Determine if there are differences in tertiary care ed attendance during Ramadan compared to other times of the year. Retrospective, using data from the hospital integrated clinical information system. Tertiary care institution in Riyadh, Saudi Arabia. All ED visits during the Islamic calendar years of 1431-1434 (December 18, 2009-October 13, 2013) were analyzed. Patient volume, acuity, demographics and admission rate variability between Ramadan and other months. During the study period of 4 years, of 226075 ED patients, 129178 (57.14%) patients were seen during the day shift (07:00 to 18:59). During Ramadan, 10 293 (60%) patients presented during the night shift compared with the day shift (P many ED patients were actually fasting during the study period. This study was conducted in a tertiary care hospital and the patient population presenting to our ed is predominantly Muslim; therefore, the results may not be generalized to populations that are not predominantly Muslim.

  2. Follow-up care of young childhood cancer survivors: attendance and parental involvement.

    Science.gov (United States)

    Vetsch, Janine; Rueegg, Corina S; Mader, Luzius; Bergstraesser, Eva; Rischewski, Johannes; Kuehni, Claudia E; Michel, Gisela

    2016-07-01

    Despite recommendations, only a proportion of long-term childhood cancer survivors attend follow-up care. We aimed to (1) describe the follow-up attendance of young survivors aged 11-17 years; (2) describe the parental involvement in follow-up, and (3) investigate predictors of follow-up attendance and parental involvement. As part of the Swiss Childhood Cancer Survivor Study, a follow-up questionnaire was sent to parents of childhood cancer survivors aged 11-17 years. We assessed follow-up attendance of the child, parents' involvement in follow-up, illness perception (Brief IPQ), and sociodemographic data. Clinical data was available from the Swiss Childhood Cancer Registry. Of 309 eligible parents, 189 responded (67 %; mean time since diagnosis 11.3 years, range 6.8-17.2) and 75 % (n = 141) reported that their child still attended follow-up. Of these, 83 % (n = 117) reported ≥1 visit per year and 17 % (n = 23) reported parents (92 %) reported being involved in follow-up (n = 130). In multivariable and Cox regression analyses, longer time since diagnosis (p = 0.025) and lower perceived treatment control (assessed by IPQ4: how much parents thought follow-up can help with late effects; p = 0.009) were associated with non-attendance. Parents' overall information needs was significantly associated with parental involvement in the multivariable model (p = 0.041). Educating survivors and their parents on the importance and effectiveness of follow-up care might increase attendance in the longer term.

  3. Challenges in the management of nutritional disorders and communicable diseases in child day care centers: a quantitative and qualitative approach.

    Science.gov (United States)

    Konstantyner, Tulio; Konstantyner, Thais Cláudia Roma de Oliveira; Toloni, Maysa Helena Aguiar; Longo-Silva, Giovana; Taddei, José Augusto de Aguiar Carrazedo

    2017-03-01

    In Brazil, although many children from low income families attend day care centers with appropriate hygiene practices and food programs, they have nutritional disorders and communicable diseases. This quantitative and qualitative cross-sectional study identified staff challenges in child day care centers and suggested alternative activity management to prevent nutritional disorders and communicable diseases. The study included 71 nursery teachers and 270 children from public and philanthropic day care centers (teacher to child ratios of 1:2.57 and 1:6.40, respectively). Interviews and focus groups were conducted with teachers and parents, and anthropometry and blood samples were drawn from the children by digital puncture. Children in philanthropic child day care centers were more likely to be hospitalized due to communicable diseases. Teachers from philanthropic child day care centers had lower age, income and education and higher work responsibilities based on the number of children and working time. The focus groups characterized institutions with organized routines, standard food practices, difficulties with caretaking, and lack of training to provide healthcare to children. Strategies to improve children's health in day care settings should focus on training of teachers about healthcare and nutrition.

  4. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Science.gov (United States)

    2010-01-01

    ... veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND PLANT... and Adequate Veterinary Care § 2.40 Attending veterinarian and adequate veterinary care (dealers and... veterinary care to its animals in compliance with this section. (1) Each dealer and exhibitor shall employ an...

  5. Day-Care in Denmark

    DEFF Research Database (Denmark)

    Bundgaard, Helle

    2011-01-01

    interacting with ethnic minority children and their parents, however, staff are occasionally forced to make explicit the reasoning behind their actions. A focus on the interaction of ethnic minority children and their parents in day-care centres therefore provides insights into the cultural beliefs and values......  The chapter explores central notions of appropriate social behavior in what is arguably the most important institution in Denmark when it comes to social integration, namely day-care, also known as pre-school. Moral values guiding everyday practices are generally taken for granted. When...

  6. Adult Day Care

    Science.gov (United States)

    ... Finding a Center Not all states license and regulate adult day care centers. There may be a ... is not usually covered by Medicare insurance, some financial assistance may be available through a federal or ...

  7. Day care for pre-school children.

    Science.gov (United States)

    Zoritch, B; Roberts, I; Oakley, A

    2000-01-01

    The debate about how, where and by whom young children should be looked after is one which has occupied much social policy and media attention in recent years. Mothers undertake most of the care of young children. Internationally, out-of-home day-care provision ranges widely. These different levels of provision are not simply a response to different levels of demand for day-care, but reflect cultural and economic interests concerning the welfare of children, the need to promote mothers' participation in paid work, and the importance of socialising children into society's values. At a time when a decline in family values is held responsible for a range of social problems, the day-care debate has a special prominence. To quantify the effects of out-of-home day-care for preschool children on educational, health and welfare outcomes for children and their families. Randomised controlled trials of day-care for pre-school children were identified using electronic databases, hand searches of relevant literature, and contact with authors. Studies were included in the review if the intervention involved the provision of non-parental day care for children under 5 years of age, and the evaluation design was that of a randomised or quasi-randomised controlled trial. A total of eight trials were identified after examining 920 abstracts and 19 books. The trials were assessed for methodological quality. Day-care increases children's IQ, and has beneficial effects on behavioural development and school achievement. Long-term follow up demonstrates increased employment, lower teenage pregnancy rates, higher socio-economic status and decreased criminal behaviour. There are positive effects on mothers' education, employment and interaction with children. Effects on fathers have not been examined. Few studies look at a range of outcomes spanning the health, education and welfare domains. Most of the trials combined non-parental day-care with some element of parent training or education

  8. Implementing Outcome Measures Within an Enhanced Palliative Care Day Care Model.

    LENUS (Irish Health Repository)

    Kilonzo, Isae

    2015-04-23

    Specialist palliative care day care (SPDC) units provide an array of services to patients and their families and can increase continuity of care between inpatient and homecare settings. A multidisciplinary teamwork approach is emphasized, and different models of day care exist. Depending on the emphasis of care, the models can be social, medical, therapeutic, or mixed. We describe our experience of introducing an enhanced therapeutic specialist day care model and using both patient- and carer-rated tools to monitor patient outcomes.

  9. Dietary intake of children attending full-time child care: What are they eating away from the child-care center?

    Science.gov (United States)

    Robson, Shannon M; Khoury, Jane C; Kalkwarf, Heidi J; Copeland, Kristen

    2015-09-01

    The Academy of Nutrition and Dietetics recommends children attending full-time child care obtain one-half to two-thirds of daily nutrient needs during their time at the child-care center, leaving one-third to one-half to be consumed away from the center. Although there are guidelines to optimize dietary intake of children attending child care, little is known about what these children consume away from the center. To describe the dietary intake away from the child-care center for preschool-aged children relative to the expected one-third to one-half proportion of recommended intake, and to examine the relationships between energy intake away from the center with weight status, food group consumption, and low-income status. Cross-sectional study conducted between November 2009 and January 2011. Participants (n=339) attended 30 randomly selected, licensed, full-time child-care centers in Hamilton County, OH. Child weight status and dietary intake (food/beverages consumed outside the child-care setting from the time of pickup from the center to the child's bedtime), including energy and servings of fruits, vegetables, milk, 100% juice, sugar-sweetened beverages, and snack foods. Generalized linear mixed models were used to examine independent associations of food group servings and low-income status to energy intake and energy intake to child weight status. The mean energy intake consumed away from the center (685±17 kcal) was more than the recommended target range (433 to 650 kcal). Intakes of fruits, vegetables, and milk were less than recommended. Food group servings and overweight/obesity status were positively associated with energy intake while away from the center. Preschool-aged children consume more energy and less fruits, vegetables, and milk outside of child-care centers than recommended. Overweight status was associated with children's dietary intake after leaving the child-care center. It may be beneficial to include parents in obesity prevention

  10. How physically active are children attending summer day camps?

    Science.gov (United States)

    Beets, Michael W; Weaver, Robert G; Beighle, Aaron; Webster, Collin; Pate, Russell R

    2013-08-01

    Summer day camps (SDC) represent one of the largest settings, outside the academic school year, where children can engage in safe, enjoyable physical activity (PA). Yet, little is known about this setting and how active children are while attending. System for Observing Play and Leisure Activity in Youth was used to categorize PA of boys/girls as Sedentary/Walking/Vigorous across multiple days (8 AM to 6 PM) in 4 large-scale community-based SDCs. Contextual characteristics of type of activity, activity management, equipment, and in/outdoors were collected simultaneously. Mixed-model regression analyses examined associations between PA categories and contextual characteristics. A total of 4649 scans of 2462 children were made across 27 days in the SDCs. Physical activity opportunities represented 38% of the daily schedule. Overall, 74%-79%, 13%-16%, and 7%-9% of children were observed Sedentary, Walking, or Vigorous during the SDC, and this changed to 62%-67%, 18%-19%, and 15%-18% observed Sedentary, Walking, or Vigorous during PA opportunities. Water-based PA, equipment, and free-play were related to increased PA. Children waiting-in-line for turns, staff instructing, and organized PA were related to increased sedentary. These findings provide evidence of modifiable characteristics of SDCs associated with PA. Improving staff skills related to facilitating active environments is a viable avenue to increase PA accumulated within SDCs.

  11. Day Care: A Program in Search of a Policy.

    Science.gov (United States)

    Bikales, Gerda

    This report examines current issues relating to day care and challenges many of the policy assumptions that underlie a major public program of subsidized day care for children. A historical perspective of day care is presented and various types of day care are described. The costs and benefits of day care are examined and the relation of day care…

  12. Bypassing Primary Care Facilities for Childbirth: Findings from a Multilevel Analysis of Skilled Birth Attendance Determinants in Afghanistan.

    Science.gov (United States)

    Tappis, Hannah; Koblinsky, Marge; Doocy, Shannon; Warren, Nicole; Peters, David H

    2016-01-01

    The objective of this study was to assess the association between health facility characteristics and other individual/household factors with a woman's likelihood of skilled birth attendance in north-central Afghanistan. Data from a 2010 household survey of 6879 households in 9 provinces of Afghanistan were linked to routine facility data. Hierarchical logistic regression models were used to assess determinants of skilled birth attendance. Women who reported having at least one antenatal visit with a skilled provider were 5.6 times more likely to give birth with a skilled attendant than those who did not. The odds of skilled birth attendance were 84% higher for literate women than those without literacy skills and 79% higher among women in the upper 2 wealth quintiles than women in the poorest quintile. This study did not show any direct linkages between facility characteristics and skilled birth attendance but provided insights into why studies assuming that women seek care at the nearest primary care facility may lead to misinterpretation of care-seeking patterns. Findings reveal a 36 percentage point gap between women who receive skilled antenatal care and those who received skilled birth care. Nearly 60% of women with a skilled attendant at their most recent birth bypassed the nearest primary care facility to give birth at a more distant primary care facility, hospital, or private clinic. Distance and transport barriers were reported as the most common reasons for home birth. Assumptions that women who give birth with a skilled attendant do so at the closest health facility may mask the importance of supply-side determinants of skilled birth attendance. More research based on actual utilization patterns, not assumed catchment areas, is needed to truly understand the factors influencing care-seeking decisions in both emergency and nonemergency situations and to adapt strategies to reduce preventable mortality and morbidity in Afghanistan. © 2016 by the American

  13. Does a chest x-ray alter the management of new patients attending a geriatric day hospital?

    Science.gov (United States)

    Logan, J A; Vallance, R; Williams, B O; Paul, H

    1997-01-01

    Studies have suggested that routine chest x-ray is never indicated but all new attenders at our day hospitals have a chest x-ray carried out. Our aim was to determine if this investigation altered the clinical management of patients and to try to select those patients in whom a chest x-ray is indicated. A prospective study was carried out over a 7 month period from February to September 1995. All new patients had cardiorespiratory symptoms/signs documented and a management plan made. A chest x-ray was then carried out and change in management as a result of the x-ray report noted. Knightswood and Drumchapel Geriatric Day Hospitals, West Glasgow University NHS Trust. All new Day Hospital attenders. Of 207 new Day Hospital attenders, 53 had no clinical indication for a chest x-ray and although 70% had an abnormal film in no case was patient management changed as a result of this. A chest x-ray was indicated in 154 patients and of these 114 (74%) had an abnormal film with a resultant change in management in 23 patients (this comprised either a change in drug treatment or a further investigation.) Of those whose management was changed as a result of the x-ray report 61% had respiratory symptoms. We would recommend that chest x-ray should be performed in those patients who have a clear clinical indication and that the diagnostic yield is highest in the presence of respiratory symptoms or signs.

  14. Patient-Centered Handovers: Ethnographic Observations of Attending and Resident Physicians: Ethnographic Observations of Attending and Resident Physicians.

    Science.gov (United States)

    Mount-Campbell, Austin F; Rayo, Michael F; OʼBrien, James J; Allen, Theodore T; Patterson, Emily S

    Handover communication improvement initiatives typically employ a "one size fits all" approach. A human factors perspective has the potential to guide how to tailor interventions to roles, levels of experience, settings, and types of patients. We conducted ethnographic observations of sign-outs by attending and resident physicians in 2 medical intensive care units at one institution. Digitally audiotaped data were manually analyzed for content using codes and time spent using box plots for emergent categories. A total of 34 attending and 58 resident physician handovers were observed. Resident physicians spent more time for "soon to be discharged" and "higher concern" patients than attending physicians. Resident physicians spent less time discussing patients which they had provided care for within the last 3 days ("handbacks"). The study suggested differences for how handovers were conducted for attending and resident physicians for 3 categories of patients; handovers differ on the basis of role or level of expertise, patient type, and amount of prior knowledge of the patient. The findings have implications for new directions for subsequent research and for how to tailor quality improvement interventions based upon the role, level of experience, level of prior knowledge, and patient categories.

  15. GYM score: 30-day mortality predictive model in elderly patients attended in the emergency department with infection.

    Science.gov (United States)

    González Del Castillo, Juan; Escobar-Curbelo, Luis; Martínez-Ortíz de Zárate, Mikel; Llopis-Roca, Ferrán; García-Lamberechts, Jorge; Moreno-Cuervo, Álvaro; Fernández, Cristina; Martín-Sánchez, Francisco Javier

    2017-06-01

    To determine the validity of the classic sepsis criteria or systemic inflammatory response syndrome (heart rate, respiratory rate, temperature, and leukocyte count) and the modified sepsis criteria (systemic inflammatory response syndrome criteria plus glycemia and altered mental status), and the validity of each of these variables individually to predict 30-day mortality, as well as develop a predictive model of 30-day mortality in elderly patients attended for infection in emergency departments (ED). A prospective cohort study including patients at least 75 years old attended in three Spanish university ED for infection during 2013 was carried out. Demographic variables and data on comorbidities, functional status, hemodynamic sepsis diagnosis variables, site of infection, and 30-day mortality were collected. A total of 293 patients were finally included, mean age 84.0 (SD 5.5) years, and 158 (53.9%) were men. Overall, 185 patients (64%) fulfilled the classic sepsis criteria and 224 patients (76.5%) fulfilled the modified sepsis criteria. The all-cause 30-day mortality was 13.0%. The area under the curve of the classic sepsis criteria was 0.585 [95% confidence interval (CI) 0.488-0.681; P=0.106], 0.594 for modified sepsis criteria (95% CI: 0.502-0.685; P=0.075), and 0.751 (95% CI: 0.660-0.841; P20 bpm; Morbidity-Charlson index ≥3) to predict 30-day mortality, with statistically significant differences (P=0.004 and Pcapacity than the classic and the modified sepsis criteria to predict 30-day mortality in elderly patients attended for infection in the ED.

  16. 75 FR 34140 - Establishment of the Personal Care Attendants Workforce Advisory Panel

    Science.gov (United States)

    2010-06-16

    ... services and supports; aging and disability populations and services; practices that help reduce high personal care attendant workforce vacancy and turnover rates; Medicaid, Medicare, the Older Americans Act...

  17. AIDS risk among students attending Seventh-day Adventist school, in North America.

    Science.gov (United States)

    Hopkins, G L; Hopp, J W; Marshak, H P; Neish, C; Rhoads, G

    1998-04-01

    In 1995, a survey was conducted among students attending 69 Seventh-day Adventist (SDA) high schools within the United States and Canada. The survey assessed the extent that these students practiced sexual and drug-use behaviors which place them at risk for contracting or transmitting the human immunodeficiency virus (HIV). A total of 1,748 respondents enrolled in grades 9 through 12 completed questionnaires similar to the instrument used in the 1993 Youth Risk Behavior Survey (YRBS). Data were collected and compared to results from the 1993 YRBS. Students who attended SDA parochial schools reported lower rates of sexual intercourse compared to YRBS school counterparts (16.3% vs. 53.1%) and lower rates of all substances measured. Furthermore, respondents were more likely to engage in substance use and sexual intercourse if they had at least one parent who used tobacco, alcohol, or marijuana, as reported by the students.

  18. Perception of orthodox health care centers among pregnant women attending traditional birth attendants clinics in two local government areas of Lagos State

    Directory of Open Access Journals (Sweden)

    A Okewole

    2013-01-01

    Full Text Available Background and Objective: Adequate antenatal care and skilled obstetric assistance during delivery are important strategies that significantly reduce maternal mortality and morbidity. This study aimed to assess the awareness, attitudes and perception of orthodox health care centres among pregnant women patronizing traditional birth attendants in Mushin and Lagos Island local government areas of Lagos state. Methods: The survey was a community-based descriptive cross-sectional survey that employed interviews to collect data from 300 antenatal care attendees of seven traditional birth attendants′ clinics in Lagos Island and Mushin local government areas between December 2010 and January 2011 using a structured questionnaire. Results: The women ranged in age from 17-43 years with a mean age of 27.6 ± 4.6 SD and most of them were primigravidas (41.5%, married (88% and traders (44.1%. Most of the women (61% and their husbands (56.7% had completed their secondary education. The majority (81.7% of respondents were aware of a modern health facility around where they lived, the most commonly known being private hospitals (43.7%. Most of them (67.3% were aware of antenatal care services provided at these facilities but only 31.3% had ever made use of the antenatal services. Most of the women were not willing to deliver in hospitals because they didn′t like the attitude of the health workers (37.3% and because it was far from their houses (12.7%; the majority (75% preferring to deliver with traditional birth attendants because they give good service. However, almost all (98.5% of the women that had children took them to the orthodox health facilities for immunization, primarily the primary health care centers (55.7%. Conclusion: Traditional birth attendants are patronized by a wide array of women who are aware of orthodox health facilities but have a negative attitude towards their services. Improvements in communication and interpersonal skills of

  19. Anesthesia for day-care surgeries: Current perspectives

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2017-01-01

    Full Text Available Day-care surgery has become a popular modality of surgical intervention throughout the globe. Numerous factors including the economic and financial issues are driving this therapeutic modality to a widespread acceptance among surgeons and anesthesiologists. Advancements in anesthesia and surgical techniques as well as availability of newer drugs are largely responsible for the progress of day-care surgeries. Numerous challenges are still faced by anesthesiologists and surgeons in carrying out day-care surgeries, especially in spite of these advancements, at resource-limited setups. The first right step in successfully delivering the day-care surgical services includes proper selection of the patients. The preanesthetic evaluation is highly essential in determining the suitability of the patient for day-care anesthesia and surgery as well as the formulation of various anesthetic plans and strategies. The current review is intended to highlight inherent challenges and probable solutions to them for this rapidly progressing anesthesia.

  20. Generic Checklist for Day Care Monitoring.

    Science.gov (United States)

    Children's Services Monitoring Transfer Consortium.

    This guide presents the results of research on day care monitoring methods conducted by the Children's Services Monitoring Transfer Consortium. It suggests a set of generic predictor items that can be used to monitor day care providers' compliance with standards. The predictor items are at the licensing or minimal compliance level and have been…

  1. WITHDRAWN: Day care for pre-school children.

    Science.gov (United States)

    Zoritch, Bozhena; Roberts, Ian; Oakley, Ann

    2016-10-11

    The debate about how, where and by whom young children should be looked after is one which has occupied much social policy and media attention in recent years. Mothers undertake most of the care of young children. Internationally, out-of-home day-care provision ranges widely. These different levels of provision are not simply a response to different levels of demand for day-care, but reflect cultural and economic interests concerning the welfare of children, the need to promote mothers' participation in paid work, and the importance of socialising children into society's values. At a time when a decline in family values is held responsible for a range of social problems, the day-care debate has a special prominence. To quantify the effects of out-of-home day-care for preschool children on educational, health and welfare outcomes for children and their families. Randomised controlled trials of day-care for pre-school children were identified using electronic databases, hand searches of relevant literature, and contact with authors. Studies were included in the review if the intervention involved the provision of non-parental day care for children under 5 years of age, and the evaluation design was that of a randomised or quasi-randomised controlled trial. A total of eight trials were identified after examining 920 abstracts and 19 books. The trials were assessed for methodological quality. Day-care increases children's IQ, and has beneficial effects on behavioural development and school achievement. Long-term follow up demonstrates increased employment, lower teenage pregnancy rates, higher socio-economic status and decreased criminal behaviour. There are positive effects on mothers' education, employment and interaction with children. Effects on fathers have not been examined. Few studies look at a range of outcomes spanning the health, education and welfare domains. Most of the trials combined non-parental day-care with some element of parent training or education

  2. Prevalence of problem alcohol use among patients attending primary care for methadone treatment

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2009-06-11

    Abstract Background Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed todetermine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. Methods We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. Results We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28–41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. Conclusion Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make

  3. Prevalence of problem alcohol use among patients attending primary care for methadone treatment.

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2012-02-01

    BACKGROUND: Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed to determine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. METHODS: We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. RESULTS: We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28-41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. CONCLUSION: Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make this

  4. [Frequent attendance in a Primary Health Care District].

    Science.gov (United States)

    Menéndez Granados, Nicolás; Vaquero Abellán, Manuel; Toledano Estepa, Manuel; Pérez Díaz, Manuel Modesto; Redondo Pedraza, Rosa

    2017-10-09

    To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain). An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural). The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics. A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Association of general psychological factors with frequent attendance in primary care: a population-based cross-sectional observational study.

    Science.gov (United States)

    Hajek, André; Bock, Jens-Oliver; König, Hans-Helmut

    2017-03-24

    Whereas several studies have examined the association between frequent attendance in primary care and illness-specific psychological factors, little is known about the relation between frequent attendance and general psychological factors. Thus, the aim of this study was to investigate the association between being a frequent attender in primary care and general psychological factors. Data were used from a large, population-based sample of community-dwelling individuals aged 40 and above in Germany in 2014 (n = 7,446). Positive and negative affect, life satisfaction, optimism, self-esteem, self-efficacy, and self-regulation were included as general psychological factors. The number of self-reported GP visits in the past twelve months was used to quantify frequency of attendance; individuals with more than 9 visits (highest decile) were defined as frequent attenders. Multiple logistic regressions showed that being a frequent attender was positively associated with less life satisfaction [OR: 0.79 (0.70-0.89)], higher negative affect [OR: 1.38 (1.17-1.62)], less self-efficacy [OR: 0.74 (0.63-0.86)], less self-esteem [OR: 0.65 (0.54-0.79)], less self-regulation [OR: 0.74 (0.60-0.91)], and higher perceived stress [OR: 1.46 (1.28-1.66)], after adjusting for sociodemographic factors, morbidity and lifestyle factors. However, frequent attendance was not significantly associated with positive affect and self-regulation. The present study highlights the association between general psychological factors and frequent attendance. As frequent GP visits produce high health care costs and are potentially associated with increased referrals and use of secondary health care services, this knowledge might help to address these individuals with high needs.

  6. Effect of probiotic Lactobacillus strains on acute diarrhea in a cohort of nonhospitalized children attending day-care centers

    DEFF Research Database (Denmark)

    Rosenfeldt, Vibeke; Michaelsen, Kim Fleischer; Jakobsen, Mogens

    2002-01-01

    BACKGROUND: Certain strains of lactobacilli have been shown to promote recovery from rotavirus enteritis in hospitalized children. Few studies have examined the effect of probiotics in nonhospitalized children with mild diarrhea. METHODS: We studied in a randomized placebo-controlled trial the ef.......03). CONCLUSIONS: In children from day-care centers with mild gastroenteritis, the combination of L. rhamnosus 19070-2 and L. reuteri DSM 12246 was effective in reducing the duration of diarrhea....

  7. Screening for autism spectrum disorders in Flemish day-care centres with the checklist for early signs of developmental disorders.

    Science.gov (United States)

    Dereu, Mieke; Warreyn, Petra; Raymaekers, Ruth; Meirsschaut, Mieke; Pattyn, Griet; Schietecatte, Inge; Roeyers, Herbert

    2010-10-01

    A new screening instrument for ASD was developed that can be filled out by child care workers: the Checklist for Early Signs of Developmental Disorders (CESDD). The predictive validity of the CESDD was evaluated in a population of 6,808 children between 3 and 39 months attending day-care centres in Flanders. The CESDD had a sensitivity of .80 and a specificity of .94. Based on the screening procedure used in this study, 41 children were diagnosed with ASD or got a working diagnosis of ASD. Thus, including child care workers' report on signs of ASD in screening procedures can help to identify cases of ASD at a young age.

  8. Introduction of soft drinks and processed juice in the diet of infants attending public day care centers

    Science.gov (United States)

    Longo-Silva, Giovana; Toloni, Maysa Helena de Aguiar; de Menezes, Risia Cristina Egito; Asakura, Leiko; Oliveira, Maria Alice Araújo; Taddei, José Augusto de Aguiar Carrazedo

    2015-01-01

    OBJECTIVE: Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice. METHODS: A cross-sectional study with the mothers of 636 children (aged 0 to 36 months) from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands. RESULTS: The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices. CONCLUSIONS: The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature.. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits. PMID:25662561

  9. Introduction of soft drinks and processed juice in the diet of infants attending public day care centers

    Directory of Open Access Journals (Sweden)

    Giovana Longo-Silva

    2015-03-01

    Full Text Available OBJECTIVE: Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice. METHODS: A cross-sectional study with the mothers of 636 children (aged 0 to 36 months from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands. RESULTS: The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices. CONCLUSIONS: The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature.. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits.

  10. Caring Teacher Qualities that Affect School Participation and Attendance: Student Portraits

    Science.gov (United States)

    Grimm, Helen M.

    2009-01-01

    This study explores the perspectives of four high school students focusing on the identification of caring teacher qualities and the influence those characteristics have on school participation and attendance. Data was collected using interviews rather than survey in order to hear the often-unheard voices of students. Portraits of each student…

  11. Antenatal care attendance, a surrogate for pregnancy outcome? The case of Kumasi, Ghana.

    Science.gov (United States)

    Asundep, Ntui N; Jolly, Pauline E; Carson, April; Turpin, Cornelius A; Zhang, Kui; Tameru, Berhanu

    2014-07-01

    Antenatal care (ANC) has been shown to influence infant and maternal outcomes. WHO recommends 4 ANC visits for uncomplicated pregnancies. However, pregnant women in Ghana are required to attend 8-13 antenatal visits. We investigated the association of ANC attendance with adverse pregnancy outcomes (defined as low infant birth weight, stillbirth, preterm delivery or small for gestational age). A quantitative cross-sectional study was conducted on 629 women, age 19-48 years who presented for delivery at two selected public hospitals and 16 traditional birth attendants from July to November 2011. Socio-demographic and antenatal information were collected using a structured questionnaire. ANC attendance, medical and obstetric/gynecological history were abstracted from maternal antenatal records. Data were analyzed using Chi square and logistic regression. Twenty-two percent of the women experienced an adverse outcome. Eleven percent of the women attended 5 children) was also associated with adverse birth outcomes. Women screened for syphilis or use of insecticide-treated bed nets had a 40 and 36% (p = 0.0447 and p = 0.0293) reduced likelihood of experiencing an adverse pregnancy outcome respectively. After adjusting for confounders, attending pregnancy outcome compared with ≥4 ANC visits (Adjusted OR 2.55; 95% CI 1.16-5.63; p = 0.0202). Attending pregnancy outcomes for uncomplicated pregnancies.

  12. Oral health care for children attending a malnutrition clinic in South Africa.

    Science.gov (United States)

    Gordon, N

    2007-08-01

    Most health problems dealt with at a primary care level have an oral health impact, making it vital for oral health services to find means to integrate with other facility-based programmes at primary health care (PHC) centres. 1) To determine the oral status of the children attending a facility-based nutrition programme and the oral health knowledge, attitude and practices of their parents/caregivers; and 2) To develop a framework for an oral health component to complement this programme. A descriptive study of children and their parents/caregivers attending a facility-based nutrition programme (n = 60 children). A structured, administered questionnaire for parents/caregivers and an oral examination for the children was used for data collection. The response rate was 82% (n = 49). Most parents start cleaning their children's mouths between 12 and 24 months (64%), add sugar to food and feeding bottles, and visit a dentist only when the child is symptomatic. These factors clearly place this group at risk for developing dental caries and gingivitis. Their malnutrition status/history increases their risk of oral diseases. The oral examination found plaque deposits, gingivitis, caries and 'white spots'. This study clearly shows the need for an oral health component for children attending the facility-based nutrition programme. Promotion, prevention and therapeutical oral care can be maximized by the involvement of a wide range of stakeholders and an interdisciplinary approach. This shows an expanded role for the dental team with specific reference the oral hygienist in such an environment.

  13. Our Day-Care Centers Respect Children: Quality Criteria for Day-Care = Criterios para um Atendimento em Creches que Respeite os Direitos Fundamentais das Criancas.

    Science.gov (United States)

    Campos, Maria Malta; Rosemberg, Fulvia

    Prepared as part of an effort to attain minimum quality standards for Brazilian day care centers, this document focuses on day-to-day provision of day care services for children from birth to 6 years old as well as broader day care administrative concerns. The first version of this document was prepared as part of a training project for day care…

  14. [Introduction of soft drinks and processed juice in the diet of infants attending public day care centers].

    Science.gov (United States)

    Longo-Silva, Giovana; Toloni, Maysa Helena de Aguiar; de Menezes, Risia Cristina Egito; Asakura, Leiko; Oliveira, Maria Alice Araújo; Taddei, José Augusto de Aguiar Carrazedo

    2015-01-01

    Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice. A cross-sectional study with the mothers of 636 children (aged 0 to 36 months) from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands. The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices. The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  15. Perancangan Interior Healthy Day Care Di Surabaya

    OpenAIRE

    Chandra, Shirley Vionita

    2017-01-01

    Healthy Day Care is a child care center which designed with priority of children's health that applied to all room elements which designed with healthy and attractive design that its application is done by making the formation, color, circulation space, lighting, which draw the attention of the child to can do their activities cheerfully but not excessive. Healthy Day Care is designed to solve the problem of any women who has some problems with her children, seeing the health of children toda...

  16. How Do Linguistically Diverse Students Fare in Full- and Half-Day Kindergarten? Examining Academic Achievement, Instructional Quality, and Attendance

    Science.gov (United States)

    Hall-Kenyon, Kendra M.; Bingham, Gary E.; Korth, Byran B.

    2009-01-01

    Research Findings: This study investigated the effects of full- and half-day kindergarten programs on classroom instructional quality and children's academic achievement. Considerations were given for how the length of the school day, language status (English language learner [ELL] and non-ELL), and children's attendance patterns influenced…

  17. Prevalence of depression among women attending a primary urban care clinic in Malaysia.

    Science.gov (United States)

    Sidik, Sherina Mohd; Arroll, Bruce; Goodyear-Smith, Felicity; Ahmad, Rozali

    2012-07-01

    Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic. A cross-sectional study was conducted in a government-funded primary care clinic in Malaysia. Consecutive adult female patients attending the clinic during the data collection period were invited to participate. The participants completed self-administered questionnaires (including the validated Patient Health Questionnaire [PHQ-9], which was translated into the Malay language). A total of 895 female patients participated in the study (response rate 87.5%). The prevalence of depression (PHQ-9 scores ≥ 10) was 12.1%. Based on multiple logistic regression analysis, certain stressful life events were found to be associated with depression (p depression among participants in this study was clinically significant and corresponded with the findings of other international studies. Factors associated with depression need to be highlighted and addressed accordingly. Clinicians in Malaysia should be aware of this prevalence when making diagnoses in primary care.

  18. Preventing dehydration-related hospitalizations: a mixed-methods study of parents, inpatient attendings, and primary care physicians.

    Science.gov (United States)

    Shanley, Leticia; Mittal, Vineeta; Flores, Glenn

    2013-07-01

    The goal of this study was to identify the proportion of dehydration-related ambulatory care-sensitive condition hospitalizations, the reasons why these hospitalizations were preventable, and factors associated with preventability. A cross-sectional survey of primary care providers (PCPs), inpatient attending physicians, and parents was conducted in a consecutive series of children with ambulatory care-sensitive conditions admitted to an urban hospital over 14 months. Eighty-five children were diagnosed with dehydration. Their mean age was 1.6 years; most had public (74%) or no (17%) insurance, and were nonwhite (91%). The proportion of hospitalizations assessed as preventable varied from 12% for agreement among all 3 sources to 45% for any source. Parents identified inadequate prevention (50%), poor self-education (34%), and poor quality of care (38%) as key factors. PCPs identified parents providing insufficient home rehydration (33%), not visiting the clinic (25%), and not calling earlier (16%) as reasons. Inpatient attending physicians cited home rehydration (40%), delays in seeking care (40%), and lacking a PCP (20%) as contributors. Physicians (PCPs and inpatient attending physicians) were more likely than parents to describe the admission as inappropriate (75% vs 67% vs 0%; P dehydration-related hospitalizations may be preventable. Inadequate parental education by physicians, insufficient home rehydration, deferring clinic visits, insurance and cost barriers, inappropriate admissions, poor quality of care, and parental dissatisfaction with PCPs are the reasons that these hospitalizations might have been prevented.

  19. Unnoticed Professional Competence in Day Care Work

    DEFF Research Database (Denmark)

    Ahrenkiel, Annegrethe; Schmidt, Camilla; Nielsen, Birger Steen

    2013-01-01

    This article presents a double perspective on social educators’ professional competence: It discusses how everyday life in day care centres (preschools) is dependent on professional competences that can be conceived as “unnoticed.” These aspects of professional competence are embedded in routines...... by a discussion of unnoticed professional competence and the related notion of gestural knowledge. The double perspective on social educators’ professional competences will be illuminated by empirical examples from a research project involving social educators from two day care centres in Denmark......., experiences and embodied forms of knowledge. However, it may be discussed whether these competences are under pressure from increased demands for documentation, standardization and evaluation of children’s learning outcomes. The article will briefly outline this development in the day care sector, followed...

  20. Assessment of indoor environment in Paris child day care centers.

    Science.gov (United States)

    Roda, Célina; Barral, Sophie; Ravelomanantsoa, Hanitriniala; Dusséaux, Murielle; Tribout, Martin; Le Moullec, Yvon; Momas, Isabelle

    2011-11-01

    Children are sensitive to indoor environmental pollution. Up until now there has been a lack of data on air quality in child day care centers. The aim of this study is to document the indoor environment quality of Paris child day care centers by repeated measurements, and to compare pollutant levels in child day care centers with levels in Paris dwellings. We selected 28 child day care centers frequented by a random sample of babies who participated in the PARIS birth cohort environmental investigation, and visited the child day care centers for one week twice in one year. Biological contaminants assessed were fungi, endotoxin, dust mite allergens, and chemical pollutants: aldehydes, volatile organic compounds and nitrogen dioxide (NO2). Relative humidity, temperature, and carbon dioxide levels were measured simultaneously. A standardized questionnaire was used to gather information about the buildings and their inhabitants. Airborne endotoxin levels in child day care centers were higher than those found in Paris dwellings. Dust mite allergens in child day care centers were below the threshold level for sensitization in the majority of samples, and in common with dwelling samples. Penicillium and Cladosporium were the most commonly identified genera fungi. The child day care center indoor/outdoor ratio for most chemical pollutants was above unity except for NO2, the levels for NO2 being significantly higher than those measured in homes. Chemical and biological contamination in child day care centers appears to be low, apart from endotoxin and NO2. Failure to take child exposure in child day care centers into account could result in an overestimation of children's exposure to other pollutants. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Pre-School Attendance and Child Development

    DEFF Research Database (Denmark)

    Bauchmüller, Robert; Gørtz, Mette; Rasmussen, Astrid Würtz

    Earlier research suggests that children's development is shaped in their early years of life. This paper examines whether differences in day-care experiences during pre-school age are important for children's cognitive and language development at the age of 15. The analysis is based on class...... performance at the end of elementary schooling. We assess the effects of attended types and qualities of day-care institutions on various child outcomes as measured by school grades in mathematics, science, English and Danish for the whole Danish population as well as outcomes from the 2006 PISA Denmark...... survey and a 2007 PISA Copenhagen survey. We use administrative registries to generate indicators such as child-staff ratios, child-pedagogues ratios, and the share of male staff and of staff with non-Danish origins. Furthermore, we use information on the average levels of educational attainments...

  2. Barriers of Chinese primary care attenders to seeking help for psychological distress in Hong Kong.

    Science.gov (United States)

    Sun, Kai Sing; Lam, Tai Pong; Lam, Kwok Fai; Lo, Tak Lam; Chao, David Vai Kiong; Lam, Edmund Wing Wo

    2016-05-15

    Most of the previous studies on help seeking for psychological distress were derived from Western countries. This study investigated the barriers to help-seeking for psychological distress among Chinese primary care attenders in Hong Kong. Nine focus groups and 6 individual interviews were conducted among Chinese primary care attenders with/without known distress, patients' significant others and the general public. The identified barriers were investigated in a questionnaire survey with data from 1626 primary care attenders recruited from 13 private clinics and 6 public clinics. Worries about side effects of drugs (79.9%, 95% CI:(77.9%, 81.8%)) and drug dependency (74.7%, 95% CI:(72.5%, 76.8%)) were rated as the top barriers in the survey. Qualitative interviews found both worries and actual experience of the side effects of drugs, which weakened patients' trust in the treatment. Factor analysis on all barrier items suggested three factors: 1) worries of treatment, 2) uncertainties on primary care physicians' capacity, 3) public's limited knowledge on distress and sources of help. Distress level, education level and age were associated with factor 1, whereas distress level and healthcare setting were associated with the other two factors. Qualitative interviews revealed that not having a regular primary care physician in the public setting discouraged disclosure of psychological problems. The findings were based on self-reported data from the respondents. Hong Kong is influenced by a mixed Chinese and Western culture. Relevant public education in a Chinese context should target at reducing patients' worries of drug treatment and strengthening the image of primary care physicians as a feasible source of help. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Exploring Group Composition among Young, Urban Women of Color in Prenatal Care: Implications for Satisfaction, Engagement, and Group Attendance.

    Science.gov (United States)

    Earnshaw, Valerie A; Rosenthal, Lisa; Cunningham, Shayna D; Kershaw, Trace; Lewis, Jessica; Rising, Sharon Schindler; Stasko, Emily; Tobin, Jonathan; Ickovics, Jeannette R

    2016-01-01

    Group models of prenatal care continue to grow in popularity. However, little is known about how group composition (similarity or diversity between members of groups) relates to care-related outcomes. The current investigation aimed to explore associations between prenatal care group composition with patient satisfaction, engagement, and group attendance among young, urban women of color. Data were drawn from two studies conducted in New Haven and Atlanta (2001-2004; n = 557) and New York City (2008-2011; n = 375) designed to evaluate group prenatal care among young, urban women of color. Women aged 14 to 25 were assigned to group prenatal care and completed surveys during their second and third trimesters of pregnancy. Group attendance was recorded. Data were merged and analyzed guided by the Group Actor-Partner Interdependence Model using multilevel regression. Analyses explored composition in terms of age, race, ethnicity, and language. Women in groups with others more diverse in age reported greater patient engagement and, in turn, attended more group sessions, b(se) = -0.01(0.01); p = .04. The composition of prenatal care groups seems to be associated with young women's engagement in care, ultimately relating to the number of group prenatal care sessions they attend. Creating groups diverse in age may be particularly beneficial for young, urban women of color, who have unique pregnancy needs and experiences. Future research is needed to test the generalizability of these exploratory findings. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  4. Effect of horticultural therapy on wellbeing among dementia day care programme participants: A mixed-methods study (Innovative Practice).

    Science.gov (United States)

    Hall, Jodi; Mitchell, Gary; Webber, Catherine; Johnson, Karen

    2016-04-11

    Fourteen people attending an adult day programme were recruited to a structured horticultural therapy programme which took place over 10 weeks. The effects were assessed using Dementia Care Mapping and questionnaires completed by family carers. High levels of wellbeing were observed while the participants were engaged in horticultural therapy, and these were sustained once the programme was completed. This study adds to the growing evidence on the benefits of horticultural therapy for people with dementia who have enjoyed gardening in the past. © The Author(s) 2016.

  5. Weather daily variation in winter and its effect on behavior and affective states in day-care children

    Science.gov (United States)

    Ciucci, Enrica; Calussi, Pamela; Menesini, Ersilia; Mattei, Alessandra; Petralli, Martina; Orlandini, Simone

    2011-05-01

    This study aimed to analyze the impact of winter weather conditions on young children's behavior and affective states by examining a group of 61 children attending day-care centers in Florence (Italy). Participants were 33 males, 28 females and their 11 teachers. The mean age of the children at the beginning of the observation period was 24.1 months. The day-care teachers observed the children's behavioral and emotional states during the morning before their sleeping time and filled in a questionnaire for each baby five times over a winter period of 3 weeks. Air temperature, relative humidity, air pressure and solar radiation data were collected every 15 min from a weather station located in the city center of Florence. At the same time, air temperature and relative humidity data were collected in the classroom and in the garden of each day-care center. We used multilevel linear models to evaluate the extent to which children's emotional and behavioral states could be predicted by weather conditions, controlling for child characteristics (gender and age). The data showed that relative humidity and solar radiation were the main predictors of the children's emotional and behavioral states. The outdoor humidity had a significant positive effect on frustration, sadness and aggression; solar radiation had a significant negative effect only on sadness, suggesting that a sunny winter day makes children more cheerful. The results are discussed in term of implications for parents and teachers to improve children's ecological environment.

  6. Barriers and facilitators for men to attend prenatal care and obtain HIV voluntary counseling and testing in Brazil.

    Science.gov (United States)

    Yeganeh, Nava; Simon, Mariana; Mindry, Deborah; Nielsen-Saines, Karin; Chaves, Maria Cristina; Santos, Breno; Melo, Marineide; Mendoza, Brenna; Gorbach, Pamina

    2017-01-01

    Providing HIV voluntary counseling and testing (VCT) to men who attend their partner's prenatal care is an intervention with potential to reduce HIV transmission to women and infants during the vulnerable period of pregnancy. Little is known about the acceptability of this intervention in global settings outside of Africa. We conducted in-depth qualitative interviews to evaluate potential barriers and facilitators to prenatal care attendance for HIV VCT with 20 men who did and 15 men who did not attend prenatal care with their partners at Hospital Conceiçao in Porto Alegre, Brazil. Men were recruited at the labor and delivery unit at Hospital Conceiçao via a scripted invitation while visiting their newborn infant. Interviews lasted from 35-55 minutes and were conducted in Portuguese by a local resident trained extensively in qualitative methods. All interviews were transcribed verbatim, translated, and then analyzed using Atlast.ti software. An analysis of themes was then conducted using direct quotes and statements. We applied and adapted the AIDS Risk Reduction Theoretical Model and HIV Testing Decisions Model to the qualitative data to identify themes in the 35 interviews. If offered HIV testing during prenatal care, all men in both groups stated they would accept this intervention. Yet, individual, relationship and systemic factors were identified that affect these Brazilian men's decision to attend prenatal care, informing our final conceptual model. The men interviewed had a general understanding of the value of HIV prevention of mother to child transmission. They also described open and communicative relationships with their significant others and displayed a high level of enthusiasm towards optimizing the health of their expanding family. The major barriers to attending prenatal care included perceived stigma against HIV infected individuals, men's lack of involvement in planning of the pregnancy as well as inconvenient scheduling of prenatal care, due to

  7. Barriers and facilitators for men to attend prenatal care and obtain HIV voluntary counseling and testing in Brazil.

    Directory of Open Access Journals (Sweden)

    Nava Yeganeh

    Full Text Available Providing HIV voluntary counseling and testing (VCT to men who attend their partner's prenatal care is an intervention with potential to reduce HIV transmission to women and infants during the vulnerable period of pregnancy. Little is known about the acceptability of this intervention in global settings outside of Africa.We conducted in-depth qualitative interviews to evaluate potential barriers and facilitators to prenatal care attendance for HIV VCT with 20 men who did and 15 men who did not attend prenatal care with their partners at Hospital Conceiçao in Porto Alegre, Brazil. Men were recruited at the labor and delivery unit at Hospital Conceiçao via a scripted invitation while visiting their newborn infant. Interviews lasted from 35-55 minutes and were conducted in Portuguese by a local resident trained extensively in qualitative methods. All interviews were transcribed verbatim, translated, and then analyzed using Atlast.ti software. An analysis of themes was then conducted using direct quotes and statements. We applied and adapted the AIDS Risk Reduction Theoretical Model and HIV Testing Decisions Model to the qualitative data to identify themes in the 35 interviews.If offered HIV testing during prenatal care, all men in both groups stated they would accept this intervention. Yet, individual, relationship and systemic factors were identified that affect these Brazilian men's decision to attend prenatal care, informing our final conceptual model. The men interviewed had a general understanding of the value of HIV prevention of mother to child transmission. They also described open and communicative relationships with their significant others and displayed a high level of enthusiasm towards optimizing the health of their expanding family. The major barriers to attending prenatal care included perceived stigma against HIV infected individuals, men's lack of involvement in planning of the pregnancy as well as inconvenient scheduling of

  8. Evaluating Home Day Care Mothers' Work with Young Children.

    Science.gov (United States)

    Seattle Community Coll., Washington.

    This checklist was developed to determine the skills of day care home mothers before and after training as observed by a day care home educator. Areas evaluated are: Professional Attitude; Parent Relationships; Nutrition; Health and Safety; Baby Care; Preparing the Teaching Environment; Guidance; Teaching Techniques, Language and Literature; Art;…

  9. 7 CFR 226.18 - Day care home provisions.

    Science.gov (United States)

    2010-01-01

    ... children enrolled in the day care home, through collection of free and reduced price applications and/or... price meals; (13) The State agency's policy to restrict transfers of day care homes between sponsoring..., lunch, supper, and snack. Reimbursement may not be claimed for more than two meals and one snack, or one...

  10. Delivery of Services of Day Care Workers In Sta. Maria, Laguna

    Directory of Open Access Journals (Sweden)

    ROLANDO R. CRUZADA, JR.

    2014-02-01

    Full Text Available This study focused on the determination of the delivery of services of day care workers in the municipality of Sta. Maria, Province of Laguna during the first semester of school year 2012-2013. Descriptive research was used in this study. Among the key findings were that Day Care Workers with respect to interactional relationship accomplished the functions with outstanding adequacy such as constantly giving feedback and praises on the performance of children, along with workers and parents coordination and cooperation, with verbal interpretation of Always Observe. In terms of instructional quality both group of respondents perceived that day care workers in-charge had adequate abilities and competencies concerning their education and trainings in connection with teaching small children with verbal interpretation of Always Observe. The parents had confidence to the day care workers in-charge of their children aside from regularly consulting the day care workers about their children’s progress with verbal interpretation of Always Observe. There were only 871 households who availed of the services of day care centers in which 27 workers were employed and each of them assigned to handle an average of 33 children. Notable along with other findings was the day care workers and parents had the same perception as to the extent of services provided by the Day Care Center with respect to interactional relationship, instructional quality and parental participation. Subsequently the study ensued with these five factual remarks: Children’s interactions with parents in the centers were the direct mechanisms through which children learn. The educational qualification and the capability of the day care workers to handle small children were the primary essentials in children’s learning. Parents’ participation in the day care centers premises brought harmonious relationship between the Day Care Workers and children as well. The capacity of day care worker

  11. Impact of Training of Traditional Birth Attendants on Maternal Health Care: A Community-based Study.

    Science.gov (United States)

    Satishchandra, D M; Naik, V A; Wantamutte, A S; Mallapur, M D; Sangolli, H N

    2013-12-01

    To study the impact of Training of Traditional Birth Attendants (TBAs) on maternal health care in a rural area. An interventional study in the Primary Health Center area was conducted over 1-year period between March 2006 and February 2007, which included all the 50 Traditional Birth Attendants (30 previously trained and 20 untrained), as study participants. Pretest evaluation regarding knowledge, attitude, and practices about maternal care was done. Post-test evaluation was done at the first month (early) and at the fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi-square test with Yates's correction and Fischer's exact test. Early and late post-test evaluation showed that there was a progressive improvement in the maternal health care provided by both the groups. Significant reduction in the maternal and perinatal deaths among the deliveries conducted by TBAs after the training was noted. Training programme for TBAs with regular follow-ups in the resource-poor setting will not only improve the quality of maternal care but also reduce perinatal deaths.

  12. [Barriers in the attendance of health care interventions by immigrants].

    Science.gov (United States)

    Bermejo, I; Hölzel, L P; Kriston, L; Härter, M

    2012-08-01

    Analysis of barriers regarding attendance at the health care system under consideration of cultural and migration-related factors. Cross-sectional survey with immigrants from Turkey (n = 77), Spain (n = 67), Italy (n = 95) and German resettlers from the former Soviet Union (n = 196), recruited on migration and addiction services of the German Caritasverband, the Arbeiterwohlfahrt and migrant organizations. Spanish and Italian immigrants mainly search for help within their families and social environment. Immigrants from the former Soviet Union use home remedies and experience more linguistic difficulties as barriers for the use of health services, just like Turkish immigrants. Turkish immigrants reported feeling misunderstood regarding their cultural peculiarities by the expert staff as another main barrier. Other major influencing factors were German language proficiency and the subjective wellbeing in Germany. The consideration of cultural-related as well as linguistic factors in health care services is an essential contribution for improving health care of immigrants.

  13. Consensus statement on anaesthesia for day care surgeries

    Directory of Open Access Journals (Sweden)

    Satish Kulkarni

    2017-01-01

    Full Text Available The primary aim of day-care surgery units is to allow for early recovery of the patients so that they can return to their familiar 'home' environment; the management hence should be focused towards achieving these ends. The benefits could include a possible reduction in the risk of thromboembolism and hospital-acquired infections. Furthermore, day-care surgery is believed to reduce the average unit cost of treatment by up to 70% as compared to inpatient surgery. With more than 20% of the world's disease burden, India only has 6% of the world's hospital beds. Hence, there is an immense opportunity for expansion in day-care surgery in India to ensure faster and safer, cost-effective patient turnover. For this to happen, there is a need of change in the mindset of all concerned clinicians, surgeons, anaesthesiologists and even the patients. A group of nine senior consultants from various parts of India, a mix of private and government anaesthesiologists, assembled in Mumbai and deliberated and discussed on the various aspects of day-care surgery. They formulated a consensus statement, the first of its kind in the Indian scenario, which can act as a guidance and tool for day-care anaesthesia in India. The statements are derived from the available published evidence in peer-reviewed literature including guidelines of several bodies such as the American Society of Anesthesiologists, British Association of Day Surgery and International Association of Ambulatory Surgery. The authors also offer interpretive comments wherever such evidence is inadequate or contradictory.

  14. Day care monopolar transurethral resection of prostate: Is it feasible?

    Directory of Open Access Journals (Sweden)

    Altaf Khan

    2014-01-01

    Full Text Available Introduction: Benign prostatic hyperplasia is a common disease accounting for 30% of our OPD cases and about 25% of our surgery cases. Various treatment options are now available for more efficient care and early return to work. We wanted to determine the safety and feasibility of day care monopolar transurethral resection of prostate (m-TURP, by admitting the patients on the day of surgery and discharging the patient without catheter on the same day. We also compared the morbidity associated with conventional TURP where in the catheter is removed after 24-48 h of surgery and day care TURP where in the catheter is removed on the day of surgery. Materials and Methods: A total of 120 patients who fulfilled the criteria were included in the study which was conducted between November 2008 and December 2010. A total of 60 patients were assigned for day care and 60 for conventional monopolar TURP. There was no significant difference in age, prostatic volume or IPSS score. Day care patients were admitted on day of surgery and discharged the same day after the removal of catheter. Results: Both the groups were comparable in outcome. Stricture rate was less with day care TURP. Mean catheterization time was similar to laser TURP. Conclusion: Monopolar TURP is still the gold standard of care for BPH. If cases are selected properly and surgery performed diligently it remains the option of choice for small and medium sized glands and patients can be back to routine work early.

  15. Social interaction among people with psychiatric disabilities--does attending a day centre matter?

    Science.gov (United States)

    Argentzell, Elisabeth; Leufstadius, Christel; Eklund, Mona

    2014-09-01

    Engaging in social interaction has, for people with psychiatric disabilities, been shown to enhance well-being and the experience of meaning and to generally prevent the worsening of mental illness. The aim of the study was to investigate how day centre attendees differed from non-attendees regarding different aspects of social interaction and to investigate how occupational factors, including day centre attendance, and previously known predictors were related to social interaction in the study sample as a whole. A total of 93 day centre attendees and 82 non-attendees with psychiatric disabilities were examined regarding social interaction, subjective perception of occupation, activity level, sense of self-mastery and socio-demographic and clinical variables. Data were analysed with non-parametric statistics, mainly logistic regression. Social support was mainly provided by informal caregivers such as family members. The day centre attendees had more social relations but did not experience better quality or closeness in their relationships than non-attendees. Important factors for social interaction were subjective perceptions of daily occupation, being married/cohabiting, self-mastery and severity of psychiatric symptoms. Alternative ways of enhancing social interactions in the community is needed, targeting the group's feeling of satisfaction and value in daily life together with self-mastery. © The Author(s) 2013.

  16. Intestinal Parasites in Children from a Day Care Centre in Matanzas City, Cuba

    Science.gov (United States)

    Cañete, Roberto; Díaz, Mariuska Morales; Avalos García, Roxana; Laúd Martinez, Pedro Miguel; Manuel Ponce, Félix

    2012-01-01

    Background Intestinal parasitic infections are widely distributed throughout the world and children are the most affected population. Day care centres are environments where children have proven to be more susceptible to acquiring IP. Methods and Principal Findings A cross-sectional study was carried to determine the prevalence of intestinal parasites in stool samples among children who attend to a day care centre in an urban area of Matanzas city, Cuba, from March to June 2012. 104 children under five years old were included on the study after informed consent form was signed by parents or legal guardians. Three fresh faecal samples were collected from each child in different days and were examined by direct wet mount, formalin-ether, and Kato- Katz techniques. Data relating to demography, socioeconomic status, source of drinking water, and personal hygiene habits were also collected using a standardized questionnaire. In total, 71.1% of children harbored at least one type of intestinal parasite and 47 (45.2%) were infected by more than one species. Giardia duodenalis and Blastocystis sp. were the most common parasites found, with prevalence rates of 54.8% and 38.5% respectively. Conclusions Despite public health campaigns, improvement in the level of education, and the availability of and access to medical services in Cuba infections by intestinal protozoan is high in this centre. Almost nothing is published regarding intestinal parasites in Matanzas province during the last 40 years so this work could also be the initial point to carry out other studies to clarify the IP status in this region. PMID:23236493

  17. Trends in the development of obesity in elderly day care attendees ...

    African Journals Online (AJOL)

    2013-09-09

    Sep 9, 2013 ... and the South African Medical Research Council guidelines for research on human ..... Ann Hum Biol. 2003;30(5):551-562. 11. ... attending a geriatric clinic in a tertiary care hospital in Dehi, India. Indian J Med Sci. 2004 ...

  18. Epidemiology of frequent attenders: a 3-year historic cohort study comparing attendance, morbidity and prescriptions of one-year and persistent frequent attenders

    Directory of Open Access Journals (Sweden)

    ter Riet Gerben

    2009-01-01

    Full Text Available Abstract Background General Practitioners spend a disproportionate amount of time on frequent attenders. So far, trials on the effect of interventions on frequent attenders have shown negative results. However, these trials were conducted in short-term frequent attenders. It would be more reasonable to target intervention at persistent frequent attenders. Typical characteristics of persistent frequent attenders, as opposed to 1-year frequent attenders and non-frequent attenders, may generate hypotheses regarding modifiable factors on which new randomized trials may be designed. Methods We used the data of all 28,860 adult patients from 5 primary healthcare centers. Frequent attenders were patients whose attendance rate ranked in the (age and sex adjusted top 10 percent during 1 year (1-year frequent attenders or 3 years (persistent frequent attenders. All other patients on the register over the 3-year period were referred to as non-frequent attenders. The lists of medical problems coded by the GP using the International Classification of Primary Care (ICPC were used to assess morbidity. First, we determined which proportion of 1-year frequent attenders was still a frequent attender during the next two consecutive years and calculated the GPs' workload for these patients. Second, we compared morbidity and number of prescriptions for non-frequent attenders, 1-year frequent attenders and persistent frequent attenders. Results Of all 1-year frequent attenders, 15.4% became a persistent frequent attender equal to 1.6% of all patients. The 1-year frequent attenders (3,045; 10.6% were responsible for 39% of the face-to-face consultations; the 470 patients who would become persistent frequent attenders (1.6% were responsible for 8% of all consultations in 2003. Persistent frequent attenders presented more social problems, more psychiatric problems and medically unexplained physical symptoms, but also more chronic somatic diseases (especially diabetes

  19. Factors Affecting Antenatal Care Attendance: Results from Qualitative Studies in Ghana, Kenya and Malawi

    Science.gov (United States)

    Pell, Christopher; Meñaca, Arantza; Were, Florence; Afrah, Nana A.; Chatio, Samuel; Manda-Taylor, Lucinda; Hamel, Mary J.; Hodgson, Abraham; Tagbor, Harry; Kalilani, Linda; Ouma, Peter; Pool, Robert

    2013-01-01

    Background Antenatal care (ANC) is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi) with varying levels of ANC attendance. Methods Data were collected as part of a programme of qualitative research investigating the social and cultural context of malaria in pregnancy. A range of methods was employed interviews, focus groups with diverse respondents and observations in local communities and health facilities. Results Across the sites, women attended ANC at least once. However, their descriptions of ANC were often vague. General ideas about pregnancy care – checking the foetus’ position or monitoring its progress – motivated women to attend ANC; as did, especially in Kenya, obtaining the ANC card to avoid reprimands from health workers. Women’s timing of ANC initiation was influenced by reproductive concerns and pregnancy uncertainties, particularly during the first trimester, and how ANC services responded to this uncertainty; age, parity and the associated implications for pregnancy disclosure; interactions with healthcare workers, particularly messages about timing of ANC; and the cost of ANC, including charges levied for ANC procedures – in spite of policies of free ANC – combined with ideas about the compulsory nature of follow-up appointments. Conclusion In these socially and culturally diverse sites, the findings suggest that ‘supply’ side factors have an important influence on ANC attendance: the design of ANC and particularly how ANC deals with the needs and concerns of women during the first trimester has implications for timing of initiation. PMID:23335973

  20. Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi.

    Directory of Open Access Journals (Sweden)

    Christopher Pell

    Full Text Available BACKGROUND: Antenatal care (ANC is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi with varying levels of ANC attendance. METHODS: Data were collected as part of a programme of qualitative research investigating the social and cultural context of malaria in pregnancy. A range of methods was employed interviews, focus groups with diverse respondents and observations in local communities and health facilities. RESULTS: Across the sites, women attended ANC at least once. However, their descriptions of ANC were often vague. General ideas about pregnancy care - checking the foetus' position or monitoring its progress - motivated women to attend ANC; as did, especially in Kenya, obtaining the ANC card to avoid reprimands from health workers. Women's timing of ANC initiation was influenced by reproductive concerns and pregnancy uncertainties, particularly during the first trimester, and how ANC services responded to this uncertainty; age, parity and the associated implications for pregnancy disclosure; interactions with healthcare workers, particularly messages about timing of ANC; and the cost of ANC, including charges levied for ANC procedures - in spite of policies of free ANC - combined with ideas about the compulsory nature of follow-up appointments. CONCLUSION: In these socially and culturally diverse sites, the findings suggest that 'supply' side factors have an important influence on ANC attendance: the design of ANC and particularly how ANC deals with the needs and concerns of women during the first trimester has implications for timing of initiation.

  1. What Do Older People Learn from Young People? Intergenerational Learning in "Day Centre" Community Settings in Malta

    Science.gov (United States)

    Spiteri, Damian

    2016-01-01

    This study analyses what motivates older people to attend "day centres" in Malta and what they believe that they derive from young people who carry out their placements at these day "centres" These young people, who are aged 16-17, attend a vocational college in Malta and are studying health and social care. The study is based…

  2. Nutritional practices in full-day-care pre-schools.

    LENUS (Irish Health Repository)

    Jennings, A

    2011-06-01

    Full-day-care pre-schools contribute significantly to the nutritional intake and acquisition of dietary habits of the pre-school child. The present study investigated nutritional practices in full-day-care pre-schools in Dublin, Ireland, aiming to determine the nutritional support that pre-school managers deem necessary, thereby facilitating the amelioration of existing pre-school nutritional training and practices.

  3. Unnoticed professional competence and knowledge in day care work

    DEFF Research Database (Denmark)

    Warring, Niels; Ahrenkiel, Annegrethe; Nielsen, Birger Steen

    In research on professions in the public care and health sector the issue of professional competence and knowledge is central. Discussions on tacit knowledge (Polanyi), modus 1 and 2 knowledge (Gibbons), intuitive expertise (Dreyfus), reflective practice (Schön), practical knowledge (Bourdieu...... has had an important impact on care and health work imposing demands for documentation, standardization and evaluation. These increasing demands seem to be in contrast with the tacit and embodied parts of professional competence that not easily can be documented, standardized and evaluated. It can...... educators in day care centers. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union...

  4. Hygiene of Toys in Day Care Centers: a Care With Children

    Directory of Open Access Journals (Sweden)

    Evelise Pires Cogo Simão

    2017-03-01

    Full Text Available Objective: to investigate how the hygiene of the toys used in day care centers and the possible tendencies in the processes are done. Method: descriptive, cross-sectional study, having as a unit of observation 51 day care centers. The object of investigation was the toy hygiene procedure, in which the information on the variables was obtained by interview and recorded in an online questionnaire. Results: It was observed that water and soap was the most used method of hygiene (72.5% and the periodicity of cleaning was 2 times a month or more in 50% of the units interviewed, and six nurseries declared no Such procedure. Conclusion: there was no standardized procedures in the toy hygiene technique used in the sample of nurseries studied. Although most institutions demonstrate intent to carry out the toy hygiene procedure, it is necessary to equip practitioners to deal with this issue. Descriptors: Day Care Centers; Fomites; Disinfection; Play Sets and Toys; Nursing.

  5. Frequência à creche e estado nutricional de pré-escolares: uma revisão sistemática Day care centers attendance and preschool children's nutritional status: a systematic review

    Directory of Open Access Journals (Sweden)

    Alessandra da Silva Pereira

    2010-12-01

    goal of this study. Among the papers gathered in the literature, very few of them allowed any inference about the influence of daycare centers on preschoolers' nutritional status. Nevertheless, some longitudinal studies showed a causal association between children's attendance to daycare centers and improvement of their nutritional status. CONCLUSIONS: There is a positive relation between children's attendance to day care centers and improvement of their nutritional status.

  6. Perceptions of 24/7 In-house Attending Coverage on Fellow Education and Autonomy in a Pediatric Cardiothoracic Intensive Care Unit.

    Science.gov (United States)

    Owens, Sonal T; Owens, Gabe E; Rajput, Shaili H; Charpie, John R; Kidwell, Kelley M; Mullan, Patricia B

    2015-01-01

    The 24/7 in-house attending coverage is emerging as the standard of care in intensive care units. Implementation costs, workforce feasibility, and patient outcomes resulting from changes in physician staffing are widely debated topics. Understanding the impact of staffing models on the learning environment for medical trainees and faculty is equally warranted, particularly with respect to trainee education and autonomy. This study aims to elicit the perceptions of pediatric cardiology fellows and attendings toward 24/7 in-house attending coverage and its effect on fellow education and autonomy. We surveyed pediatric cardiology fellows and attendings practicing in the pediatric cardiothoracic intensive care unit (PCTU) of a large, university-affiliated medical center, using structured Likert response items and open-ended questions, prior to and following the transition to 24/7 in-house attending coverage. All (100%) trainees and faculty completed all surveys. Both prior to and following transition to 24/7 in-house attending coverage, all fellows, and the majority of attendings agreed that the overnight call experience benefited fellow education. At baseline, trainees identified limited circumstances in which on-site attending coverage would be critical. Preimplementation concerns that 24/7 in-house attending coverage would negatively affect the education of fellows were not reflected following actual implementation of the new staffing policy. However, based upon open-ended questions, fellow autonomy was affected by the new paradigm, with fellows and attendings reporting decreased "appropriateness" of autonomy after implementation. Our prospective study, showing initial concerns about limiting the learning environment in transitioning to 24/7 in-house attending coverage did not result in diminished perceptions of the educational experience for our fellows but revealed an expected decrease in fellow autonomy. The study indirectly facilitated open discussions about

  7. Is socially integrated community day care for people with dementia associated with higher user satisfaction and a higher job satisfaction of staff compared to nursing home-based day care?

    Science.gov (United States)

    Marijke van Haeften-van Dijk, A; Hattink, Bart J J; Meiland, Franka J M; Bakker, Ton J E M; Dröes, Rose-Marie

    2017-06-01

    To investigate whether community-based (CO) day care with carer support according to the proven effective Meeting Centres Support Programme model is associated with higher satisfaction of people with dementia (PwD) and their informal caregivers (CG) and with a higher job satisfaction among care staff compared to traditional nursing home-based (NH) day care. Data were collected in 11 NH day care centres and 11 CO day care centres. User satisfaction of PwD and CG was evaluated in the 11 NH day care centres (n PwD = 41, n CG = 39) and 11 CO day care centres (n PwD = 28, n CG = 36) with a survey after six months of participation. Job satisfaction was measured only in the six NH day care centres that recently transformed to CO day care, with two standard questionnaires before (n STAFF = 35), and six months after the transition (n STAFF = 35). PwD were more positive about the communication and listening skills of staff and the atmosphere and activities at the CO day care centre. Also, CG valued the communication with, and expertise of, staff in CO day care higher, and were more satisfied with the received emotional, social and practical support. After the transition, satisfaction of staff with the work pace increased, but satisfaction with learning opportunities decreased. PwD and CG were more satisfied about the communication with the staff and the received support in CO day care than in NH day care. Overall job satisfaction was not higher, except satisfaction about work pace.

  8. The meaning and importance of vigilant attendance for the relatives of intensive care unit patients.

    Science.gov (United States)

    Plakas, Sotirios; Taket, Ann; Cant, Bob; Fouka, Georgia; Vardaki, Zambia

    2014-09-01

    To explore the meaning of vigilant attendance for relatives of critically ill patients in Greece. A plethora of international research has identified proximity to the patient to be a major concern for relatives of critically ill patients. Greece however follows a strict visiting policy in intensive care units (ICUs) so Greek relatives spend great amounts of time just outside the ICUs. This qualitative study adopted the social constructionist version of grounded theory. Data were collected from three ICUs in Athens through in depth interviews with 25 informants and approximately 10 h of observations outside the ICUs on 159 relatives. Vigilant attendance was one of the main coping mechanisms identified for relatives. Four subcategories were found to comprise vigilant attendance: (1) being as close as possible to feel relief, (2) being there to find out what is going on, (3) monitoring changes in the loved one and making own diagnosis and (4) interacting with the ICU professionals. Vigilant attendance describes the way in which relatives in Greece stayed outside the ICUs. Relatives felt satisfaction from being close as the best alternative for not actually being inside the ICU and they tried to learn what was going on by alternative methods. By seeing the patients, relatives were also able to make their own diagnoses and could therefore avoid relying solely on information given to them. However, a prerequisite for successful vigilant attendance was to get on well with doctors and nurses. Changes in visiting policies in Greece are needed to meet the needs of relatives adequately. Recommendations for changes with minimal investment of time and funding are made. © 2013 British Association of Critical Care Nurses.

  9. Psychiatric disorders in children attending a Nigerian primary care unit: functional impairment and risk factors

    Directory of Open Access Journals (Sweden)

    Tunde-Ayinmode Mosunmola

    2012-07-01

    Full Text Available Abstract Background There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians. Methods A cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7 and 30% of low scorers (score  In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity. Results It was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p  Conclusions Child psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of

  10. Influence of the day care, home and neighbourhood environment on young children's physical activity and health: protocol for the PLAYCE observational study.

    Science.gov (United States)

    Christian, Hayley; Maitland, Clover; Enkel, Stephanie; Trapp, Georgina; Trost, Stewart G; Schipperijn, Jasper; Boruff, Bryan; Lester, Leanne; Rosenberg, Michael; Zubrick, Stephen R

    2016-12-08

    The early years are a critical period in a child's health and development, yet most preschool children fail to meet physical activity guidelines. Outside of the home and neighbourhood, children spend a large proportion of time within early childhood education and care (ECEC) services such as long day care. Research is required to determine how the design of day care outdoor (and indoor) spaces provides opportunities or constraints for physical activity. A significant evidence gap surrounds what objectively measured attributes of the home and neighbourhood environment influence preschoolers' physical activity. The PLAY Spaces & Environments for Children's Physical Activity (PLAYCE) study will empirically investigate the relative and cumulative influence of the day care, home and neighbourhood environment on preschoolers' physical activity. The PLAYCE study is a cross-sectional observational study (April 2015 to April 2018) of 2400 children aged 2-5 years attending long day care in metropolitan Perth, Western Australia. Accelerometers will measure physical activity with indoor physical activity measured using radio frequency identification. Global positioning systems will be used to determine outdoor location of physical activity around the home and neighbourhood for a subsample (n=310). The day care environment will be objectively measured using a validated audit tool. Other potential individual, social and physical environmental influences on preschoolers' physical activity will be collected by geographic information systems measures, parent and day care educator surveys. Ethical approval has been granted by The University of Western Australia Human Ethics Research Committee, approval number RA/4/1/7417. Findings will be published in international peer-reviewed journals and presented at international conferences. Key findings will be disseminated to stakeholders, collaborators, policymakers and practitioners working in the ECEC sector. Day care centre directors

  11. Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia.

    Science.gov (United States)

    Titaley, Christiana R; Hunter, Cynthia L; Dibley, Michael J; Heywood, Peter

    2010-08-11

    Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. A qualitative study using focus group discussions (FGDs) and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. A comprehensive strategy to increase the availability, accessibility, and affordability of delivery care services should be considered in these West Java

  12. "I Have to Rest All the Time Because You Are Not Allowed to Play": Exploring Children's Perceptions of Autonomy during Sleep-Time in Long Day Care Services

    Science.gov (United States)

    Nothard, Michaela; Irvine, Susan; Theobald, Maryanne; Staton, Sally; Pattinson, Cassandra; Thorpe, Karen

    2015-01-01

    Daytime sleep is a significant part of the daily routine for children attending early childhood education and care (ECEC) services in Australia and many other countries. The practice of sleep-time can account for a substantial portion of the day in ECEC and often involves a mandated sleep/rest period for all children, including older…

  13. Investigation of an Escherichia coli O145 outbreak in a child day-care centre - extensive sampling and characterization of eae- and stx1-positive E. coli yields epidemiological and socioeconomic insight

    Directory of Open Access Journals (Sweden)

    Bruheim Torkjel

    2011-09-01

    Full Text Available Abstract Background On October 29th 2009 the health authorities in the city of Trondheim, Norway were alerted about a case of Shiga toxin-positive E. coli (STEC O145 in a child with bloody diarrhoea attending a day-care centre. Symptomatic children in this day-care centre were sampled, thereby identifying three more cases. This initiated an outbreak investigation. Methods A case was defined as a child attending the day-care centre, in whom eae- and stx1- but not stx2-positive E. coli O145:H28 was diagnosed from a faecal sample, with multilocus variable number of tandem repeat analysis (MLVA profile identical to the index isolate. All 61 children, a staff of 14 in the day-care centre, and 74 close contacts submitted faecal samples. Staff and parents were interviewed about cases' exposure to foods and animals. Faecal samples from 31 ewes from a sheep herd to which the children were exposed were analyzed for E. coli O145. Results Sixteen cases were identified, from which nine presented diarrhoea but not haemolytic uremic syndrome (HUS. The attack rate was 0.26, and varied between age groups (0.13-0.40 and between the three day-care centre departments (0.20-0.50, and was significantly higher amongst the youngest children. Median duration of shedding was 20 days (0-71 days. Children were excluded from the day-care centre during shedding, requiring parents to take compassionate leave, estimated to be a minimum total of 406 days for all cases. Atypical enteropathogenic E. coli (aEPEC were detected among 14 children other than cases. These isolates were genotypically different from the outbreak strain. Children in the day-care centre were exposed to faecal pollution from a sheep herd, but E. coli O145 was not detected in the sheep. Conclusions We report an outbreak of stx1- and eae-positive STEC O145:H28 infection with mild symptoms among children in a day-care centre. Extensive sampling showed occurrence of the outbreak strain as well as other STEC and

  14. Using formative research to promote antenatal care attendance and iron folic acid supplementation in Zinder, Niger.

    Science.gov (United States)

    Hess, Sonja Y; Ouédraogo, Césaire T; Bamba, Ibrahim F; Wessells, K Ryan; Keith, Nancy; Faye, Thierno; Ndiaye, Banda; Doudou, Maimouna; Nielsen, Jennifer

    2018-04-01

    In Niger, use of antenatal care (ANC) and iron folic acid (IFA) supplements is suboptimal. The objectives of this paper are as follows: (a) to conduct formative research to understand barriers and beliefs among pregnant women related to ANC, IFA supplementation, and pregnancy outcomes; (b) assess the quality of currently provided ANC services; (c) use the findings to guide the development of programmatic interventions to improve coverage of ANC services and IFA supplementation of pregnant women. Structured in-home interviews (n = 72) and focus groups (n = 4) were conducted with pregnant women in 4 randomly selected villages in rural Zinder. ANC consultations (n = 33) were observed in 5 randomly selected health centres, and exit interviews were conducted with all pregnant women and seven health agents following these observations. During workshops with stakeholders, results of the formative research were interpreted, and programmatic interventions were developed. In home interviews, 72% of women reported having attended at least one ANC visit. They also reported husbands (71%), mothers (40%), and friends (33%) supporting ANC attendance. Among those having attended ANC, only 65% reported taking IFA the day prior to the interview. Three of five health centres visited had IFA in stock. Health staff did not provide IFA supplements during 18 of 33 observed ANC consultations of which only 7 cases could be explained by the lack of IFA supplements in stock. Findings were used to design a 3-pronged intervention: (a) behaviour change communication activities in communities; (b) quality improvement activities in health centres to strengthen ANC; and (c) provision of key supplies required for ANC. © 2017 John Wiley & Sons Ltd.

  15. The epidemiology of assault-related hospital in-patient admissions and ED attendances.

    LENUS (Irish Health Repository)

    O'Farrell, A

    2013-03-01

    The aim of this study was to describe the epidemiology and impact of serious assault warranting in-patient care over six years and its impact on ED attendances in a large teaching hospital in Dublin over 2 years. There were 16,079 emergency assault-related inpatient hospital discharges reducing from 60.1 per 100,000 population in 2005 to 50.6 per 100,000 population in 2010. The median length of stay was 1 day (1-466) representing 49,870 bed days. The majority were young males (13,921, 86.6%; median age 26 years). Overall crime figures showed a similar reduction. However, knife crimes did not reduce over this period. Data on ED attendances confirmed the age and gender profile and also showed an increase at weekends. Alcohol misuse was recorded in 2,292\\/16079 (14%) of in-patient cases and 242\\/2484 (10%) in ED attendances. An inter-sectoral preventative approach specifically targeting knife crime is required to reduce this burden on health services.

  16. [Inclusion of traditional birth attendants in the public health care system in Brazil: reflecting on challenges].

    Science.gov (United States)

    Gusman, Christine Ranier; Viana, Ana Paula de Andrade Lima; Miranda, Margarida Araújo Barbosa; Pedrosa, Mayane Vilela; Villela, Wilza Vieira

    2015-05-01

    The present article describes an experience with traditional birth attendants carried out in the state of Tocantins, Brazil, between 2010 and 2014. The experience was part of a diagnostic project to survey home deliveries in the state of Tocantins and set up a registry of traditional birth attendants for the Health Ministry's Working with Traditional Birth Attendants Program (PTPT). The project aimed to articulate the home deliveries performed by traditional birth attendants to the local health care systems (SUS). Sixty-seven active traditional birth attendants were identified in the state of Tocantins, and 41 (39 indigenous) participated in workshops. During these workshops, they discussed their realities, difficulties, and solutions in the context of daily adversities. Birth attendants were also trained in the use of biomedical tools and neonatal resuscitation. Based on these experiences, the question came up regarding the true effectiveness of the strategy to include traditional birth attendants in the SUS. The present article discusses this theme with support from the relevant literature. The dearth of systematic studies focusing on the impact of PTPT actions on the routine of traditional birth attendants, including perinatal outcomes and remodeling of health practices in rural, riverfront, former slave, forest, and indigenous communities, translates into a major gap in terms of the knowledge regarding the effectiveness of such initiatives.

  17. Digital technologies in Day-care institutions

    DEFF Research Database (Denmark)

    Schrøder, Vibeke; Søndergaard, Steen

    Digital technologies are gaining an ever increasing access into the activities in Danish and Nordic day-care institutions. The traditional critical viewpoint of technologies as being opposed to the well-being of children is challenged in part by substantial access to digital tools in infant life......, in part by new technologies designed with an intuitive and inviting user interface. In a one-year research project ’Digital tools in day-care-institutions’ (2015) financed by The Danish Agency for Digitisation and The Ministry of Education we have investigated the role of digital technologies in relation...... in performances of dominant cultural ways of acting and thinking. Also, most often the pedagogues’ use of technologies follow the immediate possibilities offered by the technologies. From the videos of these activities it appears that the children follow two tracks of participation. Either the children work...

  18. Need and feasibility of telemedicine in non-urban day care centres.

    Science.gov (United States)

    Setia, Monika; DelliFraine, Jami L

    2010-01-01

    There appear to have been no studies of telemedicine in rural day care centres. We have assessed the feasibility of using telemedicine in eight rural day care centres in Pennsylvania, from the day care centres' perspective. The average number of children in these centres was 76 (range 20-150). The centres sent an average of 4.7 children home each month because of illness. Using telephone and face-to-face interviews, we assessed their perceived need for and familiarity with telemedicine, as well as their openness and preparedness for implementing telemedicine. Most day care centres reported a need for telemedicine and were open to learning how to use it. Some centres were concerned about adequate space for the equipment, but overall, the centres felt that their resources were adequate. Telemedicine in rural day care centres appears to be feasible, and would have the potential to save time and money for parents, as well as perhaps improving health care for children in rural areas.

  19. Cortisol Levels and Children's Orientation in Day Care

    Science.gov (United States)

    Reunamo, Jyrki; Sajaniemi, Nina; Suhonen, Eira; Kontu, Elina

    2012-01-01

    Children's stress in day care is related to the stressful qualities of the environment and to children's orientations in that environment. The study involved 55 children in five day centres in Finland. Baseline saliva samples for measuring cortisol (stress) levels were collected five times during the day. Children were interviewed to measure their…

  20. Prevalence and determinants of antenatal depression among women attending primary health care centers in Western Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Jamala A. Bawahab

    2017-12-01

    Full Text Available Objectives: To measure the prevalence of antenatal depression among pregnant women attending the primary health care (PHC antenatal care clinics in Jeddah, Saudi Arabia and to determine associated factors. Methods: Following a cross-sectional study design, 320 pregnant women attending the antenatal care clinics in the Ministry of Health PHC Centers in Jeddah, Saudi Arabia between January 1st 2017 and February 15th 2017 were interviewed. A self-administered questionnaire used for data collection asked about socio-demographic variables and included the Edinburgh Postnatal Depression Scale. Results: The most common contributor was the harming herself (mean±SD, 2.7±0.60. Factors significantly associated with depression among participants were the number of daughters, previous diagnosis of depression, and financial problems. Conclusions: The prevalence of antepartum depression among pregnant women in Jeddah is 57.5%, and the greatest contributor is the thought of harming herself.

  1. Reconceptualizing the understanding of professional knowledge in day care work in Denmark

    DEFF Research Database (Denmark)

    Schmidt, Camilla

    Re conceptualizing the understanding of professional knowledge in day care work As development of children’s competences increasingly sets the agenda for what counts as professional practice in day care, there is a risk that the majority of everyday practices become invisible, unnoticed and regar...... of departure in participative research conducted in day care institutions for 0-6 year olds, focusing on reconceptualizing pedagogical knowledge and paying attention to interrelations in every day practices.......Re conceptualizing the understanding of professional knowledge in day care work As development of children’s competences increasingly sets the agenda for what counts as professional practice in day care, there is a risk that the majority of everyday practices become invisible, unnoticed...... and regarded as unimportant in professional knowledge. Hence we lose sight of unique learning arenas for developing professional knowledge in day care work, and the everyday practices and routines are not considered to be in need for reflection and attention. The proposed presentation takes its’ point...

  2. 7 CFR 226.12 - Administrative payments to sponsoring organizations for day care homes.

    Science.gov (United States)

    2010-01-01

    ... amount of administrative payments and food service payments for day care home operations. (b) Start-up... for day care homes. 226.12 Section 226.12 Agriculture Regulations of the Department of Agriculture... day care homes. (a) General. Sponsoring organizations for day care homes shall receive payments for...

  3. Factors Associated With Follow-Up Attendance Among Rape Victims Seen in Acute Medical Care.

    Science.gov (United States)

    Darnell, Doyanne; Peterson, Roselyn; Berliner, Lucy; Stewart, Terri; Russo, Joan; Whiteside, Lauren; Zatzick, Douglas

    2015-01-01

    Rape is associated with posttraumatic stress disorder (PTSD) and related comorbidities. Most victims do not obtain treatment for these conditions. Acute care medical settings are well positioned to link patients to services; however, difficulty engaging victims and low attendance at provided follow-up appointments is well documented. Identifying factors associated with follow-up can inform engagement and linkage strategies. Administrative, patient self-report, and provider observational data from Harborview Medical Center were combined for the analysis. Using logistic regression, we examined factors associated with follow-up health service utilization after seeking services for rape in the emergency department. Of the 521 diverse female (n = 476) and male (n = 45) rape victims, 28% attended the recommended medical/counseling follow-up appointment. In the final (adjusted) logistic regression model, having a developmental or other disability (OR = 0.40, 95% CI = 0.21-0.77), having a current mental illness (OR = 0.25, 95% CI = 0.13-0.49), and being assaulted in public (OR = 0.50, 95% CI = 0.28-0.87) were uniquely associated with reduced odds of attending the follow-up. Having a prior mental health condition (OR = 3.02, 95% CI = 1.86-4.91), a completed Sexual Assault Nurse Examiner's (SANE) examination (OR = 2.97, 95% CI = 1.84-4.81), and social support available to help cope with the assault (OR = 3.54, 95% CI = 1.76-7.11) were associated with an increased odds of attending the follow-up. Findings point to relevant characteristics ascertained at the acute care medical visit for rape that may be used to identify victims less likely to obtain posttraumatic medical and mental health services. Efforts to improve service linkage for these patients is warranted and may require alternative service delivery models that engage rape survivors and support posttraumatic recovery.

  4. Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia

    Directory of Open Access Journals (Sweden)

    Titaley Christiana R

    2010-08-01

    Full Text Available Abstract Background Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. Methods A qualitative study using focus group discussions (FGDs and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. Results The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. Conclusions A comprehensive strategy to increase the availability, accessibility, and

  5. Education of staff--a key factor for a safe environment in day care.

    Science.gov (United States)

    Sellström, E; Bremberg, S

    2000-05-01

    In order to create a safe environment in day-care settings, an understanding of factors within the organization of day care, factors which influence safety, is essential. Day-care directors in 83 daycare centres completed a mail-in survey that contained questions about professional experience, the day-care centre's organization of child safety measures and a battery of questions designed to evaluate the directors' perceptions and beliefs about child safety. The day-care directors also carried out a safety inspection at their centre. The results were analysed using the multivariate logistic regression technique. The existence of a continuing plan for continued staff education in child safety was shown to be the strongest predictor of few safety hazards in day-care centres. The day-care directors' perceptions and beliefs about injury prevention were of less importance. This study indicates that in order to promote safety in day-care settings, an on-going plan for continued staff education in child safety should be a matter of routine. The introduction of such a plan should be the concern of the individual day-care directors, policy-makers and managers at the local and national level, and health professionals working in this field.

  6. Parental satisfaction with pediatric day-care surgery and its determinants in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Cenita James Sam

    2017-01-01

    Conclusion: Perception of quality of pediatric day-care surgery was assessed with a questionnaire and was found to be good. Variables related to surgery such as pain may be included in the questionnaire for assessing satisfaction in the day-care surgery.

  7. Inequality in access to health care in Cambodia: socioeconomically disadvantaged women giving birth at home assisted by unskilled birth attendants.

    Science.gov (United States)

    Hong, Rathavuth; Them, Rathnita

    2015-03-01

    Cambodia faces major challenges in its effort to provide access to health care for all. Although there is a sharp improvement in health and health care in Cambodia, 6 in 10 women still deliver at home assisted by unskilled birth attendants. This practice is associated with higher maternal and infant deaths. This article analyzes the 2005 Cambodia Demographic and Health Survey data to examine the relationship between socioeconomic inequality and deliveries at home assisted by unskilled birth attendants. It is evident that babies in poorer households are significantly more likely to be delivered at home by an unskilled birth attendant than those in wealthier households. Moreover, delivery at home by an unskilled attendant is associated with mothers who have no education, live in a rural residence, and are farmers, and with higher birth order children. Results from this analysis demonstrate that socioeconomic inequality is still a major factor contributing to ill health in Cambodia. © 2011 APJPH.

  8. Experiences of Everyday Occupation among People with Psychiatric Disabilities - Relationships to social interaction, the worker role and day centre attendance

    OpenAIRE

    Argentzell, Elisabeth

    2012-01-01

    The thesis aims to explore subjective experiences of everyday occupation, social interaction and the view of the worker role among people with psychiatric disabilities(PD), while also addressing the importance of day centre attendance. The thesis consists of one qualitative study, exploring which characteristics in everyday occupation provide meaning to people with PD, and three quantitative studies based on questionnaires to both day centre attendees and non-attendees. Study I showed that fe...

  9. CTEPP DATA COLLECTION FORM 05: CHILD DAY CARE CENTER PRE-MONITORING QUESTIONNAIRE

    Science.gov (United States)

    This data collection form is used to identify the potential sources of pollutants at the day care center. The day care teacher is asked questions related to the age of their day care building; age and frequency of cleaning carpets or rugs; types of heating and air conditioning de...

  10. Meaning in family caregiving for people with dementia: a narrative study about relationships, values, and motivation, and how day care influences these factors.

    Science.gov (United States)

    Tretteteig, Signe; Vatne, Solfrid; Rokstad, Anne Marie Mork

    2017-01-01

    In addition to care-related burdens, most caregivers of a person with dementia perceive a variety of positive and satisfying experiences, such as feeling needed and useful in their family caregiving role. "Meaning-focused coping" describes both positive and negative emotions in periods with high levels of stress. Day care service may have the potential to increase caregivers' positive experiences and meaning-focused coping, and positively influence interpersonal relationships between those giving care and those receiving care. The aim of this study was to gain knowledge about family caregivers' experiences of meaning in their caring role. Additionally, the influence of day care services on caregivers' experiences and motivation in their caregiving role is explored. A qualitative design based on individual interviews was used. The interviews were analyzed using a narrative method and a case study approach. Family caregivers' roles and coping strategies were related to their relational ties. Caregivers had to make decisions about whether to enhance, maintain, or let go of emotional ties to find a good balance between meeting their own needs and the needs of the person with dementia. Family caregivers reported that day care positively influenced their "relationship-oriented coping" and experience of meaning. Finding meaning in the role of a family caregiver for persons with dementia is closely connected to the caregivers' own values and goals. Finding a balance between attending to their own needs and the needs of the person with dementia is crucial. Day care has the potential to increase family caregivers' motivation to care by supporting their capacity to meet their own needs, cooperate and communicate with the person with dementia, and make competent and autonomous choices, thus increasing their feeling of mastery.

  11. Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London.

    Science.gov (United States)

    Hullah, Esther; Turok, Yaroslava; Nauta, Maud; Yoong, Wai

    2008-05-01

    The aim of this study was to describe self-reported oral health, oral hygiene habits, frequency of visits to a dentist and factors associated with dental attendance among pregnant women at a North London Hospital, the majority of whom are immigrants. Peridontal disease is associated with an increased risk of adverse pregnancy outcomes. The aim of this study is to describe self-reported oral health, oral hygiene habits, frequency of visits to a dentist and factors associated with dental attendance among pregnant women at a North London Hospital, the majority of whom are immigrants. A questionnaire designed by the authors was completed by postnatal women within 3 days of delivery. Data collected included past dental attendance, reasons for attendance and information about age, parity and socio-economic group. In total, 206 women completed the questionnaires within 3 days of delivery; 74.2% of the mothers were not born in the UK and 38.3% were Black African. The mean age of was 28.19 +/- 6.07 years. The majority reported good oral hygiene habits such as brushing their teeth twice a day (73.7%) and using mouthwash (51%). However, their dental attendance was poor and the average time since their last visit to a dentist was 1.8 +/- 1.61 years. Over a third of the women questioned did not know about the availability of free dental care during pregnancy and for 12 months after; 33% visited a dentist in pregnancy and half of them needed and received treatment; 15% of mothers had more than one pregnancy and yet were still unaware of free dental care provided during pregnancy and 12 months after birth. Only 36% of questioned women regularly visited a dentist. Pregnancy did little to change their attitudes to dental care. There appears no difference in attitudes to dental care between immigrant and British born pregnant women. Efforts to improve the uptake of dental care should be directed towards immigrant groups in order to promote better maternal health. Further research is

  12. INCLUSION OF CHILDREN WITH DEVELOPMENTAL DISORDERS IN DAY CARE INSTITUTION ESTREA MARA IN BITOLA

    Directory of Open Access Journals (Sweden)

    M. SOTIROVSKA-SIRVINI

    1997-09-01

    Full Text Available The Day Care Institutions for children are forms of organized protection for improvement of the psycho-physical, emotional and social development of children. In this period, the growth and development are in their most intensive phase when the outside influence plays an extraordinary role both in a positive and in negative a direction. Directed and well-organized protection is of a great importance. By inclusion of children with developmental disorders in the group and with special, individual treatment of each child by adequate specialized staff, their socialization and stimulus for developmental acceleration is achieved.Many years ago, by recommendation of the Advisory Institution for Development, the doctors from the Advisory Institution for small children, the public-health nurses or by the parents initiative, the kindergartens accept children with Down syndrome, children with limited and lower level backwardness, with disharmonious development, with lower level forms of cerebral paralysis and with speech disorders.Children at the earliest age of one month are resided at the Advisory Institu­­tion for Development and receive treatment until they are categorized and are ready to start school, but certain children are sent to the kindergartens at the age of 3.In the previous years, out of five children with Down syndrome treated in the Advisory Institution for Development, four were sent to the kindergarten. Now, one of these children attends the fifth grade and two attend the first grade in a regular elementary school and one attends the special school. Three children with Spastic dyplegia, four children with lower level of retardation, two with surdomutitas and four with disharmonious development are still in the kindergarten.

  13. Suitability of a structured Fundamental Movement Skills program for long day care centres: a process evaluation.

    Science.gov (United States)

    Petrunoff, Nick; Lloyd, Beverley; Watson, Natalie; Morrisey, David

    2009-04-01

    Early childhood presents an opportunity to encourage development of Fundamental Movement Skills (FMS). Implementation of a structured program in the Long Day Care (LDC) setting presents challenges. Implementation of a structured FMS program FunMoves was assessed in LDC in metropolitan New South Wales. LDC staff attended a training session conducted by trained Health Promotion Officers (HPOs) and completed an evaluation. During implementation HPOs completed lesson observations. De-identified attendance data was collected and director and staff feedback on the program including barriers to implementation was obtained via questionnaire. Qualitative information relevant to process evaluation was obtained via open questions on questionnaires, and a de-brief diary recording feedback from directors and staff. Knowledge of FMS and FunMoves and staff confidence to deliver the program were high after training. On average, staff stated they ran lessons more than the suggested twice weekly and the majority of children attended 1-3 lessons per week. However, lesson delivery was not as designed, and staff found FunMoves disruptive and time consuming. Six directors and the majority of staff thought that FunMoves could be improved. Structured program delivery was hampered by contextual issues including significant staff turnover and program length and structure being at odds with the setting. Implementation could be enhanced by guidelines for more flexible delivery options including less structured approaches, shorter and simpler lessons, ongoing conversations with the early childhood sector, in-centre engagement of staff and post-training support.

  14. How common is multiple general practice attendance in Australia?

    Science.gov (United States)

    Wright, Michael; Hall, Jane; van Gool, Kees; Haas, Marion

    2018-05-01

    Australians can seek general practice care from multiple general practitioners (GPs) in multiple locations. This provides high levels of patient choice but may reduce continuity of care. The aim of this study was to estimate the prevalence of attendance at multiple general practices in Australia, and identify patient characteristics associated with multiple practice attendances. A cross-sectional survey of 2477 Australian adults was conducted online in July 2013. Respondents reported whether they had attended more than one general practice in the past year, and whether they had a usual general practice and GP. Demographic information, health service use and practice characteristics were also obtained from the survey. Over one-quarter of the sample reported attending more than one practice in the previous year. Multiple practice attendance is less common with increasing age, and less likely for survey respondents from regional Australia, compared with respondents from metropolitan areas. Multiple practice attenders are just as likely as single practice attenders to have a usual GP. A significant proportion of general practice care is delivered away from usual practices. This may have implications for health policy, in terms of continuity and quality of primary care.

  15. Detection of anti-Giardia lamblia serum antibody among children of day care centers

    Directory of Open Access Journals (Sweden)

    Guimarães Semíramis

    2002-01-01

    Full Text Available OBJETIVES: To detect anti-Giardia lamblia serum antibodies in healthy children attending public day care centers and to assess serological tests as tools for estimating the prevalence of G. lamblia in endemic areas. METHODS: Three separate stool specimens and filter paper blood samples were collected from 147 children ranging from 0 to 6 years old. Each stool sample was processed using spontaneous sedimentation and zinc sulfate flotation methods. Blood samples were tested by indirect immunofluorescence (IIF and enzyme-linked immunosorbent assay (ELISA for Giardia IgG. RESULTS AND CONCLUSIONS: Of 147 individuals tested, 93 (63.3% showed Giardia cysts in their feces. Using IIF and ELISA, serum antibodies were detected in 93 (63.3% and 100 (68% samples , respectively. Sensitivity of IIF and ELISA was 82% and 72%, respectively. However, ELISA revealed to be less specific (39% than IIF (70%. IIF also showed a higher concordance with microscopic examination than ELISA.

  16. Home iv Antibiotic Therapy through a Medical Day Care Unit

    Directory of Open Access Journals (Sweden)

    Marie Gourdeau

    1993-01-01

    Full Text Available An out-patient parenteral antibiotic therapy program provided through a medical day care unit was evaluated in a tertiary care hospital. From July 11, 1988 to December 31, 1990, 122 patients were treated either on site at the unit or at home with self-administered intravenous antibiotics. In all, 142 courses of parenteral antibiotics (mostly cephalosporins and clindamycin were given for a total of 124 infections, mostly bone and soft tissue infections (67 of 124, 54%. The duration of out-patient therapy ranged from two to 62 days with a mean duration of 9.4 days if treated at the unit, or 13.2 days in the home care model (1476 patient-days. Vein access was peripheral and catheters remained functional for an average of 4.9 days (range 0.5 to 22 days. Only two patients experienced adverse drug reactions that necessitated modification of treatment. One other case was readmitted to the hospital for surgical debridement. The average cost per patient-day was $66 compared with $375 for in-hospital therapy. This program proved to be safe, efficient, and cost-effective.

  17. MANAJEMEN SARANA PRASARANA DI DAY CARE BABY’S HOME SALATIGA

    Directory of Open Access Journals (Sweden)

    Desi Kusumawati

    2017-01-01

    Full Text Available Day Care is one form of early childhood education in non formal education program that organize nurturing and social welfare of children from birth up to the age of 6 years. This study aimed to identify the suitability of existing infrastructure in Baby's Home day care with the ACT of Minister of Education and Culture No. 137 of 2014 Article 32 Paragraph 3; and to provide an overview why the planning, maintenance and inventory in Baby's Home day care were not optimal. This study was qualitative research. The subject was Baby's Home day care Salatiga. Technique of collecting data using interviews, observation and documents. Data were analyzed using Miles and Huberman Model. Data validation using triangulation technique of data. Facilities and infrastructure in Baby's Home day care which conform with ACT of Minister of Education and Culture No. 137 of 2014 Article 32 Paragraph 3 of were the area of land, space of activities inside and outside, hand washing facilities, showers and latrines, and access to health facilities. While things were not conform included the bedroom, dining room, and covered trash. The cause of the planning, maintenance and inventory of facilities and infrastructure have not optimally done because the plan was not carried out continuously, the lack of personnel to assist in the maintenance, and did not have the administrative staff specifically for inventory. Advice can be given to Baby's Home day care is to conduct procurement planning infrastructure on sleeping room, dining room and trash. In addition, the maintenance to existing infrastructure must be made as well as the inventory of infrastructure in order to facilitate the planning purchasing.

  18. Birth preparedness and complication readiness in pregnant women attending urban tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Vasundhara Kamineni

    2017-01-01

    Full Text Available Background: Birth preparedness and complication readiness (BP/CR is a strategy to promote the timely use of skilled maternal and neonatal care and is based on the theory that preparing for childbirth and being ready for complications reduce delay in obtaining care. Study Objective: The objective of this study was to evaluate the incidence and predictors of birth preparedness, knowledge on danger signs, and emergency readiness among pregnant women attending outpatient clinic of a tertiary care hospital. Patients and Methods: Six hundred pregnant women attending the outpatient department of a tertiary care hospital for the first time in an urban setting were interviewed using a tool adapted from the “Monitoring BP/CR-tools and indicators for maternal and new born health” of the “JHPIEGO.” The outcomes of the study were birth preparedness, knowledge of severe illness, and emergency readiness. Results: Six hundred pregnant women were in the study. Mean age of respondents was 25.2 (±4 years. The mean gestation at enrolment was 18.7 ± 8 weeks. Among the women who participated in the survey, 20% were illiterate, 70% were homemakers and nearly 70% had a monthly family income >Rs. 15,197 (n = 405. Three hundred and sixteen mothers (52% were primigravida. As defined in the study, 71.5% were birth prepared. However, 59 women (9.8% did not identify a place of delivery, 102 (17% had not started saving money, and 99 mothers (16.5% were not aware of purchasing materials needed for delivery. The predictors of birth preparedness are multiparity (odds ratio [OR]: 2.2, 95% confidence interval [CI]: 1.4–3.1, registration in the antenatal clinic in the first trimester (OR: 3.7, 95% CI: 2.2–6.1, educational status of women (OR: 1.9, 95% CI: 1.2–3.0, and pregnancy supervison by a doctor (OR: 5, 95% CI: 2.8–6.6. One hundred and sixty-four women (27% made no arrangements in the event of an emergency, 376 women (63% were not aware of their blood group

  19. Dental Care Every Day: A Caregiver's Guide

    Science.gov (United States)

    DENTAL CARE EVERY DAY A Caregiver’s Guide U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES NATIONAL INSTITUTES OF HEALTH National Institute of Dental and Craniofacial Research Contents Getting Started ................................................................................ 2 Three ...

  20. Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ebuehi OM

    2012-02-01

    Full Text Available Olufunke M Ebuehi, IA AkintujoyeReproductive and International Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, NigeriaBackground: In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women’s perceptions and utilization of traditional birth attendant (TBA services in a rural Local Government Area (LGA in Ogun State, southwest Nigeria.Methods: A quantitative design was used to obtain information using a structured questionnaire from 250 pregnant women attending four randomly selected primary health care clinics in the LGA. Data were analyzed using Epi Info (v 3.5.1 statistical software.Results: Almost half (48.8% of the respondents were in the age group 26–35 years, with a mean age of 29.4 ± 7.33 years. About two-thirds (65.6% of the respondents had been pregnant 2–4 times before. TBA functions, as identified by respondents, were: “taking normal delivery” (56.7%, “providing antenatal services” (16.5%, “performing caesarean section” (13.0%, “providing family planning services” (8.2%, and “performing gynaecological surgeries” (5.6%. About 6/10 (61.0% respondents believed that TBAs have adequate knowledge and skills to care for them, however, approximately 7/10 (69.7% respondents acknowledged that complications could arise from TBA care. Services obtained from TBAs were: routine antenatal care (81.1%, normal delivery (36.1%, “special maternal bath to ward off evil spirits” (1.9%, “concoctions for mothers to drink to make baby strong” (15.1%, and family planning services (1.9%. Reasons for using TBA services were: “TBA services are cheaper” (50.9%, “TBA services are more culturally acceptable in my environment” (34.0%,

  1. Health profiles of foreigners attending primary care clinics in Malaysia.

    Science.gov (United States)

    Ab Rahman, Norazida; Sivasampu, Sheamini; Mohamad Noh, Kamaliah; Khoo, Ee Ming

    2016-06-14

    The world population has become more globalised with increasing number of people residing in another country for work or other reasons. Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia. Data were derived from the 2012 National Medical Care Survey (NMCS), a cross sectional survey of primary care encounters from public and private primary care clinics sampled from five regions in Malaysia. Patients with foreign nationality were identified and analysed for demographic profiles, reasons for encounter (RFEs), diagnosis, and provision of care. Foreigners accounted for 7.7 % (10,830) of all patient encounters from NMCS. Most encounters were from private clinics (90.2 %). Median age was 28 years (IQR: 24.0, 34.8) and 69.9 % were male. Most visits to the primary care clinics were for symptom-based complaints (69.5 %), followed by procedures (23.0 %) and follow-up visit (7.4 %). The commonest diagnosis in public clinics was antenatal care (21.8 %), followed by high risk pregnancies (7.5 %) and upper respiratory tract infection (URTI) (6.8 %). Private clinics had more cases for general medical examination (13.5 %), URTI (13.1 %) and fever (3.9 %). Medications were prescribed to 76.5 % of these encounters. More foreigners were seeking primary medical care from private clinics and the encounters were for general medical examinations and acute minor ailments. Those who sought care from public clinics were for obstetric problems and chronic diseases. Medications were prescribed to two-thirds of the encounters while other interventions: laboratory investigations, medical procedures and follow-up appointment had lower rates in private clinics. Foreigners are generally of young working group and are expected to have mandatory medical checks. The preponderance of obstetrics seen in public

  2. Malaria among antenatal clients attending primary health care ...

    African Journals Online (AJOL)

    This study assessed the prevalence of fever, malarial parasitemia and anemia among pregnant women attending PHC facilities in Kano, northern Nigeria. Methods: A cross-sectional descriptive study was conducted among 360 ANCs attending PHC facilities in two Local Government Areas (LGAs) in Kano state. Data were ...

  3. Home birth without skilled attendants despite millennium villages project intervention in Ghana: insight from a survey of women's perceptions of skilled obstetric care.

    Science.gov (United States)

    Nakua, Emmanuel Kweku; Sevugu, Justice Thomas; Dzomeku, Veronica Millicent; Otupiri, Easmon; Lipkovich, Heather R; Owusu-Dabo, Ellis

    2015-10-07

    Skilled birth attendance from a trained health professional during labour and delivery can prevent up to 75% of maternal deaths. However, in low- and middle-income rural communities, lack of basic medical infrastructure and limited number of skilled birth attendants are significant barriers to timely obstetric care. Through analysis of self-reported data, this study aimed to assess the effect of an intervention addressing barriers in access to skilled obstetric care and identified factors associated with the use of unskilled birth attendants during delivery in a rural district of Ghana. A cross-sectional survey was conducted from June to August 2012 in the Amansie West District of Ghana among women of reproductive age. Multi-stage, random, and population proportional techniques were used to sample 50 communities and 400 women for data collection. Weighted multivariate logistic regression analysis was used to identify factors associated with place of delivery. A total of 391 mothers had attended an antenatal care clinic at least once for their most recent birth; 42.3% of them had unskilled deliveries. Reasons reported for the use of unskilled birth attendants during delivery were: insults from health workers (23.5%), unavailability of transport (21.9%), and confidence in traditional birth attendants (17.9%); only 7.4% reported to have had sudden labour. Other factors associated with the use of unskilled birth attendants during delivery included: lack of partner involvement aOR = 0.03 (95% CI; 0.01, 0.06), lack of birth preparedness aOR = 0.05 (95% CI; 0.02, 0.13) and lack of knowledge of the benefits of skilled delivery aOR = 0.37 (95% CI; 0.11, 1.20). This study demonstrated the importance of provider-client relationship and cultural sensitivity in the efforts to improve skilled obstetric care uptake among rural women in Ghana.

  4. Is frequent attendance of longer duration related to less transient episodes of care? A retrospective analysis of transient and chronic episodes of care

    NARCIS (Netherlands)

    Smits, F.T.; Brouwer, H.J.; Schene, A.H.; van Weert, H.C.; ter Riet, G.

    2016-01-01

    OBJECTIVES: Frequent attenders (FAs) suffer more and consult general practitioners (GPs) more often for chronic physical and psychiatric illnesses, social difficulties and distress than non-FAs. However, it is unclear to what extent FAs present transient episodes of care (TECs) compared with

  5. When risk becomes invisible in the everyday life of day care

    DEFF Research Database (Denmark)

    Villumsen, Anne Marie; Kristensen, Ole Steen

    2016-01-01

    Both the identification of children at risk in day care and multidisciplinary collaboration with other professions have a political focus. This study was designed as an organizational field study and attempts to establish a coherent practice of multidisciplinary collaboration between day care...... and their life circumstances become invisible in the everyday life of day care. Due to defensive routines as well as an organizational culture that frames and creates a non-explicitly structured practice using intuitive processes, the problems of children at risk become invisible in the everyday life of day care....... When risk become invisible, it not only impedes the mono-professional help the children receive, it also inhibits a crucial multidisciplinary collaborative provision of support to children at risk and their families. The identification of children at risk seems to be based on an unexamined selection...

  6. Day Care Centers for Seniors in Singapore: Looking Back and Looking Ahead.

    Science.gov (United States)

    Liu, Germaine; Yap, Philip; Wong, Gabriel H Z; Wei, Heng Xiao; Hua, Ee Chye

    2015-07-01

    The burden of care for frail elderly persons on families and the society is ever real as our population ages. Given the dual-income nature of many working families, day care centers offer a strong alternative to nursing homes for families wishing to provide custodial care and meaningful engagement for seniors while continuing to uphold their filial duties. Recognizing this, several initiatives, such as SPICE (Singapore Programme for Integrated Care for the Elderly) and Weekend Respite Care, have been launched to enhance the services of Singapore's day care centers. This article traces the evolution of this process, distills current challenges, and offers policy recommendations to improve Singapore's day care services for seniors. Copyright © 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  7. Traditional birth attendants issue: a menace in developing countries.

    Science.gov (United States)

    Buowari, O Y

    2012-01-01

    A significant proportion of births in Nigeria still occur at homes of traditional birth attendant. Traditional birth attendants are popular in developing and low resource countries. They lack no formal education or medical training and their clients end up with obstetric complications which lead to severe morbidity and mortality. Two cases of pregnant women that engaged the services of traditional birth attendants (TBA) before presenting at a health facility are presented. They ended up with severe morbidity and mortalities. A 29 year old gravida 3 + para 2+0 woman with two previous caesarean section(C/S) was counselled for elective c/s but declined. She presented at the home of a TBA, had spontaneous vagina deliver, collapsed one hour after delivery and was dead by the time she was brought to the hospital. A 30 year old gravida 10 para 7 + 3 presented in hospital after being in labour at the home of a TBA for three days. On presentation in hospital there was absent foetal heart sound. At surgery there was ruptured uterus and subtotal hysterectomy was done. To improve the situation better access to optimal antenatal care and intrapartum care together with early referral of high-risk patients must be facilitated. Increased community awareness, promotion of appropriate technology for effective health care planning strategy from the grassroots level to tertiary centres is important in the reduction of obstructed labour. One of the most effective means of reducing maternal mortality is the provision of caesarean section for all women who need it.

  8. Early Retirement in the Day-Care Sector

    DEFF Research Database (Denmark)

    Gørtz, Mette

    2012-01-01

    the child-to-teacher ratio or the size of the institution and early retirement (ERP). However, working conditions measured by the social background of the children and the share of trained day-care teachers have a significant effect on the probability of early retirement. Finally, a poor health condition......This paper studies the role of working conditions and health for elderly female day-care teachers’ decision to enter early retirement. Entry into retirement is analysed in a duration framework that allows for unobserved heterogeneity in the baseline hazard. Data are from a Danish longitudinal data...... set based on administrative register records for 1997-2006. Working conditions is measured by four indicators. First, work pressure is measured by the child-to-teacher ratio, which varies across municipalities and over time. Second, working conditions is measured by the proportion of children...

  9. Neonatal care in the home in northern rural Honduras: a qualitative study of the role of traditional birth attendants.

    Science.gov (United States)

    Sacks, Emma; Bailey, Joanne Motiño; Robles, Chayla; Low, Lisa Kane

    2013-01-01

    Traditional birth attendants (TBAs) have limited ability to reduce maternal mortality, but may be able to have a significant impact on neonatal survival. This qualitative study explores TBAs' (possessive) experience with neonatal care in a rural Honduran community. In 6 semistructured focus groups, TBAs described services they routinely provide to newborns. Using Atlas.ti, Version 6.0. (ATLAS.ti Scientific Software Development GmbH, University of Berlin), transcripts were coded by bilingual researchers and analyzed by thematic content. TBAs demonstrated limited knowledge of newborn physiology, yet were aware of many internationally recommended practices. Despite attempts to follow recommendations, all TBAs expressed difficulty due to resource constraints. TBAs were strong advocates of immediate breast-feeding and skin-to-skin care, but they did not demonstrate knowledge regarding delayed bathing and thermal care. Most TBAs stated that a sick neonate could be identified immediately at birth; thus, infections or other illnesses developed in later days may be missed. TBAs did not believe they could have averted neonatal complications or deaths that had occurred under their care. For most healthy newborns, TBAs are the primary providers until the 2-month vaccine visit at the healthcare clinic. Improved TBA training focused on infection symptomotology, physiology, and thermoregulation for newborns may increase opportunities for improved health and timely referrals to healthcare facilities.

  10. Uptake of skilled attendance along the continuum of care in rural Western Kenya: selected analysis from Global Health initiative survey-2012.

    Science.gov (United States)

    Mwangi, Winfred; Gachuno, Onesmus; Desai, Meghna; Obor, David; Were, Vincent; Odhiambo, Frank; Nyaguara, Amek; Laserson, Kayla F

    2018-05-16

    Examining skilled attendance throughout pregnancy, delivery and immediate postnatal period is proxy indicator on the progress towards reduction of maternal and neonatal mortality in developing countries. We conducted a cross-sectional baseline survey of households of mothers with at least 1 child under-5 years in 2012 within the KEMRI/CDC health and demographic surveillance system (HDSS) area in rural western Kenya. Out of 8260 mother-child pairs, data on antenatal care (ANC) in the most recent pregnancy was obtained for 89% (n = 8260); 97% (n = 7387) reported attendance. Data on number of ANC visits was available for 89% (n = 7140); 52% (n = 6335) of mothers reported ≥4 ANC visits. Data on gestation month at first ANC was available for 94% (n = 7140) of mothers; 14% (n = 6690) reported first visit was in1 st trimester (0-12 weeks), 73% in 2nd trimester (14-28 weeks) and remaining 13% in third trimester. Forty nine percent (n = 8259) of mothers delivered in a Health Facility (HF), 48% at home and 3% en route to HF. Forty percent (n = 7140) and 63% (n = 4028) of mothers reporting ANC attendance and HF delivery respectively also reported receiving postnatal care (PNC). About 36% (n = 8259) of mothers reported newborn assessment (NBA). Sixty eight percent (n = 3966) of mothers that delivered at home reported taking newborn for HF check-up, with only 5% (n = 2693) doing so within 48 h of delivery. Being ≤34 years (OR 1.8; 95% CI 1.4-2.4) and at least primary education (OR 5.3; 95% CI 1.8-15.3) were significantly associated with ANC attendance. Being ≤34 years (OR 1.7; 95% CI 1.5-2.0), post-secondary vs primary education (OR 10; 95% CI 4.4-23.4), ANC attendance (OR 4.5; 95% CI 3.2-6.1), completing ≥4 ANC visits (OR 2.0; 95% CI 1.8-2.2), were strongly associated with HF delivery. The continuum of care was such that 97% (n = 7387) mothers reported ANC attendance, 49% reported both ANC and HF delivery

  11. Ventilation in day-care centres and sick leave among nursery children

    DEFF Research Database (Denmark)

    Kolarik, Barbara; Andersen, Zorana Jovanovic; Ibfelt, Tobias

    2016-01-01

    ventilation in DCCs and sick leave among nursery children. Data on child sick leave within an 11 week period was obtained for 635 children attending 20 DCCs. Ventilation measurements included three proxies of ventilation: air exchange rate (ACR) measured with the decay method, ACR measured...... inverse relationship between the number of sick days and ACR measured with the decay method was found for crude and adjusted analysis, with a 12% decrease in number of sick days per 1 h(-1) increase in ACR measured with the decay method. This study suggests a relationship between sick leave among nursery...

  12. Social behavior correlates of cortisol activity in child care: gender differences and time-of-day effects.

    Science.gov (United States)

    Tout, K; de Haan, M; Campbell, E K; Gunnar, M R

    1998-10-01

    The relations between social behavior and daily patterns of a stress-sensitive hormone production were examined in preschool children (N = 75) attending center-based child care. Three behavioral dimensions, shy/anxious/internalizing, angry/aggressive/externalizing, and social competence, were assessed by teacher report and classroom observation, and their relations with 2 measures of cortisol activity, median (or typical) levels and reactivity (quartile range score between second and third quartile values) were explored. Cortisol-behavior relations differed by gender: significant associations were found for boys but not for girls. Specifically, for boys externalizing behavior was positively associated with cortisol reactivity, while internalizing behavior was negatively associated with median cortisol. Time of day of cortisol measurement affected the results. Surprisingly, median cortisol levels rose from morning to afternoon, a pattern opposite to that of the typical circadian rhythm of cortisol. This rise in cortisol over the day was positively correlated with internalizing behavior for boys. The methodological and theoretical implications of these findings for the study of the development of hormone-behavior relations are discussed.

  13. An outbreak of gastroenteritis associated with astrovirus serotype 1 in a day care center, in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    AMV Silva

    2001-11-01

    Full Text Available Between June 4th and June 20th1996 rotavirus, adenovirus, and astrovirus (HAstrV were investigated in fecal samples from 27 children under three years old with acute diarrhea, attending the Bertha Lutz day care center, in Rio de Janeiro. All fecal samples were analyzed by polyacrylamide gel electrophoresis (PAGE, reverse transcriptase polymerase chain reaction (RT-PCR, enzyme immunoassays (EIA, and electron microscopy (EM. Nine of them (33% showed positive results for HAstrV by at least one of the employed methodologies. Eight were positive by RT-PCR and EIA, and six by EM. All positive samples were inoculated onto HT-29 (human colon adenocarcinoma cultured cells for HAstrV isolation and seven were positive after three passages. The sequencing analysis of eight RT-PCR products (449 bp from gene that codifies VP2 protein, showed a total nucleotide identity among them and 98% with HAstrV-1 (strain Oxford type 1. This is the first report of a gastroenteritis outbreak associated with HAstrv-1 in a day care center in Rio de Janeiro and it reinforces the importance of this virus in association with infantile acute gastroenteritis.

  14. Meaning in family caregiving for people with dementia: a narrative study about relationships, values, and motivation, and how day care influences these factors

    Directory of Open Access Journals (Sweden)

    Tretteteig S

    2017-12-01

    Full Text Available Signe Tretteteig,1,2 Solfrid Vatne,3 Anne Marie Mork Rokstad1,3 1Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; 2Faculty of Medicine, University of Oslo; Oslo, Norway; 3Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway Background: In addition to care-related burdens, most caregivers of a person with dementia perceive a variety of positive and satisfying experiences, such as feeling needed and useful in their family caregiving role. “Meaning-focused coping” describes both positive and negative emotions in periods with high levels of stress. Day care service may have the potential to increase caregivers’ positive experiences and meaning-focused coping, and positively influence interpersonal relationships between those giving care and those receiving care. The aim of this study was to gain knowledge about family caregivers’ experiences of meaning in their caring role. Additionally, the influence of day care services on caregivers’ experiences and motivation in their caregiving role is explored. Methods: A qualitative design based on individual interviews was used. The interviews were analyzed using a narrative method and a case study approach. Findings: Family caregivers’ roles and coping strategies were related to their relational ties. Caregivers had to make decisions about whether to enhance, maintain, or let go of emotional ties to find a good balance between meeting their own needs and the needs of the person with dementia. Family caregivers reported that day care positively influenced their “relationship-oriented coping” and experience of meaning. Conclusion: Finding meaning in the role of a family caregiver for persons with dementia is closely connected to the caregivers’ own values and goals. Finding a balance between attending to their own needs and the needs of the person with dementia is crucial. Day care has the potential to increase

  15. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2013-07-26

    ...This notice announces the annual adjustments to the national average payment rates for meals and snacks served in child care centers, outside-school-hours care centers, at-risk afterschool care centers, and adult day care centers; the food service payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates for sponsoring organizations of day care homes, to reflect changes in the Consumer Price Index. Further adjustments are made to these rates to reflect the higher costs of providing meals in the States of Alaska and Hawaii. The adjustments contained in this notice are made on an annual basis each July, as required by the laws and regulations governing the Child and Adult Care Food Program.

  16. Exploring Parental Preferences: Care or Education: What Do Greek Parents Aspire from Day Care Centres?

    Science.gov (United States)

    Rentzou, Konstantina

    2013-01-01

    Early childhood education and care is a multifaceted institution. Based on children's age, a number of different settings operate, which have usually two distinct aims. Kindergartens provide mainly education whereas day care centres provide care. Yet, in recent years, the need to establish programmes which provide both education and care to…

  17. The effect of an occupational therapy mental health day treatment centre on the use of inpatient services in the Western Cape, South Africa.

    Science.gov (United States)

    Engelbrecht, Riekie; Plastow, Nicola; Botha, Ulla; Niehaus, Djh; Koen, Liezl

    2018-04-27

    The aim of this study was to determine whether attendance at an occupational therapy-led day treatment centre for mental health care users affects the use of inpatient services in South Africa. A retrospective pre-test/post-test quasi-experimental study design was used to compare admissions and days spent in hospital during the 24 months before and after attendance at the centre, using the hospital's electronic records. Total population sampling yielded data for 44 mental health care users who made first contact with the service between July 2009 and June 2010. Data were compared using the Kruskal-Wallis test, Wilcoxon Signed Ranks test and Mann-Whitney U test. There was a significant decrease in the number of admissions (z = -4.093, p = 0.00) and the number of days spent in hospital (z = -4.730, p = 0.00). Participants were admitted to psychiatric care 33 times less in the 24 months' post-intervention, indicating a medium effect (r = 0.436). They also spend 2569 days less in hospital, indicating a large effect (r = 0.504). The findings suggest that an occupational therapy-led day treatment centre could be effective in reducing the use of inpatient mental health services in South Africa. Implications for Rehabilitation Attendance at an occupational therapy-led community day treatment centre decreases the number of admissions and number of days spent in hospital and is therefore beneficial to mental health care users and service providers. The study indicates that the successful implementation of a community day treatment centre for mental health care users on the grounds of a tertiary hospital by utilising existing resources is possible.

  18. Dental attendance, perceptions of cost and self-care of school year 12 and 13 students: A focus on Southland, New Zealand.

    Science.gov (United States)

    Murray, Colleen; Densie, Ian Kenneth; Morgan, Christian

    2015-12-01

    Adolescents and emerging adults can provide dentists with many challenges. Little information is available on their perceptions of dental costs once they turn 18 and dentistry is no longer State-funded. The aim of this study was to explore the use of dental care by Southland students in years 12 and 13, their perceptions of the cost of four common dental procedures, self-related oral health and dental self-care habits, time off school related to dental problems, and knowledge and views regarding fluoride. After ethical approval, a 26-question survey was conducted of all Southland students in years 12 and 13. Data were statistically analysed in SPSS version 20 with the alpha value set at 0.05. The participation rate was 49.6%. Regular attendance for examinations was reported by 77.5% with non-attendance mainly related to attitudes around lack of importance or necessity. Reported dental attendance varied according to gender, ethnicity and decile rating of school attended. Although some were accurate in their estimations of dental costs, the standard deviation for all procedures was large. The majority thought that costs put people off going to the dentist. While 74.8% brushed their teeth at least twice daily, only 26.6% flossed regularly. Knowledge regarding fluoride was lacking. It may be advantageous to include education regarding costs of dental care with patients of this age. This may motivate them to improve their self-care and ensure that their oral health is of a high standard before their dental needs are no longer State-funded.

  19. Family environment, coping, and mental health in adolescents attending therapeutic day schools.

    Science.gov (United States)

    Rodriguez, Erin M; Donenberg, Geri R; Emerson, Erin; Wilson, Helen W; Brown, Larry K; Houck, Christopher

    2014-10-01

    This study examined associations among family environment, coping, and emotional and conduct problems in adolescents attending therapeutic day schools due to mental health problems. Adolescents (N = 417; 30.2% female) ages 13-20 (M = 15.25) reported on their family environment (affective involvement and functioning), coping (emotion-focused support-seeking, cognitive restructuring, avoidant actions), and emotional and conduct problems. Poorer family environment was associated with less emotion-focused support-seeking and cognitive restructuring, and more emotional and conduct problems. Emotional problems were negatively associated with cognitive restructuring, and conduct problems were negatively associated with all coping strategies. Cognitive restructuring accounted for the relationship between family environment and emotional problems. Cognitive restructuring and emotion-focused support-seeking each partially accounted for the relationship between family functioning and conduct problems, but not the relationship between family affective involvement and conduct problems. Findings implicate the role of coping in the relationship between family environment and adolescent mental health. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  20. Skilled attendance at delivery; how skilled are institutional birth attendants? : An explorative study on birth attendants at Bansang Hospital, The Gambia

    OpenAIRE

    Kreyberg, Ina; Helsingen, Lise Mørkved

    2010-01-01

    Abstract Background: As reflected in the United Nations Millennium Development Goals (UN MDG 5), reducing maternal mortality represents an important area of concern. The common causes of maternal deaths may be preventable and treatable by having access to emergency obstetric care (EmOC), including skilled birth attendance (SBA), when needed. Measuring the presence of a birth attendant has been the main focus until now, not their skills and qualifications, and by this we cannot presuppose ...

  1. Green Care Farms

    Directory of Open Access Journals (Sweden)

    Simone R. de Bruin PhD

    2015-10-01

    Full Text Available Objective: To explore the value of day services at green care farms (GCFs in terms of social participation for people with dementia. Method: Semi-structured interviews were conducted with people with dementia who attended day services at a GCF (GCF group, n = 21, were on a waiting list (WL for day services at a GCF (WL group, n = 12, or attended day services in a regular day care facility (RDCF group, n = 17 and with their family caregivers. Results: People with dementia in the GCF and WL group were primarily males, with an average age of 71 and 76 years, respectively, who almost all had a spousal caregiver. People with dementia in the RDCF group were mostly females with an average age of 85 years, most of whom had a non-spousal caregiver. For both the GCF and RDCF groups, it was indicated that day services made people with dementia feel part of society. The most important domains of social participation addressed by RDCFs were social interactions and recreational activities. GCFs additionally addressed the domains “paid employment” and “volunteer work.” Conclusion: GCFs are valuable in terms of social participation for a particular group of people with dementia. Matching characteristics of adult day services (ADS centers to the preferences and capacities of people with dementia is of importance. Diversity in ADS centers is therefore desirable.

  2. Foot care knowledge and practices and the prevalence of peripheral neuropathy among people with diabetes attending a secondary care rural hospital in southern India

    OpenAIRE

    Hanu George; P S Rakesh; Manjunath Krishna; Reginald Alex; Vinod Joseph Abraham; Kuryan George; Jasmin H Prasad

    2013-01-01

    Background: Diabetes mellitus is a multifaceted disease and foot ulceration is one of its most common complications. Poor foot care knowledge and practices are important risk factors for foot problems among people with diabetes. Aims: To assess the knowledge and practices regarding foot care and to estimate the proportion of people with peripheral neuropathy among people with diabetes. Settings and Design: The cross-sectional study was conducted in 212 consecutive diabetes patients attending ...

  3. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-20

    ... adjustments to the national average payment rates for meals and snacks served in child care centers, outside... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates for sponsoring organizations of day care homes, to reflect changes in the Consumer Price Index...

  4. Factors associated with non-attendance in a general practice super clinic population in regional Australia: A retrospective cohort study.

    Science.gov (United States)

    Nancarrow, Susan; Bradbury, Joanne; Avila, Catherine

    2014-01-01

    Non-attendance at medical appointments is associated with increased patient morbidity and is a significant drain on health service resources. Australian studies have focused on secondary healthcare settings, screening, and interventions to reduce non-attendance. To explore factors associated with non-attendance in a regional primary care setting. A retrospective cohort of all patients with a scheduled appointment between October 2011 and October 2013 at a regional, primary care clinic providing medical and allied health services in a region of New South Wales (NSW) serving a large Aboriginal population (10.7 per cent). Using multivariate logistic regression, non-attendance was regressed on a range of covariates, including number of appointments per person, gender and ethnicity, and day of the week. The overall proportion of missed appointments was 7.6 per cent. Risk factors for non-attendance were day of the week [Mondays (8.1 per cent), Fridays (8.0 per cent), and Thursdays (7.9 per cent), (χ2(4)= 20.208, pattend (FTA) (95% CI: 11-28%)]; Aboriginality (OR=4.022, 95% CI: 3.263, 4.956), and female gender (OR=1.077; 95% CI 1.024, 1.132). There was a trend toward an interaction between gender and Aboriginality, with Aboriginal females being the group most likely to miss appointments (OR=1.272, 95% CI: 0.949, 1.705). This is the largest study of non-attendance in an Australian primary healthcare setting. While not a typical setting, the study had the advantage of a large, mixed population. The suggested high rates of non-attendance by Aboriginal females have potentially important policy implications.

  5. The Rise in Cortisol in Family Day Care: Associations with Aspects of Care Quality, Child Behavior, and Child Sex

    Science.gov (United States)

    Gunnar, Megan R.; Kryzer, Erin; Van Ryzin, Mark J.; Phillips, Deborah A.

    2010-01-01

    This study examined the increase in salivary cortisol from midmorning to midafternoon in 151 children (3.0-4.5 years) in full-time home-based day care. Compared to cortisol levels at home, increases were noted in the majority of children (63%) at day care, with 40% classified as a stress response. Observations at day care revealed that intrusive,…

  6. Factors affecting attendance at and timing of formal antenatal care: results from a qualitative study in Madang, Papua New Guinea.

    Directory of Open Access Journals (Sweden)

    Erin V W Andrew

    Full Text Available BACKGROUND: Appropriate antenatal care (ANC is key for the health of mother and child. However, in Papua New Guinea (PNG, only a third of women receive any ANC during pregnancy. Drawing on qualitative research, this paper explores the influences on ANC attendance and timing of first visit in the Madang region of Papua New Guinea. METHODS: Data were collected in three sites utilizing several qualitative methods: free-listing and sorting of terms and definitions, focus group discussions, in-depth interviews, observation in health care facilities and case studies of pregnant women. Respondents included pregnant women, their relatives, biomedical and traditional health providers, opinion leaders and community members. RESULTS: Although generally reported to be important, respondents' understanding of the procedures involved in ANC was limited. Factors influencing attendance fell into three main categories: accessibility, attitudes to ANC, and interpersonal issues. Although women saw accessibility (distance and cost as a barrier, those who lived close to health facilities and could easily afford ANC also demonstrated poor attendance. Attitudes were shaped by previous experiences of ANC, such as waiting times, quality of care, and perceptions of preventative care and medical interventions during pregnancy. Interpersonal factors included relationships with healthcare providers, pregnancy disclosure, and family conflict. A desire to avoid repeat clinic visits, ideas about the strength of the fetus and parity were particularly relevant to the timing of first ANC visit. CONCLUSIONS: This long-term in-depth study (the first of its kind in Madang, PNG shows how socio-cultural and economic factors influence ANC attendance. These factors must be addressed to encourage timely ANC visits: interventions could focus on ANC delivery in health facilities, for example, by addressing healthcare staff's attitudes towards pregnant women.

  7. The pattern of mucocutaneous disorders in HIV – infected children attending care and treatment centres in Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Massawe Augustine W

    2009-07-01

    Full Text Available Abstract Background HIV/AIDS is associated with a wide range of mucocutaneous disorders some of which are useful in the clinical staging and prognosis of the syndrome. There is paucity of information regarding the prevalence and pattern of mucocutaneous disorders among HIV infected children attending paediatric Care and Treatment Centres (CTC in Dar es Salaam. Objective To determine the prevalence and pattern of mucocutaneous disorders among HIV infected children attending public paediatric 'Care and Treatment Centres' in Dar es Salaam. Methods This was a cross sectional descriptive study involving public paediatric 'Care and Treatment Centres' in Dar es Salaam. Clinical information was obtained using a questionnaire. Dermatological examination was carried out in daylight. Investigations were taken as appropriate. Data was analysed using the Statistical Package for Social Sciences (SPSS program version 10.0. Chi-squared and Fisher's exact tests were utilized. A p-value of less than 0.05 was considered statistically significant. Results Three hundred and forty seven HIV infected children (52% males attending CTCs were recruited into the study. Mucocutaneous disorders were encountered in 85% of them. There was no gender difference in the prevalence of the infective mucocutaneous disorders but males had a higher prevalence of non-infective/inflammatory dermatoses (58% than females (42% (p = 0.02. Overall, mucocutaneous disorders (infective + non infective were more prevalent in advanced stages of HIV disease. Children with advanced HIV disease had a significantly increased frequency of fungal and viral infections (43% and 25% respectively than those with less advanced disease; 24% and 13% respectively (p = 0.01. Seventy four percent of the HIV-infected children with mucocutaneous disorders were already on ART. Conclusion Mucocutaneous disorders among HIV infected children attending Care and Treatment Centres are common and highly variable

  8. From home deliveries to health care facilities: establishing a traditional birth attendant referral program in Kenya.

    Science.gov (United States)

    Tomedi, Angelo; Stroud, Sophia R; Maya, Tania Ruiz; Plaman, Christopher R; Mwanthi, Mutuku A

    2015-07-16

    To assess the effectiveness of a traditional birth attendant (TBA) referral program on increasing the number of deliveries overseen by skilled birth attendants (SBA) in rural Kenyan health facilities before and after the implementation of a free maternity care policy. In a rural region of Kenya, TBAs were recruited to educate pregnant women about the importance of delivering in healthcare facilities and were offered a stipend for every pregnant woman whom they brought to the healthcare facility. We evaluated the percentage of prenatal care (PNC) patients who delivered at the intervention site compared with the percentage of PNC patients who delivered at rural control facilities, before and after the referral program was implemented, and before and after the Kenya government implemented a policy of free maternity care. The window period of the study was from July of 2011 through September 2013, with a TBA referral intervention conducted from March to September 2013. The absolute increases from the pre-intervention period to the TBA referral intervention period in SBA deliveries were 5.7 and 24.0% in the control and intervention groups, respectively (p facility significantly increased compared to control health facilities when TBAs educated women about the need to deliver with a SBA and when TBAs received a stipend for bringing women to local health facilities to deliver. Furthermore, this TBA referral program proved to be far more effective in the target region of Kenya than a policy change to provide free obstetric care.

  9. Attendance at prenatal care and adverse birth outcomes in China: A follow-up study based on Maternal and Newborn's Health Monitoring System.

    Science.gov (United States)

    Huang, Aiqun; Wu, Keye; Zhao, Wei; Hu, Huanqing; Yang, Qi; Chen, Dafang

    2018-02-01

    to evaluate the independent association between attendance at prenatal care and adverse birth outcomes in China, measured either as the occurrence of preterm birth or low birth weight. a follow-up study. the data was collected from maternal and newborn's health monitoring system at 6 provinces in China. all pregnant women registered in the system at their first prenatal care visit. We included 40152 registered pregnant women who had delivered between October 2013 and September 2014. attendance at prenatal care was evaluated using Kessner index. χ 2 tests were used to examine the correlations between demographic characteristics and preterm birth or low birth weight. The associations between attendance at prenatal care and birth outcomes were explored using multilevel mixed-effects logistic regression models. the prevalence for preterm birth and low birth weight was 3.31% and 2.55%. The null models showed region clustering on birth outcomes. Compared with women who received adequate prenatal care, those with intermediate prenatal care (adjusted OR 1.62, 95%CI 1.37-1.92) or inadequate prenatal care (adjusted OR 2.78, 95%CI 2.24-3.44) had significantly increased risks for preterm birth, and women with intermediate prenatal care (adjusted OR 1.31, 95%CI 1.10-1.55) or inadequate prenatal care (adjusted OR 1.70, 95%CI 1.32-2.19) had significantly increased risks for low birth weight. We found very significant dose-response patterns for both preterm birth (p-trendprenatal care in China has independent effects on both preterm birth and low birth weight. Appropriate timing and number of prenatal care visits can help to reduce the occurrence of preterm birth or low birth weight. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Psychiatric status, somatisation, and health care utilization of frequent attenders at the emergency department: a comparison with routine attenders.

    Science.gov (United States)

    Williams, E R; Guthrie, E; Mackway-Jones, K; James, M; Tomenson, B; Eastham, J; McNally, D

    2001-03-01

    Seventy-seven frequent attenders at an emergency department (ED) in an inner-city hospital in the UK (defined as seven or more visits in the previous 12 months) were compared with 182 patients who were attending the same department on a routine basis. Patients completed the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and the Short Form (SF)-36. Information was obtained on 64% of the frequent attenders and 45% underwent a detailed psychiatric assessment. Of the frequent attenders, 45% had psychiatric disorder and 49% had some form of an alcohol-related disorder. Compared with routine attenders, frequent attenders reported lower health status, had more psychiatric disorder (odds ratio: OR=8.2, 95% confidence interval: CI=3.8--18.1), had more general hospital admissions (OR=19.9, 95% CI=8.3--47.8), more psychiatric admissions (OR=167.5, 95% CI=9.5--2959.0), and more GP visits (95% CI for difference=-10.2 to -5.7). There was no evidence that frequent attenders had more somatisation than routine attenders. Specific treatment and management strategies need to be developed for this group of patients, although a substantial proportion may be difficult to engage in the treatment process.

  11. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-26

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012 Correction In notice document 2011-18257 appearin...

  12. [Factors determining irregular attendance to follow-up visits among human immunodeficiency virus patients: results of the hospital survey of patients infected with human immunodeficiency virus].

    Science.gov (United States)

    Diaz, Asuncion; Ten, Alicia; Marcos, Henar; Gutiérrez, Gonzalo; González-García, Juan; Moreno, Santiago; Barrios, Ana María; Arponen, Sari; Portillo, Álvaro; Serrano, Regino; García, Maria Teresa; Pérez, José Luis; Toledo, Javier; Royo, Maria Carmen; González, Gustavo; Izquierdo, Ana; Viloria, Luis Javier; López, Irene; Elizalde, Lázaro; Martínez, Eva; Castrillejo, Daniel; Aranguren, Rosa; Redondo, Caridad; Diez, Mercedes

    2015-05-01

    To describe the occurrence of non-regular attendance to follow-up visits among HIV patients and to analyze the determining factors. One-day survey carried out annually (2002-2012) in public hospitals. Epidemiological, clinical and behavioral data are collected in all HIV-infected inpatients and outpatients receiving HIV-related care on the day of the survey. "Non-regular attendance to a follow-up visit" was defined as sporadic attendance to the medical appointments, according to the judgment of the attending physician. Descriptive and bivariate analyses were performed, and factors associated to non-regular attendance to follow-up visits were estimated using logistic regression. A total of 7,304 subjects were included, of whom 13.7% did not attend medical appointments regularly. Factors directly associated with non-regular attendance were: age between 25-49 years; birth in Sub-Saharan Africa or Latin-America; low educational level; being homeless or in prison; living alone or in closed institutions; being unemployed or retired; being an intravenous drug user; not using a condom at last sexual encounter, and injecting drugs in the last 30 days. Conversely, HIV diagnosis within the last year and being men who have sex with men were factors inversely associated with non-regular attendance to follow-up visits. In spite of health care beings free of charge for everyone in Spain, social factors can act as barriers to regular attendance to medical appointments, which, in turn, can endanger treatment effectiveness in some population groups. This should be taken into account when planning HIV policies in Spain. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  13. A Study in Child Care (Case Study from Volume II-A): "A Rolls-Royce of Day Care." Day Care Programs Reprint Series.

    Science.gov (United States)

    O'Farrell, Brigid

    The Amalgamated Day Care Center is an independent trust established through a collective bargaining agreement between the Amalgamated Clothing Workers of America, AFL-CIO, and the employers of the garment industry. The free center, open from 6:00 a.m. to 6:00 p.m., is located near the Chicago garment industries to minimize transportation problems…

  14. Small children´s movements across residential care and day-care

    DEFF Research Database (Denmark)

    Schwartz, Ida

    2018-01-01

    is then seen as closely connected with the ways in which their caregivers coordinate and involve one another across different locations. Viewed from the children's perspectives, their parental support also plays a major role, but due to the conflicts in inter-professional cooperation, parents may find...... in very different ways. Parents, child-welfare workers in residential care and day-care teachers in kindergartens may assess problems in children's everyday lives differently. These different perspectives on the common work of childcare are analysed and the challenges and conflicts inherently hidden...

  15. Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria.

    Science.gov (United States)

    Ebuehi, Olufunke M; Akintujoye, Ia

    2012-01-01

    In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women's perceptions and utilization of traditional birth attendant (TBA) services in a rural Local Government Area (LGA) in Ogun State, southwest Nigeria. A quantitative design was used to obtain information using a structured questionnaire from 250 pregnant women attending four randomly selected primary health care clinics in the LGA. Data were analyzed using Epi Info (v 3.5.1) statistical software. Almost half (48.8%) of the respondents were in the age group 26-35 years, with a mean age of 29.4 ± 7.33 years. About two-thirds (65.6%) of the respondents had been pregnant 2-4 times before. TBA functions, as identified by respondents, were: "taking normal delivery" (56.7%), "providing antenatal services" (16.5%), "performing caesarean section" (13.0%), "providing family planning services" (8.2%), and "performing gynaecological surgeries" (5.6%). About 6/10 (61.0%) respondents believed that TBAs have adequate knowledge and skills to care for them, however, approximately 7/10 (69.7%) respondents acknowledged that complications could arise from TBA care. Services obtained from TBAs were: routine antenatal care (81.1%), normal delivery (36.1%), "special maternal bath to ward off evil spirits" (1.9%), "concoctions for mothers to drink to make baby strong" (15.1%), and family planning services (1.9%). Reasons for using TBA services were: "TBA services are cheaper" (50.9%), "TBA services are more culturally acceptable in my environment" (34.0%), "TBA services are closer to my house than hospital services" (13.2%), "TBAs provide more compassionate care than orthodox health workers" (43.4%), and "TBA service is the only maternity service that I know" (1.9%). Approximately 8/10 (79.2%) of the users (past

  16. Togetherness--A Manifestation of Day Care Life.

    Science.gov (United States)

    Hannikainen, Maritta

    1999-01-01

    This study used observations of quality of 5-year olds' lives in Danish, Finnish, and Swedish day-care centers to examine impact of adults on development of togetherness. Findings suggest that togetherness has to do with positive emotional relations. Article hypothesizes that togetherness may contribute to building of a real community of learners…

  17. CTEPP NC DATA COLLECTED ON FORM 05: CHILD DAY CARE CENTER PRE-MONITORING QUESTIONNAIRE

    Science.gov (United States)

    This data set contains data concerning the potential sources of pollutants at the day care center including the chemicals that have been applied in the past at the day care center by staff members or by commercial contractors. The day care teacher was asked questions related to t...

  18. CTEPP-OH DATA COLLECTED ON FORM 05: CHILD DAY CARE CENTER PRE-MONITORING QUESTIONNAIRE

    Science.gov (United States)

    This data set contains data for CTEPP-OH concerning the potential sources of pollutants at the day care center including the chemicals that have been applied in the past at the day care center by staff members or by commercial contractors. The day care teacher was asked questions...

  19. Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis

    Science.gov (United States)

    Munabi-Babigumira, Susan; Glenton, Claire; Lewin, Simon; Fretheim, Atle; Nabudere, Harriet

    2017-01-01

    Background In many low- and middle-income countries women are encouraged to give birth in clinics and hospitals so that they can receive care from skilled birth attendants. A skilled birth attendant (SBA) is a health worker such as a midwife, doctor, or nurse who is trained to manage normal pregnancy and childbirth. (S)he is also trained to identify, manage, and refer any health problems that arise for mother and baby. The skills, attitudes and behaviour of SBAs, and the extent to which they work in an enabling working environment, impact on the quality of care provided. If any of these factors are missing, mothers and babies are likely to receive suboptimal care. Objectives To explore the views, experiences, and behaviours of skilled birth attendants and those who support them; to identify factors that influence the delivery of intrapartum and postnatal care in low- and middle-income countries; and to explore the extent to which these factors were reflected in intervention studies. Search methods Our search strategies specified key and free text terms related to the perinatal period, and the health provider, and included methodological filters for qualitative evidence syntheses and for low- and middle-income countries. We searched MEDLINE, OvidSP (searched 21 November 2016), Embase, OvidSP (searched 28 November 2016), PsycINFO, OvidSP (searched 30 November 2016), POPLINE, K4Health (searched 30 November 2016), CINAHL, EBSCOhost (searched 30 November 2016), ProQuest Dissertations and Theses (searched 15 August 2013), Web of Science (searched 1 December 2016), World Health Organization Reproductive Health Library (searched 16 August 2013), and World Health Organization Global Health Library for WHO databases (searched 1 December 2016). Selection criteria We included qualitative studies that focused on the views, experiences, and behaviours of SBAs and those who work with them as part of the team. We included studies from all levels of health care in low- and middle

  20. Establishment and assessment of cataract surgery in Day-care Unit at northwest of China

    Directory of Open Access Journals (Sweden)

    Xiu-Li Zhang

    2018-04-01

    Full Text Available AIM: To describe the protocol and economic cost of the Day-care Unit cataract surgery procedure in northwest of China.METHODS: Patients who received phacoemulcification and intraocular lens implantation in both Day-care Unit and regular Unit were recruited from January 2016 to December 2016. The baseline data and average cost were recorded and analyzed. Furthermore, satisfaction questionnaire of patients were collected.RESULTS: Patients with Day-care Unit showed shorter registration duration, less cost including housing and nursing charge as well as higher rate of patient satisfaction. Meanwhile, Day-care Unit shorten the time the doctors and nurses spending on filling the medical charts.CONCLUSION:Day-care Unit cataract surgery procedure could benefit both patients and medical staffs and is worthy to generalize.

  1. Day-care versus inpatient pediatric surgery: a comparison of costs incurred by parents.

    OpenAIRE

    Stanwick, R S; Horne, J M; Peabody, D M; Postuma, R

    1987-01-01

    The cost-effectiveness for parents of day-care pediatric surgery was assessed by comparing time and financial costs associated with two surgical procedures, one (squint repair) performed exclusively as a day-care procedure, the other (adenoidectomy) performed exclusively as an inpatient procedure. All but 1 of 165 eligible families participated. The children underwent surgery between February and July 1981. The day-care surgery group (59 families) incurred average total time costs of 16.1 hou...

  2. Perceived benefits and barriers and self-efficacy affecting the attendance of health education programs among uninsured primary care patients.

    Science.gov (United States)

    Kamimura, Akiko; Nourian, Maziar M; Jess, Allison; Chernenko, Alla; Assasnik, Nushean; Ashby, Jeanie

    2016-12-01

    Lifestyle interventions have shown to be effective in improving health status, health behaviors, and self-efficacy. However, recruiting participants to health education programs and ensuring the continuity of health education for underserved populations is often challenging. The goals of this study are: to describe the attendance of health education programs; to identify stages of change to a healthy lifestyle; to determine cues to action; and to specify factors affecting perceived benefits and barriers to healthy food choices and physical activity among uninsured primary care patients. Uninsured primary care patients utilizing a free clinic (N=621) completed a self-administered survey from September to December of 2015. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of cues to action in attending health education programs. While self-efficacy increases perceived benefits and decreases perceived barriers for physical activity, it increases both perceived benefits and perceived barriers for healthy food choices. The participants who had attended health education programs did not believe that there were benefits for healthy food choices and physical activity. This study adds to the body of literature on health education for underserved populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. A qualitative evaluation of the choice of traditional birth attendants for maternity care in 2008 Sierra Leone: implications for universal skilled attendance at delivery.

    Science.gov (United States)

    Oyerinde, Koyejo; Harding, Yvonne; Amara, Philip; Garbrah-Aidoo, Nana; Kanu, Rugiatu; Oulare, Macoura; Shoo, Rumishael; Daoh, Kizito

    2013-07-01

    Maternal and newborn death is common in Sierra Leone; significant reductions in both maternal and newborn mortality require universal access to a skilled attendant during labor and delivery. When too few women use health facilities MDGs 4 and 5 targets will not be met. Our objectives were to identify why women use services provided by TBAs as compared to health facilities; and to suggest strategies to improve utilization of health facilities for maternity and newborn care services. Qualitative data from focus group discussions in communities adjacent to health facilities collected during the 2008 Emergency Obstetric and Newborn Care Needs Assessment were analyzed for themes relating to decision-making on the utilization of TBAs or health facilities. The prohibitive cost of services, and the geographic inaccessibility of health facilities discouraged women from using them while trust in the vast experience of TBAs as well as their compassionate care drew patients to them. Poor facility infrastructure, often absent staff, and the perception that facilities were poorly stocked and could not provide continuum of care services were barriers to facility utilization for maternity and newborn care. Improvements in infrastructure and the 24-hour provision of free, quality, comprehensive, and respectful care will minimize TBA preference in Sierra Leone.

  4. Gaps along the HIV care continuum: findings among a population seeking sexual health care services in New York City.

    Science.gov (United States)

    Pathela, Preeti; Jamison, Kelly; Braunstein, Sarah L; Schillinger, Julia A; Tymejczyk, Olga; Nash, Denis

    2018-03-02

    Linkage/re-linkage to HIV care for virally unsuppressed persons with new sexually transmitted infections is critical for ending the HIV epidemic. We quantified HIV care continuum gaps, and viral suppression, among HIV-positive patients attending New York City (NYC) sexual health clinics (SHC). 1,649 HIV-positive patients and a 10% sample of 11,954 patients with unknown HIV status on clinic visit date (DOV) were matched against the NYC HIV registry. Using registry diagnosis dates, we categorized matched HIV-positive patients as "new-positives" (newly diagnosed on DOV), "recent-positives (diagnosed ≤90 days before DOV), "prevalent-positives" (diagnosed >90 days before DOV), and "unknown-positives" (previously diagnosed, but status unknown to clinic on DOV). We assessed HIV care continuum outcomes before and after DOV for new-positives, prevalent-positives, and unknown-positives using registry laboratory data. In addition to 1,626 known HIV-positive patients, 5% of the unknown sample (63/1,196) matched to the registry, signifying that about 630 additional HIV-positive patients attended SHCs. Of new-positives, 65% were linked to care after DOV. Of prevalent-positives, 66% were in care on DOV; 43% of the out-of-care were re-linked after DOV. Of unknown-positives, 40% were in care on DOV; 21% of the out-of-care re-linked after DOV. Viral suppression was achieved by: 88% of in-care unknown-positives, 76% in-care prevalent-positives, 50% new-positives, 42% out-of-care prevalent-positives, and 16% out-of-care unknown-positives. Many HIV-positive persons, including those with uncontrolled HIV infection, attend SHCs and potentially contribute to HIV spread. However, HIV status often is not known to staff, resulting in missed linkage/re-linkage to care opportunities. Better outcomes could be facilitated by real-time ascertainment of HIV status and HIV care status.

  5. Out-of-pocket costs, primary care frequent attendance and sample selection: Estimates from a longitudinal cohort design.

    Science.gov (United States)

    Pymont, Carly; McNamee, Paul; Butterworth, Peter

    2018-03-20

    This paper examines the effect of out-of-pocket costs on subsequent frequent attendance in primary care using data from the Personality and Total Health (PATH) Through Life Project, a representative community cohort study from Canberra, Australia. The analysis sample comprised 1197 respondents with two or more GP consultations, and uses survey data linked to administrative health service use (Medicare) data which provides data on the number of consultations and out-of-pocket costs. Respondents identified in the highest decile of GP use in a year were defined as Frequent Attenders (FAs). Logistic regression models that did not account for potential selection effects showed that out-of-pocket costs incurred during respondents' prior two consultations were significantly associated with subsequent FA status. Respondents who incurred higher costs ($15-$35; or >$35) were less likely to become FAs than those who incurred no or low (attenders. Copyright © 2018. Published by Elsevier B.V.

  6. Associations between introduction and withdrawal of a financial incentive and timing of attendance for antenatal care and incidence of small for gestational age: natural experimental evaluation using interrupted time series methods

    Science.gov (United States)

    van der Waal, Zelda; Rushton, Steven; Rankin, Judith

    2018-01-01

    Objectives To determine whether introduction or withdrawal of a maternal financial incentive was associated with changes in timing of first attendance for antenatal care (‘booking’), or incidence of small for gestational age. Design A natural experimental evaluation using interrupted time series analysis. Setting A hospital-based maternity unit in the north of England. Participants 34 589 women (and their live-born babies) who delivered at the study hospital and completed the 25th week of pregnancy in the 75 months before (January 2003 to March 2009), 21 months during (April 2009 to December 2010) and 36 months after (January 2011 to December 2013) the incentive was available. Intervention The Health in Pregnancy Grant was a financial incentive of £190 ($235; €211) payable to pregnant women in the UK from the 25th week of pregnancy, contingent on them receiving routine antenatal care. Primary and secondary outcome measures The primary outcome was mean gestational age at booking. Secondary outcomes were proportion of women booking by 10, 18 and 25 weeks’ gestation; and proportion of babies that were small for gestational age. Results By 21 months after introduction of the grant (ie, immediately prior to withdrawal), compared with what was predicted given prior trends, there was an reduction in mean gestational age at booking of 4.8 days (95% CI 2.3 to 8.2). The comparable figure for 24 months after withdrawal was an increase of 14.0 days (95% CI 2.8 to 16.8). No changes in incidence of small for gestational age babies were seen. Conclusions The introduction of a universal financial incentive for timely attendance at antenatal care was associated with a reduction in mean gestational age at first attendance, but not the proportion of babies that were small for gestational age. Future research should explore the effects of incentives offered at different times in pregnancy and of differing values; and how stakeholders view such incentives. PMID:29391362

  7. Associations between introduction and withdrawal of a financial incentive and timing of attendance for antenatal care and incidence of small for gestational age: natural experimental evaluation using interrupted time series methods.

    Science.gov (United States)

    Adams, Jean; van der Waal, Zelda; Rushton, Steven; Rankin, Judith

    2018-01-31

    To determine whether introduction or withdrawal of a maternal financial incentive was associated with changes in timing of first attendance for antenatal care ('booking'), or incidence of small for gestational age. A natural experimental evaluation using interrupted time series analysis. A hospital-based maternity unit in the north of England. 34 589 women (and their live-born babies) who delivered at the study hospital and completed the 25th week of pregnancy in the 75 months before (January 2003 to March 2009), 21 months during (April 2009 to December 2010) and 36 months after (January 2011 to December 2013) the incentive was available. The Health in Pregnancy Grant was a financial incentive of £190 ($235; €211) payable to pregnant women in the UK from the 25th week of pregnancy, contingent on them receiving routine antenatal care. The primary outcome was mean gestational age at booking. Secondary outcomes were proportion of women booking by 10, 18 and 25 weeks' gestation; and proportion of babies that were small for gestational age. By 21 months after introduction of the grant (ie, immediately prior to withdrawal), compared with what was predicted given prior trends, there was an reduction in mean gestational age at booking of 4.8 days (95% CI 2.3 to 8.2). The comparable figure for 24 months after withdrawal was an increase of 14.0 days (95% CI 2.8 to 16.8). No changes in incidence of small for gestational age babies were seen. The introduction of a universal financial incentive for timely attendance at antenatal care was associated with a reduction in mean gestational age at first attendance, but not the proportion of babies that were small for gestational age. Future research should explore the effects of incentives offered at different times in pregnancy and of differing values; and how stakeholders view such incentives. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No

  8. [Factors related to self-care in diabetes mellitus patients attended at emergency service in Mexico].

    Science.gov (United States)

    Baquedano, Irasema Romero; dos Santos, Manoel Antônio; Teixeira, Carla Regina de Souza; Martins, Tatiane Aparecida; Zanetti, Maria Lúcia

    2010-12-01

    This cross-sectional study aimed to determine the self-care ability of individuals with type 2 diabetes mellitus and to relate this capacity with some sociodemographic and clinical variables. Participants were 251 patients who attended the Emergency Service at the Mérida Regional Hospital in Yucatán, Mexico, in 2006. Data were obtained through directed home interviews, using a form, a questionnaire and the Self-Care Capacity Scale. Descriptive and correlation statistics were used for data analysis. The results showed 83 (33.5%) subjects with good and 168 (66.5%) subjects with regular ability. A directly proportional correlation was found between self-care ability and years of study (r = 0.124; p diabetes patients, and further research needs to be developed with a focus on other variables involved in the behavior adopted to benefit their health.

  9. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study.

    Science.gov (United States)

    Gill, Christopher J; Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-02-03

    To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Prospective, cluster randomised and controlled effectiveness study. Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers' homes, in rural village settings. 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by intervention birth attendants (0.37, 0.17 to 0.81) and by 81% within the first two days

  10. Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster-randomised controlled trial.

    Science.gov (United States)

    Lund, S; Hemed, M; Nielsen, B B; Said, A; Said, K; Makungu, M H; Rasch, V

    2012-09-01

    To examine the association between a mobile phone intervention and skilled delivery attendance in a resource-limited setting. Pragmatic cluster-randomised controlled trial with primary healthcare facilities as the unit of randomisation. Primary healthcare facilities in Zanzibar. Two thousand, five hundred and fifty pregnant women (1311 interventions and 1239 controls) who attended antenatal care at one of the selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery. All pregnant women were eligible for study participation. Twenty-four primary healthcare facilities in six districts in Zanzibar were allocated by simple randomisation to either mobile phone intervention (n = 12) or standard care (n = 12). The intervention consisted of a short messaging service (SMS) and mobile phone voucher component. Skilled delivery attendance. The mobile phone intervention was associated with an increase in skilled delivery attendance: 60% of the women in the intervention group versus 47% in the control group delivered with skilled attendance. The intervention produced a significant increase in skilled delivery attendance amongst urban women (odds ratio, 5.73; 95% confidence interval, 1.51-21.81), but did not reach rural women. The mobile phone intervention significantly increased skilled delivery attendance amongst women of urban residence. Mobile phone solutions may contribute to the saving of lives of women and their newborns and the achievement of Millennium Development Goals 4 and 5, and should be considered by maternal and child health policy makers in developing countries. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  11. Medical education and the ACGME duty hour requirements: assessing the effect of a day float system on educational activities.

    Science.gov (United States)

    Roey, Steve

    2006-01-01

    In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted new resident work hour mandates, which are being shown to improve resident well-being and patient safety. However, there are limited data on the impact these new mandates may have on educational activities. To assess the impact on educational activities of a day float system created to meet ACGME work hour mandates. The inpatient ward coverage was changed by adding a day float team responsible for new patient admissions in the morning, with the on-call teams starting later and being responsible for new patient admissions thereafter. I surveyed the residents to assess the impact of this new system on educational activities-resident autonomy, attending teaching, conference attendance, resident teaching, self-directed learning, and ability to complete patient care responsibilities. There was no adverse effect of the day float system on educational activities. House staff reported increased autonomy, enhanced teaching from attending physicians, and improved ability to complete patient care responsibilities. Additionally, house staff demonstrated improved compliance with the ACGME mandates. The implementation of a novel day float system for the inpatient medicine ward service improved compliance with ACGME work duty requirements and did not adversely impact educational activities of the residency training program.

  12. Effects of Day Care and Maternal Employment: Views from Introductory Psychology Textbooks.

    Science.gov (United States)

    Etaugh, Claire; Cohen, Joseph; Cummings-Hill, Myra; Massey, Michelle; Detweiler, Kelly Selchow

    1999-01-01

    Examines the treatment of day care and maternal employment in introductory psychology textbooks between 1970 and 1997. Finds that the coverage of day care and maternal employment increased over the 28 year span, while 95% of the later textbooks presented views ranging from positive to balanced in the mid-1990s. (CMK)

  13. The return of the Traditional Birth Attendant

    Directory of Open Access Journals (Sweden)

    Karen Lane

    2016-12-01

    Full Text Available Sub–Saharan Africa and Southern Asia lag behind other regions in the provision of antenatal care and skilled attendance at birth (although typically attended by a family member or villager and over 32 million of the 40 million births not attended by skilled health personnel in 2012 occurred in rural areas. Overall, one–quarter of women in developing nations still birth alone or with a relative to assist them.

  14. Factors associated with early neonatal attendance to a paediatric emergency department.

    Science.gov (United States)

    Flanagan, C F; Stewart, M

    2014-03-01

    To examine the demographic and perinatal factors involved in the presentation of newborn babies to a paediatric emergency department (PED) and outcome following attendance. Term babies who attended the PED of the Royal Belfast Hospital for Sick Children (RBHSC) in the first 2 weeks of life, during two separate 3-month periods in summer and winter 2010-2011 were identified retrospectively from the PED electronic database. Perinatal and demographic data were also obtained on all babies born in the Royal Jubilee Maternity Hospital (RJMH) during the same time period. A total of 223 attendances to the PED involving 208 babies were identified with almost equal distribution during summer and winter months. Almost two thirds (n=139, 62%) of babies presented out-of-hours. Over half of babies were self-referred by parent/carer. The most common presentation was feeding difficulty, vomiting or faltering growth, accounting for 36%. Significant factors associated with attendance to PED included birth weight working day. Overall, a third of babies admitted stayed less than 24 h (34%). Large numbers of babies attend the PED in the first 2 weeks of life, commonly out of hours, from deprived areas and with feeding difficulties. A quarter of babies attending are admitted to hospital, with one-third discharged following an overnight stay. Services should be reevaluated, particularly in this current financial climate, in an attempt to find new models of care for these young babies.

  15. Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis.

    Science.gov (United States)

    Munabi-Babigumira, Susan; Glenton, Claire; Lewin, Simon; Fretheim, Atle; Nabudere, Harriet

    2017-11-17

    In many low- and middle-income countries women are encouraged to give birth in clinics and hospitals so that they can receive care from skilled birth attendants. A skilled birth attendant (SBA) is a health worker such as a midwife, doctor, or nurse who is trained to manage normal pregnancy and childbirth. (S)he is also trained to identify, manage, and refer any health problems that arise for mother and baby. The skills, attitudes and behaviour of SBAs, and the extent to which they work in an enabling working environment, impact on the quality of care provided. If any of these factors are missing, mothers and babies are likely to receive suboptimal care. To explore the views, experiences, and behaviours of skilled birth attendants and those who support them; to identify factors that influence the delivery of intrapartum and postnatal care in low- and middle-income countries; and to explore the extent to which these factors were reflected in intervention studies. Our search strategies specified key and free text terms related to the perinatal period, and the health provider, and included methodological filters for qualitative evidence syntheses and for low- and middle-income countries. We searched MEDLINE, OvidSP (searched 21 November 2016), Embase, OvidSP (searched 28 November 2016), PsycINFO, OvidSP (searched 30 November 2016), POPLINE, K4Health (searched 30 November 2016), CINAHL, EBSCOhost (searched 30 November 2016), ProQuest Dissertations and Theses (searched 15 August 2013), Web of Science (searched 1 December 2016), World Health Organization Reproductive Health Library (searched 16 August 2013), and World Health Organization Global Health Library for WHO databases (searched 1 December 2016). We included qualitative studies that focused on the views, experiences, and behaviours of SBAs and those who work with them as part of the team. We included studies from all levels of health care in low- and middle-income countries. One review author extracted data and

  16. Characteristics of care management agencies affect expenditure on home help and day care services: A population-based cross-sectional study in Japan.

    Science.gov (United States)

    Feng, Mei; Igarashi, Ayumi; Noguchi-Watanabe, Maiko; Yoshie, Satoru; Iijima, Katsuya; Yamamoto-Mitani, Noriko

    2017-11-01

    The financial interests of care management agencies can affect how care managers assist clients' use of long-term care insurance services. The present study examined the relationship between clients' service expenditures, and whether the home help and day care service agencies belonged to the same organization as the care management agency. Population-based data were obtained from a suburban municipality in Japan. We investigated 4331 persons with care needs certificates (levels 1-5), including those using home help (n = 1780) or day care (n = 2141) services. Data on the service expenditures, and clients' and agencies' characteristics were analyzed using multiple linear regression analyses controlling for potential confounders. Home help service users spent an average of US$558.1 ± 590.1 for home help service, and day care service users spent US$665.0 ± 415.9 for day care service. Living alone, living in a condominium/apartment, higher care needs, more severe cognitive impairment and lower use of other services were associated with higher home help service expenditure. Day care service expenditure increased with older age, female sex, higher care needs, more severe cognitive impairment and higher physical function. Clients whose service agencies and care management agencies belonged to the same organization had higher expenditures, even after adjusting for confounders (home help: β = 0.126, P = 0.007; day care: β = 0.085, P = 0.002, respectively). Financial interests of care management agencies might significantly influence clients' service expenditure. We should develop an effective system to minimize this influence. Geriatr Gerontol Int 2017; 17: 2224-2231. © 2017 Japan Geriatrics Society.

  17. Fecal coliforms on environmental surfaces in two day care centers.

    Science.gov (United States)

    Weniger, B G; Ruttenber, A J; Goodman, R A; Juranek, D D; Wahlquist, S P; Smith, J D

    1983-01-01

    A survey of environmental surfaces in two Atlanta area day care centers was conducted to determine the prevalence of fecal coliform bacteria, considered a marker for the presence of fecal contamination which might contain pathogenic parasites, bacteria, or viruses. Fecal coliforms were found in 17 (4.3%) of 398 representative samples of building surfaces, furniture, and other objects. These surfaces may be involved in the chain of transmission of enteric diseases among children. Therefore, disinfection of inanimate objects, in addition to good handwashing, may be important in controlling the spread of enteric diseases in day care centers. PMID:6830225

  18. The Effects of Adult Day Services on Family Caregivers’ Daily Stress, Affect, and Health: Outcomes From the Daily Stress and Health (DaSH) Study

    OpenAIRE

    Zarit, Steven H.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Klein, Laura C.

    2013-01-01

    Purpose: We examine the effects of use of adult day service (ADS) by caregivers of individuals with dementia (IWD) on daily stressors, affect, and health symptoms. Participants were interviewed for 8 consecutive days. On some days, the IWD attended an ADS program and on the other days caregivers provide most or all of the care at home. Methods: Participants were 173 family caregivers of IWDs using an ADS program. Daily telephone interviews assessed care-related stressors, noncare stressors, p...

  19. Attending and non-attending patients in a real-life setting of an early arthritis clinic: why do people leave clinics and where do they go?

    Science.gov (United States)

    Nell-Duxneuner, Valerie; Rezende, Lucila Stange; Stamm, Tanja A; Duer, Mona; Smolen, Josef S; Machold, Klaus P

    2012-01-01

    Rheumatologist assessment as early as possible is considered essential for patients with inflammatory joint disease. In our Very Early Arthritis Clinic (VEAC), a substantial proportion of initially included and followed patients later stop attendance in the clinic. We questioned attending (AP) and non-attending patients (NAP) regarding current health status and satisfaction with care as well as reasons for discontinuation and current care received by NAP. VEAC patients first seen between 1996 and 2003 were included. Assessment included the RADAI, HAQ, and visual analogue scales for pain, disease activity, fatigue, satisfaction with current health care. Current (DMARD) treatment was recorded. Among AP, 87% had rheumatoid arthritis (RA) and 13% non-RA. Of NAP, 37% had RA, 23% non-RA and 40% no more rheumatic disease. Satisfaction with health care concerning rheumatic disease was better in AP than NAP. Likewise, most outcome parameters were better in AP. Substantially more RA patients in the AP than NAP group received DMARDs. Apart from the disappearance of arthritis, logistic reasons were given most frequently for discontinuation of attendance. Less than 10% of NAP indicated dissatisfaction with medical care. We found advantages in both disease activity measures and satisfaction with health care for patients receiving continuous care in a highly specialised Rheumatology clinic. Furthermore, different DMARD usage in RA in AP and NAP may indicate significant deficits in treatment quality outside specialist care. Logistic issues associated with access to continuous Rheumatology care for early arthritis patients need improvement.

  20. Effect of weather on football attendances

    Energy Technology Data Exchange (ETDEWEB)

    Cairns, J A

    1984-01-01

    On the premise that weather should have an effect on spectator attendance at sports events in outdoor settings (a topic which has received surprisingly little formalized study), the author examined the record of home attendances for three football teams in Scotland. In general, it was found that the greater the rainfall on the day of the match the lower the attendance. Dividing spectators into different groups, it was further found that an additional hour of sunshine was associated 162 more adults attending Aberdeen matches, while high temperatures appeared to increase juvenile attendance (by 57 for ever 1 deg. C. rise in temperature). Weather disruption of football games is attended by a number of costs, both direct and indirect. Quantifying the impact of weather can shed substantial light on the problem of scheduling for the season. For example, since certain periods are, on average, wetter than others, rescheduling to drier periods might encourage greater attendance.

  1. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

    Science.gov (United States)

    Ofoedu, John N.; Njoku, Patrick U.; Amadi, Agwu N.; Godswill-Uko, Ezinne U.

    2013-01-01

    Abstract Background As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP) control has become an important management challenge. Objectives To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria. Methods A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented. Results Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03), antihypertensive medication duration ≥3 years (p = 0.042), and taking ≥ one form of antihypertensive medication (p = 0.04). BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036). The most common reason for non-adherence was forgetfulness (p = 0.046). Conclusions The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  2. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Gabriel UP. Iloh

    2013-02-01

    Full Text Available Background: As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP control has become an important management challenge.Objectives: To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria.Methods: A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented.Results: Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03, antihypertensive medication duration ≥3 years (p = 0.042, and taking ≥ one form of antihypertensive medication (p = 0.04. BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036. The most common reason for non-adherence was forgetfulness (p = 0.046. Conclusion: The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  3. Establishment and assessment of cataract surgery in Day-care Unit at northwest of China

    OpenAIRE

    Xiu-Li Zhang; Xing Yang; Juan-Juan Yang; Bao-Jian Yan; Jing-Ming Li; Cheng Pei; Li Qin

    2018-01-01

    AIM: To describe the protocol and economic cost of the Day-care Unit cataract surgery procedure in northwest of China.METHODS: Patients who received phacoemulcification and intraocular lens implantation in both Day-care Unit and regular Unit were recruited from January 2016 to December 2016. The baseline data and average cost were recorded and analyzed. Furthermore, satisfaction questionnaire of patients were collected.RESULTS: Patients with Day-care Unit showed shorter registration duration,...

  4. Barriers and facilitators to accessing skilled birth attendants in Afar region, Ethiopia.

    Science.gov (United States)

    King, Rosemary; Jackson, Ruth; Dietsch, Elaine; Hailemariam, Asseffa

    2015-05-01

    to explore barriers and facilitators that enable women to access skilled birth attendance in Afar Region, Ethiopia. researchers used a Key Informant Research approach (KIR), whereby Health Extension Workers participated in an intensive training workshop and conducted interviews with Afar women in their communities. Data was also collected from health-care workers through questionnaires, interviews and focus groups. fourteen health extension workers were key informants and interviewers; 33 women and eight other health-care workers with a range of experience in caring for Afar childbearing women provided data as individuals and in focus groups. participants identified friendly service, female skilled birth attendants (SBA) and the introduction of the ambulance service as facilitators to SBA. There are many barriers to accessing SBA, including women׳s low status and restricted opportunities for decision making, lack of confidence in health-care facilities, long distances, cost, domestic workload, and traditional practices which include a preference for birthing at home with a traditional birth attendant. many Afar men and women expressed a lack of confidence in the services provided at health-care facilities which impacts on skilled birth attendance utilisation. ambulance services that are free of charge to women are effective as a means to transfer women to a hospital for emergency care if required and expansion of ambulance services would be a powerful facilitator to increasing institutional birth. Skilled birth attendants working in institutions need to ensure their practice is culturally, physically and emotionally safe if more Afar women are to accept their midwifery care. Adequate equipping and staffing of institutions providing emergency obstetric and newborn care will assist in improving community perceptions of these services. Most importantly, mutual respect and collaboration between traditional birth attendants (Afar women׳s preferred caregiver), health

  5. Losing women along the path to safe motherhood: why is there such a gap between women's use of antenatal care and skilled birth attendance? A mixed methods study in northern Uganda.

    Science.gov (United States)

    Anastasi, Erin; Borchert, Matthias; Campbell, Oona M R; Sondorp, Egbert; Kaducu, Felix; Hill, Olivia; Okeng, Dennis; Odong, Vicki Norah; Lange, Isabelle L

    2015-11-04

    Thousands of women and newborns still die preventable deaths from pregnancy and childbirth-related complications in poor settings. Delivery with a skilled birth attendant is a vital intervention for saving lives. Yet many women, particularly where maternal mortality ratios are highest, do not have a skilled birth attendant at delivery. In Uganda, only 58 % of women deliver in a health facility, despite approximately 95 % of women attending antenatal care (ANC). This study aimed to (1) identify key factors underlying the gap between high rates of antenatal care attendance and much lower rates of health-facility delivery; (2) examine the association between advice during antenatal care to deliver at a health facility and actual place of delivery; (3) investigate whether antenatal care services in a post-conflict district of Northern Uganda actively link women to skilled birth attendant services; and (4) make recommendations for policy- and program-relevant implementation research to enhance use of skilled birth attendance services. This study was carried out in Gulu District in 2009. Quantitative and qualitative methods used included: structured antenatal care client entry and exit interviews [n = 139]; semi-structured interviews with women in their homes [n = 36], with health workers [n = 10], and with policymakers [n = 10]; and focus group discussions with women [n = 20], men [n = 20], and traditional birth attendants [n = 20]. Seventy-five percent of antenatal care clients currently pregnant reported they received advice during their last pregnancy to deliver in a health facility, and 58 % of these reported having delivered in a health facility. After adjustment for confounding, women who reported they received advice at antenatal care to deliver at a health facility were significantly more likely (aOR = 2.83 [95 % CI: 1.19-6.75], p = 0.02) to report giving birth in a facility. Despite high antenatal care coverage, a number of demand and supply side

  6. Day care quality and children's free play activities.

    Science.gov (United States)

    Vandell, D L; Powers, C P

    1983-07-01

    Social and nonsocial behavior of white, middle-class preschoolers in high, moderate, and low quality day care centers were contrasted. Children in high quality centers were more likely to interact positively with adults, while children in lower quality programs were more likely to engage in solitary play and aimless wandering.

  7. Improving Skilled Birth Attendance in Ghana: An Evidence-Based Policy Brief.

    Science.gov (United States)

    Apanga, Paschal Awingura; Awoonor-Williams, John Koku

    2017-01-01

    This commentary has the objective of improving skilled birth attendance in Ghana to reduce maternal and neonatal mortality and morbidity. We have provided evidence of causes of low-skilled birth attendance in Ghana. Physical accessibility of health care, sociocultural factors, economic factors and health care system delivery problems were found as the main underlying causes of low levels of skilled birth attendance in Ghana. The paper provides potential strategies in addressing maternal and child health issues in Ghana.

  8. Day Care Centers, US, 2010, Oak Ridge National Laboratory

    Data.gov (United States)

    U.S. Environmental Protection Agency — This database contains locations of day care centers for 39 states which include the states of AZ, CA, , NV, NY, HI. This is a work in progress and data for...

  9. Feeding pattern of children in day care centres in Port Harcourt ...

    African Journals Online (AJOL)

    2015-05-11

    May 11, 2015 ... Data entry and analyses utilised. SPSS version 20 and ... the global economic recession more mothers now work ... tional or home day care and care given by a non-relative ... technique, based on the location of the school.

  10. Where There Are (Few) Skilled Birth Attendants

    Science.gov (United States)

    Prata, Ndola; Rowen, Tami; Bell, Suzanne; Walsh, Julia; Potts, Malcolm

    2011-01-01

    Recent efforts to reduce maternal mortality in developing countries have focused primarily on two long-term aims: training and deploying skilled birth attendants and upgrading emergency obstetric care facilities. Given the future population-level benefits, strengthening of health systems makes excellent strategic sense but it does not address the immediate safe-delivery needs of the estimated 45 million women who are likely to deliver at home, without a skilled birth attendant. There are currently 28 countries from four major regions in which fewer than half of all births are attended by skilled birth attendants. Sixty-nine percent of maternal deaths in these four regions can be attributed to these 28 countries, despite the fact that these countries only constitute 34% of the total population in these regions. Trends documenting the change in the proportion of births accompanied by a skilled attendant in these 28 countries over the last 15-20 years offer no indication that adequate change is imminent. To rapidly reduce maternal mortality in regions where births in the home without skilled birth attendants are common, governments and community-based organizations could implement a cost-effective, complementary strategy involving health workers who are likely to be present when births in the home take place. Training community-based birth attendants in primary and secondary prevention technologies (e.g. misoprostol, family planning, measurement of blood loss, and postpartum care) will increase the chance that women in the lowest economic quintiles will also benefit from global safe motherhood efforts. PMID:21608417

  11. The association between home care visits and same-day emergency department use: a case-crossover study.

    Science.gov (United States)

    Jones, Aaron; Schumacher, Connie; Bronskill, Susan E; Campitelli, Michael A; Poss, Jeffrey W; Seow, Hsien; Costa, Andrew P

    2018-04-30

    The extent to which home care visits contribute to the delay or avoidance of emergency department use is poorly characterized. We examined the association between home care visits and same-day emergency department use among patients receiving publicly funded home care. We conducted a population-based case-crossover study among patients receiving publicly funded home care in the Hamilton-Niagara-Haldimand-Brant region of Ontario between January and December 2015. Within individuals, all days with emergency department visits after 5 pm were selected as cases and matched with control days from the previous week. The cohort was stratified according to whether patients had ongoing home care needs ("long stay") or short-term home care needs ("short stay"). We used conditional logistical regression to estimate the association between receiving a home care visit during the day and visiting the emergency department after 5 pm on the same day. A total of 4429 long-stay patients contributed 5893 emergency department visits, and 2836 short-stay patients contributed 3476 visits. Receiving a home care nursing visit was associated with an increased likelihood of visiting the emergency department after 5 pm on the same day in both long-stay (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.17-1.48) and short-stay patients (OR 1.22, 95% CI 1.07-1.39). Stronger associations were observed for less acute visits to the emergency department. No associations were observed for other types of home care visits. Patients receiving home care were more likely to visit the emergency department during the evening on days they received a nursing visit. The mechanism of the association between home care visits and same-day emergency department use and the extent to which same-day emergency department visits could be prevented or diverted require additional investigation. © 2018 Joule Inc. or its licensors.

  12. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study

    Science.gov (United States)

    Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-01-01

    Objective To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Design Prospective, cluster randomised and controlled effectiveness study. Setting Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers’ homes, in rural village settings. Participants 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Interventions Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). Main outcome measures The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Results Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by

  13. Adult Dental Health Survey 2009: relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care.

    Science.gov (United States)

    Hill, K B; Chadwick, B; Freeman, R; O'Sullivan, I; Murray, J J

    2013-01-01

    The importance of understanding barriers to dental attendance of adults in the UK was acknowledged in the first Adult Dental Health Survey in 1968 and has been investigated in all subsequent ADH surveys. In 1968, approximately 40% of dentate adults said they attended for a regular check-up; by 2009 this was 61%. Attendance patterns were associated with greater frequency of toothbrushing, use of additional dental hygiene products, lower plaque and calculus levels. Just under three-fifths of adults said they had tried to make an NHS dental appointment in the previous five years. The vast majority (92%) successfully received and attended an appointment, while a further 1% received an appointment but did not attend. The remaining 7% of adults were unable to make an appointment with an NHS dentist. The majority of adults were positive about their last visit to the dentist, with 80% of adults giving no negative feedback about their last dentist visit. Cost and anxiety were important barriers to care. Twenty-six percent of adults said the type of treatment they had opted for in the past had been affected by the cost and 19% said they had delayed dental treatment for the same reason. The 2009 survey data demonstrated a relationship between dental anxiety and dental attendance. Adults with extreme dental anxiety were more likely to attend only when they had trouble with their teeth (22%) than for a regular check-up.

  14. A study on knowledge and practices of antenatal care among pregnant women attending antenatal clinic at a Tertiary Care Hospital of Pune, Maharashtra

    Directory of Open Access Journals (Sweden)

    Barun Bhai Patel

    2016-01-01

    Full Text Available Background: The maternal health status of Indian women was noted to be lower as compared to other developed countries. Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. For sustainable growth and development of country, there is a need to improve MCH Care in the country. Safe motherhood by providing good antenatal care (ANC is very important to reduce maternal mortality ratio and infant mortality rate and to achieve millennium development goals. Objectives: This study aimed to determine the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic at a Tertiary Care Hospital in Pune and their association with various sociodemographic factors. Materials and Methods: A cross-sectional study was carried out among 384 pregnant women in their 3 rd trimester attending the antenatal clinic in a Tertiary Care Hospital of Pune, Maharashtra during October 2011 to September 2012. Pretested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed using SPSS version 20 and Epi Info Software. Results: Study reveals that about 58% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, education, occupation, parity, type of family, and socioeconomic status (SES had a significant association with awareness about ANC. 100% women were having a positive attitude toward ANC. Around 70%, women were practicing adequately, and variables such as education and SES had a significant association with practices about ANC. Conclusion: These findings can be used to plan a Health Intervention Program aiming to improve the maternal health practices and eventually improve the health status of the women.

  15. Strategies of day care center educators in dealing crying babies

    Directory of Open Access Journals (Sweden)

    Lígia Ebner Melchiori

    2004-06-01

    Full Text Available The purpose of this study is to explore the views of day care center educators on how they act when babies cry, if they are able to identify the causes of crying and what are the subjection reasons that make them take action or not. Twenty-one caretakers were interviewed about each of the ninety babies, aged 4 to 24 months, under their care, using a semi-structured guide. The results show that overall the proportion of babies that do not cry significantly increases with age. However, crying for primary needs, in the view of the educators, tends to decrease as the average age increases, whilst crying for secondary needs tends to increase. Most of the time, the educators try to eliminate the needs that provoke crying, giving priority to the baby’s welfare. The article discusses the caretakers’ educative practices with data found in literature. Keywords: day care; educative practices; educators.

  16. [Survival of out-hospital cardiac arrests attended by a mobile intensive care unit in Asturias (Spain) in 2010].

    Science.gov (United States)

    Iglesias-Llaca, F; Suárez-Gil, P; Viña-Soria, L; García-Castro, A; Castro-Delgado, R; Fente Álvarez, A I; Álvarez-Ramos, M B

    2013-12-01

    To evaluate attendance timings, out- and in-hospital characteristics, and survival of cardiac arrests attended by an advanced life support unit in Asturias (Spain) in 2010. Factors related to survival upon admission and at discharge were also analyzed. A retrospective, observational trial was carried out involving a cohort of out-hospital cardiac arrests (OHCA) occurring between 1 January 2010 and 31 December 2010, with one year of follow-up from OHCA. Health Care Area IV of the Principality of Asturias, with a population of 342,020 in 2010. All patients with OHCA and attended by an advanced life support unit were considered. Demographic data, the etiology of cardiac arrest, bystander cardiopulmonary resuscitation (CPR), attendance timings and survival upon admission, at discharge and after one year. A total of 177 OHCA were included. Of these, 120 underwent CPR by the advanced life support team. Sixty-six of these cases (55%) were caused by presumed heart disease. A total of 63 patients (52.5%) recovered spontaneous circulation, and 51 (42.5%) maintained circulation upon admission to hospital. Thirteen patients (10.8%) were discharged alive. After one year, 11 patients were still alive (9.2%) - 9 of them (7.5%) with a Cerebral Performance Category (CPC) score of 1. Ventricular fibrillation and short attendance timings were related to increased survival. The survival rate upon admission was better than in other series and similar at discharge. Initial rhythm and attendance timings were related. Public automated external defibrillators (AED) were not used, and bystander CPR was infrequent. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  17. Text messages to increase attendance to follow-up cervical cancer screening appointments among HPV-positive Tanzanian women (Connected2Care)

    DEFF Research Database (Denmark)

    Linde, Ditte S; Andersen, Marianne S; Mwaiselage, Julius D

    2017-01-01

    group (standard care). In a period of 10 months, the intervention group will receive 15 one-directional health educative text messages and SMS reminders for their appointment. The total sample size will be 700 with 350 women in each study arm. Primary outcome is attendance rate for follow-up. Secondary...... on how such interventions may perform in relation to cervical cancer screening in low-income settings. This study aims to assess the degree to which a Short Message Service (SMS) intervention can increase attendance at appointments among women who have tested positive for high-risk (HR) Human...

  18. The Ethical Imperative to Move to a Seven-Day Care Model.

    Science.gov (United States)

    Bell, Anthony; McDonald, Fiona; Hobson, Tania

    2016-06-01

    Whilst the nature of human illness is not determined by time of day or day of week, we currently structure health service delivery around a five-day delivery model. At least one country is endeavouring to develop a systems-based approach to planning a transition from five- to seven-day healthcare delivery models, and some services are independently instituting program reorganization to achieve these ends as research, amongst other things, highlights increased mortality and morbidity for weekend and after-hours admissions to hospitals. In this article, we argue that this issue does not merely raise instrumental concerns but also opens up a normative ethical dimension, recognizing that clinical ethical dilemmas are impacted on and created by systems of care. Using health policy ethics, we critically examine whether our health services, as currently structured, are at odds with ethical obligations for patient care and broader collective goals associated with the provision of publicly funded health services. We conclude by arguing that a critical health policy ethics perspective applying relevant ethical values and principles needs to be included when considering whether and how to transition from five-day to seven-day models for health delivery.

  19. Text messages to increase attendance to follow-up cervical cancer screening appointments among HPV-positive Tanzanian women (Connected2Care)

    DEFF Research Database (Denmark)

    Linde, Ditte S; Andersen, Marianne S; Mwaiselage, Julius D

    2017-01-01

    Background: Cervical cancer is a major health concern in Tanzania, caused by poor attendance for cervical cancer screening and follow-up of women at risk. Mobile telephone health interventions are proven effective tools to improve health behaviour in African countries. So far, no knowledge exists...... on how such interventions may perform in relation to cervical cancer screening in low-income settings. This study aims to assess the degree to which a Short Message Service (SMS) intervention can increase attendance at appointments among women who have tested positive for High-Risk (HR) Human Papiloma...... (standard care). In a period of 10 months, the intervention group will receive 15 one-directional health educative text messages and SMS-reminders for their appointment. The total sample size will be 700 with 350 women in each study arm. Primary outcome is attendance rate for follow-up. Secondary objectives...

  20. No-fault compensation for ventilator-dependent children: a reasonable settlement value for lifetime attendant care

    Directory of Open Access Journals (Sweden)

    Jenkins RC

    2016-08-01

    Full Text Available Randall C Jenkins,1–3 Brian W Boelens,1 Kari L Aasheim,1 Nikolaus Gravenstein4–5 1University of Florida Self-Insurance Program, 2University of Florida Healthcare Education Insurance Company, 3Department of Health Services Research, Management & Policy, College of Public Health and Health Professions, 4Department of Anesthesiology, 5Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, USA Abstract: Severe neurological outcomes sustained in childhood often result in lifetime health care needs that are beyond the financial means of most families. When severe neurological deficits are alleged to have resulted from professional negligence, relief may be sought through litigation; however, the American tort system often yields inconsistent results or no compensation for patients. We sought to identify a reasonable, objective, and data-based monetary range for a no-fault compensation system with high- and low-financial limits for those with severe neurological deficits. Based on documented life expectancies and attendant care cost studies, the data analysis indicates a no-fault settlement payment ranging from US$479,712.24 to $3,098,504.16, reasonably ensures care and services for life. Keywords: cost of health care, health law, health regulation, long-term care, medical malpractice

  1. A qualitative study on why did the poorly-educated Chinese elderly fail to attend nurse-led case manager clinic and how to facilitate their attendance.

    Science.gov (United States)

    Hung, Susanna Lok Lam; Fu, Sau Nga; Lau, Po Shan; Wong, Samuel Yeung Shan

    2015-01-31

    This study explored the views, barriers and facilitators of the poorly-educated elderly who were non-attendee of the nurse-led case manager clinic. The case managers provide assessment for diabetes complication screening and can refer patients to the appropriate multidisciplinary team in public outpatient primary care setting. We adopted qualitative research method by individual semi-structured face to face interviews. Nineteen Chinese type 2 diabetes mellitus subjects aged ≥ 60 who failed to attend the nurse-led case manager clinic were interviewed. They all came from a socially deprived urban district in Hong Kong. Content and thematic analysis was performed. Seven men and twelve women aged 60 to 89 were interviewed. Nine of them received no formal education and ten of them attended up to primary school. The reasons for non-attendance included attitude and poor knowledge towards diabetes complication screening and confusion of the nurse-led clinic as an educational talk. Most respondents could not understand the reason for the screening of diabetic complications, the concept of multidisciplinary care and the procedure and outcomes of nurse assessment. Five respondents were unable to follow multiple appointments because they could not read. Other reasons included physical barriers and comorbidity, family and financial constraint. They either had a tight daily schedule because of the need to take care of family members, or the family members who brought them to clinic had difficulty in attending multiple appointments. Enhanced understanding of the importance and procedure of diabetes multidisciplinary management, a flexible appointment system and a single clear appointment sheet may facilitate their attendance. Poorly-educated Chinese elderly with DM and their care givers faced physical, social and psychological barriers when attending the nurse-led case manager clinic. Strategies targeting on their low literacy include effective communication and education

  2. Effect of Ambulatory Transitional Care Management on 30-Day Readmission Rates.

    Science.gov (United States)

    Ballard, Jonathan; Rankin, Wade; Roper, Karen L; Weatherford, Sarah; Cardarelli, Roberto

    2018-05-01

    A process improvement initiative for transitional care management (TCM) was evaluated for effectiveness in reducing 30-day readmission rates in a retrospective cohort study. Regression models analyzed the association between level of TCM component implementation and readmission rates among patients discharged from a university medical center hospital. Of the 1884 patients meeting inclusion criteria, only 3.7% (70) experienced a 30-day readmission. Patients receiving the full complement of TCM had 86.6% decreased odds of readmission compared with patients who did not receive TCM ( P < .001). However, the complete package of TCM services under Medicare guidelines may not be essential. A postdischarge telephone call did not reduce readmission odds, provided a TCM office visit occurred. Important for risk assessment models targeting patients for TCM, the number of previous hospital admissions, not age, predicted 30-day readmission risk. This study provides evidence that primary care-based TCM can reduce 30-day readmissions even when overall rates are low.

  3. Common mental disorder symptoms among patients with malaria attending primary care in Ethiopia: a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Markos Tesfaye

    Full Text Available Common Mental Disorders (CMDs are frequent among patients attending primary care. In Africa, CMDs are often misdiagnosed as physical illnesses because many of the patients complain of somatic symptoms of mental distress. We explored whether there was difference in the levels of CMD symptoms between patients with thick film confirmed and clinical cases of malaria with negative thick film in primary care.A cross-sectional comparative study was conducted on 300 adults with a clinical diagnosis of malaria in primary care centres in Jimma, Ethiopia. Patients were recruited consecutively until 100 cases of 'malaria' with a negative thick film and 200 cases of malaria with a positive thick film consented to participate. The 20-item Self-Reporting Questionnaire (SRQ-20 was used to measure CMD. The non-parametric Wilcoxon rank-sum test was used to explore the association between thick film result and CMD.Participants had a mean age of 28.2 (S.D = 10.9 years and the majority (57.3% were women. The prevalence of high CMD symptoms (six or more symptoms on the SRQ-20 was 24.5%. Suicidal ideation was reported by 13.8% of the participants. CMD symptoms were significantly higher in patients who had taken medication prior to visiting the primary care (p = 0.012 and in those whose symptoms had been present for seven days or more (p = 0.041. There was no statistically significant association between level of CMD symptoms and having a negative thick film result (OR 0.98; 95%CI 0.92, 1.04 or objective presence of fever (OR 1.04; 95%CI 0.93, 1.15.CMD symptoms among cases of malaria did not appear to be associated with a negative thick film result. The high levels of CMD symptoms, including suicidal ideation, calls for further studies to investigate the persistence and progression of these symptoms following resolution of the acute malarial episode.

  4. MULTIMEDIA CONCENTRATIONS OF PAH IN SEVERAL DAY CARE CENTERS

    Science.gov (United States)

    Concentrations of polycyclic aromatic hydrocarbons were measured in nine day care centers in the spring of 1997. Indoor and outdoor air, food and beverages, indoor dust, and outdoor play area soil were sampled. The mean sums of 20 target PAH concentrations were 265 and 199 ng...

  5. Proceedings of the Conference on Industry and Day Care (Urban Research Corporation, Chicago, 1970).

    Science.gov (United States)

    Urban Research Corp., Chicago, IL.

    This booklet of conference proceedings reflects the efforts of the Urban Research Corporation to continue conversation between industry and day care specialists. A group of 175 industry representatives, early childhood specialists, community agency representatives, and day care operators and franchisers convened to discuss their mutual concerns.…

  6. Digital media and aesthetical learning in day care education

    DEFF Research Database (Denmark)

    Holm, Søren

    from a aesthetic view wherein the digital media can be used as a resource for the child to learn about body awareness and better understanding and remembrance of their own subjectivity, while still gaining the knowledge education the Danish system demands. In this paper I will use an existential...... that the child should no longer be seen as a user with an ipad, but instead should the ipad while in use be seen as an extension of the users subject. The importance comes in how the pedagog helps the user not to lose awareness of the body while this takes place, but instead let the user experience both the body......Digital media and aesthetical learning in day care education. The digital media is one of the major subjects that are to be included in everyday life in the Danish day care. This is a strategy from the Danish government, who view it as a necessary step in educating children for the future. In 2013...

  7. A Cost Analysis of Day Care Centers in Pennsylvania. Center for Human Service Development Report No. 21.

    Science.gov (United States)

    Hu, Teh-Wei; Wise, Karl

    The purpose of this study is to provide day care center management and government funding agencies with empirical estimates of the costs of day care centers in Pennsylvania. Based on cost data obtained from the Department of Public Welfare and survey information from the Pennsylvania Day Care Study Project, average and marginal costs of day care…

  8. Factors affecting attendance at and timing of formal antenatal care: Results from a qualitative study in Madang, Papua New Guinea

    NARCIS (Netherlands)

    Andrew, E.V.W.; Pell, C.; Angwin, A.; Auwun, A.; Daniels, J.; Mueller, I.; Phuanukoonnon, S.; Pool, R.

    2014-01-01

    Background: Appropriate antenatal care (ANC) is key for the health of mother and child. However, in Papua New Guinea (PNG), only a third of women receive any ANC during pregnancy. Drawing on qualitative research, this paper explores the influences on ANC attendance and timing of first visit in the

  9. Information-Seeking in Family Day Care: Access, Quality and Personal Cost

    Science.gov (United States)

    Corr, L.; Davis, E.; Cook, K.; Mackinnon, A.; Sims, M.; Herrman, H.

    2014-01-01

    Family day-care (FDC) educators work autonomously to provide care and education for children of mixed ages, backgrounds and abilities. To meet the demands and opportunities of their work and regulatory requirements, educators need access to context-relevant and high quality information. No previous research has examined how and where these workers…

  10. Perceptions of Eye Health and Eye Health Services among Adults Attending Outreach Eye Care Clinics in Papua New Guinea.

    Science.gov (United States)

    Burnett, Anthea; Yu, Mitasha; Paudel, Prakash; Naduvilath, Thomas; Fricke, Tim R; Hani, Yvonne; Garap, Jambi

    2015-01-01

    To determine how people attending outreach eye care clinics in Papua New Guinea (PNG) perceive eye health and eye health services. An interview-based questionnaire was administrated to a convenience sample of 614 adult participants across four provinces and perceptions of eye health and eye health services were recorded. Presenting and near visual acuity were measured and cause of visual impairment (VI) determined. In this sample, 113/614 participants (18.4%) presented with distance VI, 16 (2.6%) with distance blindness, and 221 (47.6%) with near VI. Older participants and those with near VI were more likely to indicate that it is hard to have an eye examination due to travel time, lack of transport and transport costs. Female participants and those from underserved areas were more likely to report shame and fear of jealousy from others when asked about their attitudes towards spectacles. Participants reporting that they were willing to pay higher amounts for testing and spectacles/treatment also reported higher education levels, higher household incomes and were more likely to be male. A quarter of participants (25.9%) indicated that they did not like having an eye examination because their reading and writing was poor. People attending outreach eye care clinics in PNG reported finding it difficult to attend eye health services due to transport difficulties and anticipated high costs. Negative attitudes towards spectacles were also prevalent, and negative perceptions appeared more frequently among older participants and those with less education.

  11. [Patients' satisfaction and waiting time in oncology day care centers in Champagne-Ardenne].

    Science.gov (United States)

    Debreuve-Theresette, A; Jovenin, N; Stona, A C; Kraïem-Leleu, M; Burde, F; Parent, D; Hettler, D; Rey, J B

    2015-12-01

    Quality of life of patients suffering from cancer may be influenced by the way healthcare is organized and by patient experiences. Nowadays, chemotherapy is often provided in day care centers. This study aimed to assess patient waiting time and satisfaction in oncology day care centers in Champagne-Ardenne, France. This cross-sectional survey involved all patients receiving ambulatory chemotherapy during a one-week period in day care centers of Champagne-Ardenne public and private healthcare institutions participating in the study. Sociodemographic, medical and outpatient data were collected. Patient satisfaction was measured using the Out-Patsat35 questionnaire. Eleven (out of 16) oncology day care centers and 441 patients participated in the study. Most of the patients were women (n=252, 57.1%) and the mean age was 61±12 years. The mean satisfaction score was 82±14 (out of 100) and the mean waiting time between the assigned appointment time and administration of chemotherapy was 97±60 min. This study has shown that waiting times are important. However, patients are satisfied with the healthcare organization, especially regarding nursing support. Early preparation of chemotherapy could improve these parameters. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Family physician-patient relationship and frequent attendance of primary and specialist health care: Results from a German population-based cohort study.

    Science.gov (United States)

    Dinkel, Andreas; Schneider, Antonius; Schmutzer, Gabriele; Brähler, Elmar; Häuser, Winfried

    2016-07-01

    To investigate the association between the quality of the family physician-patient relationship and frequent attendance of primary and specialist health care. Cross-sectional survey of a representative German population sample (N=2.266). Family physician-patient relationship was assessed with the Patient Doctor Relationship Questionnaire (PDRQ-9). Determinants of frequent attendance were analyzed using logistic regression. Frequent attendance of family physicians was associated with lower income (OR 1.43, 95% CI 1.02-2.00), not being in paid work (OR 1.58, CI 1.08-2.30), psychological distress (OR 1.14, CI 1.07-1.22), somatic symptoms (OR 1.07, CI 1.04-1.11), and physical comorbidity (OR 1.54, CI 1.36-1.74) in the multivariate analysis. Frequent attendance of specialists was related to psychological distress (OR 1.12, CI 1.04-1.20), somatic symptoms (OR 1.08, CI 1.04-1.11), and physical comorbidity (OR 1.69, CI 1.48-1.93) in the multivariate analysis. Quality of the relationship was associated with frequent attendance only in the univariate analyses. A stronger relationship with the family physician was not associated with reduced contact with specialists. The quality of the family physician-patient relationship is not independently associated with frequent attendance. Family physicians should be aware that need factors, i.e. symptom burden and physical comorbidities, are main drivers of frequent attendance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Women's Autonomy and Skilled Attendance During Pregnancy and Delivery in Nepal.

    Science.gov (United States)

    Kc, Situ; Neupane, Subas

    2016-06-01

    Objectives This study aims to explore the association between women's autonomy and skilled attendance during pregnancy and delivery in Nepal. Methods We adopt data from the Nepal Demographic and Health Survey (NDHS, 2011). We include only married women who gave birth in the 5 years preceding the survey (N = 4148). Women's autonomy was assessed on the basis of four indicators of decision making: healthcare, visiting friends or relatives, household purchases and spending earned money. Each indicator was dichotomized (yes/no) and then summarized into a single variable to measure overall autonomy. Next, we measured health attendance (skilled vs. unskilled) during antenatal and delivery care. The association between women's autonomy and skilled attendance was analysed using a logistic regression model. Results Most women had a medium (40 %) and high (35 %) level of overall autonomy. The proportion of women accessing skilled providers during antenatal and delivery care was 51 and 36 %. Women with autonomy in healthcare, visiting friends or relatives, making household purchases and spending money earned were associated with a higher likelihood of receiving care from skilled providers during antenatal care and delivery. An elevated probability of access to skilled attendance during antenatal (aOR 1.33; 95 % CI 1.10-1.59) and delivery care (aOR 1.38; 95 % CI 1.12-1.70) was reported among women with higher levels of overall autonomy. Conclusion Women's autonomy was significantly associated with the maternal health care utilization by skilled attendants. This study will provide insights for policy makers to develop strategies in improving maternal health.

  14. Value Imposition in Day Care: Fact, Fancy, and Irrelevant?

    Science.gov (United States)

    Horner, William C.

    1977-01-01

    A questionnaire addressed to 70 parents and 30 staff members of an early intervention program revealed no substantial discrepancies in their respective evaluations of a number of child behavior characteristics (mainly social). Even when parents subjectively perceived some value dissonance, their satisfaction with the day care program was not…

  15. Playful Actions as a Sign of Togetherness in Day Care Centres.

    Science.gov (United States)

    Hannikainen, Maritta

    2001-01-01

    Examined observational data on daily activities in a day care center to articulate different manifestations of playful actions and analyze their role in creating and maintaining togetherness. Found that, in their play, children were subjects and active agents in creating their own culture, realized throughout the day by means of humor, fantasy,…

  16. Day hospital as an alternative to inpatient care for cancer patients: a random assignment trial.

    Science.gov (United States)

    Mor, V; Stalker, M Z; Gralla, R; Scher, H I; Cimma, C; Park, D; Flaherty, A M; Kiss, M; Nelson, P; Laliberte, L

    1988-01-01

    A stratified, random-assignment trial of 442 cancer patients was conducted to evaluate medical, psychosocial, and financial outcomes of day hospital treatment as an alternative to inpatient care for certain cancer patients. Eligible patients required: a 4- to 8-hour treatment plan, including chemotherapy and other long-term intravenous (i.v.) treatment; a stable cardiovascular status; mental competence; no skilled overnight nursing; and a helper to assist with home care. Patients were ineligible if standard outpatient treatment was possible. No statistically significant (p less than 0.05) differences were found between the Adult Day Hospital (ADH) and Inpatient care in medical or psychosocial outcomes over the 60-day study period. The major difference was in medical costs--approximately one-third lower for ADH patients (p less than 0.001) than for the Inpatient group. The study demonstrates that day hospital care of medical oncology patients is clinically equivalent to Inpatient care, causes no negative psychosocial effects, and costs less than Inpatient care. Findings support the trend toward dehospitalization of medical treatment.

  17. Effects of health insurance on non-working married women's medical care use and bed days at home.

    Science.gov (United States)

    Lee, Changwoo; Shin, Euichul

    2013-07-01

    This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual's health insurance status. This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. In contrast to previous studies' findings indicating that absences from work and medical care use among working males may be complements, this study's results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements.

  18. [Day hospital in internal medicine: A chance for ambulatory care].

    Science.gov (United States)

    Grasland, A; Mortier, E

    2018-04-16

    Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems. Using preferentially email for communication, the general practitioners can contact an internist who is committed to respond on the same day and take over the patient within 7 days if day-hospital is appropriate for his condition. The other patients are directed either to the emergency department, consultation or full hospitalization. In 14 months, the center has received 213 (144 women, 69 men) patients, mean age 53.6, addressed by 88 general practitioners for 282 day-hospital sessions. Requests included problem diagnoses (n=105), synthesis reviews for complex patients (n=65), and treatment (n=43). In the ambulatory shift advocated by the authorities, this experience shows that internal medicine should engage in the recognition of day-hospital as a place for diagnosis and synthesis reviews connected with the city while leaving the general practitioners coordinator of their patient care. This activity of synthesis in day-hospital is useful for the patients and efficient for our healthcare system. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  19. Electronic medical file exchange between on-duty care providers and the attending paediatrician: a Belgian paediatric pilot project.

    Science.gov (United States)

    Deneyer, M; Hachimi-Idrissi, S; Michel, L; Nyssen, M; De Moor, G; Vandenplas, Y

    2012-01-01

    The authors propose the introduction of a pilot project: "paediatric core file exchange in emergencies" (PCF-EXEM) which enables the exchange of medical data between the attending paediatrician (AP), holder of the medical record, and on-duty medical units (i.e. general practitioners, paediatricians, surgeons, emergency physicians,...). This project is based on two pillars: a protected server (PCF-server) containing paediatric core files (PCF), with important clinical data that should be available for the physician in order to quickly get a clear insight into the relevant clinical medical history of the child, and secondly, the possibility to provide feedback to the attending physician about the findings recorded during the on-call duty. The permanent availability of health data on the PCF-server and the possibility to provide feedback represent together the PCF-EXEM-project. This project meets the demand of the care providers to have relevant medical information permanently available in order to guarantee high quality care in emergency situations. The frail balance between the right to informative privacy and professional confidentiality on the one hand and the right to quality health care on the other hand has been taken into account. The technical and practical feasibility of this project is described. The objectives and vision of the PCF-EXEM project are conform to Belgian legislation concerning the processing of medical data and are in line with the still under consideration European projects which are focusing on interoperability and the development of a common access control to databanks containing health data for care providers. PCF-EXEM could therefore be a model for other EU countries as well.

  20. Ecological factors regulating brood attendance patterns of the western sandpiper calidris mauri

    Science.gov (United States)

    Ruthrauff, D.R.; Keller, J.N.; Rizzolo, D.J.

    2009-01-01

    Parental brood attendance patterns vary greatly among shorebird species. For monogamous calidridine species, biparental care with female-first brood departure is most common. It is believed that adult sandpipers balance potential individual survival costs associated with extended parental care against the benefit gained by their brood of prolonged parental care. These costs and benefits are difficult to quantify and factors affecting the termination of parental brood attendance are unclear. We compared clutch size, nesting phenology, and parental attendance patterns of Western Sandpipers Calidris mauri at Nome and Kanaryarmiut, Alaska, sites separated by three degrees of latitude. The sites differed in breeding density and duration of breeding season, but the distribution of clutch sizes did not differ between sites or between nesting attempts. Parental attendance patterns were similar between sites, suggesting that parental attendance is a highly conserved life-history trait in Western Sandpipers. Male Western Sandpipers attended broods longer than females, and the duration of parental attendance decreased at a similar rate for both sexes as the season progressed. Male and female Western Sandpipers undertake differential migrations to their non-breeding grounds, with males typically settling at more northerly locations and females at more southerly sites, a migration pattern shared by certain other monogamous calidridine species. These same species exhibit similar parental brood attendance patterns, suggesting the strong role of overall migration distance in shaping the expression of parental attendance behaviours. A contrast of more geographically disjunct sites coupled with a better understanding of the migratory connectivity between Western Sandpiper breeding and non-breeding populations would elucidate the role of cross-seasonal effects on parental brood attendance decisions. ?? 2009 British Ornithologists' Union.

  1. Awareness of the Care Team in Electronic Health Records

    Science.gov (United States)

    Vawdrey, D.K.; Wilcox, L.G.; Collins, S.; Feiner, S.; Mamykina, O.; Stein, D.M.; Bakken, S.; Fred, M.R.; Stetson, P.D.

    2011-01-01

    Objective To support collaboration and clinician-targeted decision support, electronic health records (EHRs) must contain accurate information about patients’ care providers. The objective of this study was to evaluate two approaches for care provider identification employed within a commercial EHR at a large academic medical center. Methods We performed a retrospective review of EHR data for 121 patients in two cardiology wards during a four-week period. System audit logs of chart accesses were analyzed to identify the clinicians who were likely participating in the patients’ hospital care. The audit log data were compared with two functions in the EHR for documenting care team membership: 1) a vendor-supplied module called “Care Providers”, and 2) a custom “Designate Provider” order that was created primarily to improve accuracy of the attending physician of record documentation. Results For patients with a 3–5 day hospital stay, an average of 30.8 clinicians accessed the electronic chart, including 10.2 nurses, 1.4 attending physicians, 2.3 residents, and 5.4 physician assistants. The Care Providers module identified 2.7 clinicians/patient (1.8 attending physicians and 0.9 nurses). The Designate Provider order identified 2.1 clinicians/patient (1.1 attending physicians, 0.2 resident physicians, and 0.8 physician assistants). Information about other members of patients’ care teams (social workers, dietitians, pharmacists, etc.) was absent. Conclusions The two methods for specifying care team information failed to identify numerous individuals involved in patients’ care, suggesting that commercial EHRs may not provide adequate tools for care team designation. Improvements to EHR tools could foster greater collaboration among care teams and reduce communication-related risks to patient safety. PMID:22574103

  2. [Variation in the pathology attended in out-patient Neurology Clinics: a demented future].

    Science.gov (United States)

    Morera-Guitart, J; Pedro Cano, M J

    2003-10-01

    We analyze the changes observed between 1996 and 2001 in the distribution of the pathology attended and the follow up model used by the out-patient Neurology Clinic in the Marina Alta area, in order to confirm possible variations that may have repercussions for Human Resource needs in the provision of adequate neurological care. We prospectively registered the attendance records for visits made to the Out-patient Neurology Clinic of Marina Alta in 1996. The variation coefficients between both series were calculated and compared. The average age of patients increased in 5 years. The number of patients attended increased 42.3%, new patients 40%, visits 13%, the "Review visit/First Visit" ratio reduced 29%. The attendance of patients with Cognitive Impairment (Cog. Imp.) doubled. There were no changes in the origins of the patients. Requests due to Cog. Imp. and parkinsonism increased significantly from Primary Care and Emergency Department. The delay to be attended increased 23%. Discharges increased 43.9%, highlighting an increase of 144% observed in the Cog. Imp. group. Changes have been observed in: the age of the population studied; the follow up of patients; the delay in attending them; and the pathology attended, with a significant increase in demand due to neurodegenerative pathology (especially Cog. Imp.). All this requires an increase in care needs that the Health Service has not been able to assume, creating an incongruous care model: we suggest a direct follow up model and offer a consultancy model.

  3. Self-reported practices among traditional birth attendants surveyed in western Kenya: a descriptive study.

    Science.gov (United States)

    Bucher, Sherri; Konana, Olive; Liechty, Edward; Garces, Ana; Gisore, Peter; Marete, Irene; Tenge, Constance; Shipala, Evelyn; Wright, Linda; Esamai, Fabian

    2016-08-12

    The high rate of home deliveries conducted by unskilled birth attendants in resource-limited settings is an important global health issue because it is believed to be a significant contributing factor to maternal and newborn mortality. Given the large number of deliveries that are managed by unskilled or traditional birth attendants outside of health facilities, and the fact that there is on-going discussion regarding the role of traditional birth attendants in the maternal newborn health (MNH) service continuum, we sought to ascertain the practices of traditional birth attendants in our catchment area. The findings of this descriptive study might help inform conversations regarding the roles that traditional birth attendants can play in maternal-newborn health care. A structured questionnaire was used in a survey that included one hundred unskilled birth attendants in western Kenya. Descriptive statistics were employed. Inappropriate or outdated practices were reported in relation to some obstetric complications and newborn care. Encouraging results were reported with regard to positive relationships that traditional birth attendants have with their local health facilities. Furthermore, high rates of referral to health facilities was reported for many common obstetric emergencies and similar rates for reporting of pregnancy outcomes to village elders and chiefs. Potentially harmful or outdated practices with regard to maternal and newborn care among traditional birth attendants in western Kenya were revealed by this study. There were high rates of traditional birth attendant referrals of pregnant mothers with obstetric complications to health facilities. Policy makers may consider re-educating and re-defining the roles and responsibilities of traditional birth attendants in maternal and neonatal health care based on the findings of this survey.

  4. Why September Matters: Improving Student Attendance. Policy Brief

    Science.gov (United States)

    Olsen, Linda S.

    2014-01-01

    This brief examines absences in September and students' attendance over the rest of the year. Attendance should be addressed before it becomes problematic. Chronic absenteeism, missing more than 20 days of a school year, is an early indicator of disengagement. High absence rates have negative consequences not only for individual students, but also…

  5. Outbreaks of Streptococcus pneumoniae carriage in day care cohorts in Finland – implications for elimination of transmission

    Directory of Open Access Journals (Sweden)

    Auranen Kari

    2009-06-01

    Full Text Available Abstract Background Day care centre (DCC attendees play a central role in maintaining the circulation of Streptococcus pneumoniae (pneumococcus in the population. Exposure within families and within DCCs are the main risk factors for colonisation with pneumococcal serotypes in DCC attendees. Methods Transmission of serotype specific carriage was analysed with a continuous time event history model, based on longitudinal data from day care attendees and their family members. Rates of acquisition, conditional on exposure, were estimated in a Bayesian framework utilising latent processes of carriage. To ensure a correct level of exposure, non-participating day care attendees and their family members were included in the analysis. Posterior predictive simulations were used to quantify transmission patterns within day care cohorts, to estimate the basic reproduction number for pneumococcal carriage in a population of day care cohorts, and to assess the critical vaccine efficacy against carriage to eliminate pneumococcal transmission. Results The model, validated by posterior predictive sampling, was successful in capturing the strong temporal clustering of pneumococcal serotypes in the day care cohorts. In average 2.7 new outbreaks of pneumococcal carriage initiate in a day care cohort each month. While 39% of outbreaks were of size one, the mean outbreak size was 7.6 individuals and the mean length of an outbreak was 2.8 months. The role of families in creating and maintaining transmission was minimal, as only 10% of acquisitions in day care attendees were from family members. Considering a population of day care cohorts, a child-to-child basic reproduction number was estimated as 1.4 and the critical vaccine efficacy against acquisition of carriage as 0.3. Conclusion Pneumococcal transmission occurs in serotype specific outbreaks of carriage, driven by within-day-care transmission and between-serotype competition. An amplifying effect of the day

  6. Frequency and characteristics of individuals with seasonal pattern among depressive patients attending primary care in France.

    Science.gov (United States)

    Azorin, Jean-Michel; Adida, Marc; Belzeaux, Raoul

    2015-01-01

    High rates of bipolar disorder (BD) have been found among major depressives with seasonal pattern (SP) consulting in psychiatric departments, as well as among patients seeking primary care. As SP was reported to be common in the latter, the current study was designed to assess (a) the frequency and characteristics of SP among major depressives attending primary care and (b) the prevalence and aspects of BD in this population. Among 400 patients who consulted French general practitioners (GPs) for major depression between February and December 2010, 390 could be included in the study: 167 (42.8%) met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for seasonal pattern [SP(+)], whereas 223 (57.2%) did not meet these criteria [SP(-)]. The two groups were compared on demographic, clinical, family history and temperamental characteristics. Compared to SP(-), SP(+) patients were more frequently female, married and with a later age at first depressive episode, and showed more atypical vegetative symptoms, comorbid bulimia and stimulant abuse. They also exhibited more lifetime depressive episodes, were more often diagnosed as having BD II and met more often bipolarity specifier criteria, with higher rates of bipolar temperaments and a higher BD family loading. Among SP(+) patients, 68.9% met the bipolarity specifier criteria, whereas 31.1% did not. Seasonality was not influenced by climatic conditions. The following independent variables were associated with SP: BD according to bipolarity specifier, female gender, comorbid bulimia nervosa, hypersomnia, number of depressive episodes and family history of substance abuse. Seasonal pattern is frequent among depressive patients attending primary care in France and may be indicative of hidden bipolarity. Given the risks associated with both SP and bipolarity, GPs are likely to have a major role in regard to prevention. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Changing the role of the traditional birth attendant in Somaliland.

    Science.gov (United States)

    Pyone, Thidar; Adaji, Sunday; Madaj, Barbara; Woldetsadik, Tadesse; van den Broek, Nynke

    2014-10-01

    To explore the feasibility of changing the role of the traditional birth attendant (TBA) to act as birth companion and promoter of skilled birth attendance. Between 2008 and 2012, 75 TBAs received 3days of training and were paid US $5 for each patient brought to any of five healthcare facilities in Maroodi Jeex, Somaliland. Health facilities were upgraded (infrastructure, drugs and equipment, staff training, and incentivization). Eight key informant interviews (KIIs) and 10 focus group discussions (FGDs) involving 32 TBAs and 32 mothers were conducted. A framework approach was used for analysis. TBAs adopted their new role easily; instead of conducting home births and referring women to a facility only at onset of complications, they accompanied or referred mothers to a nearby facility for delivery, prenatal care, or postnatal care. Both TBAs and mothers accepted this new role, resulting in increased deliveries at health facilities. Facilitating factors included the creation of an enabling environment at the health facility, acceptance of the TBA by health facility staff, and monetary incentivization. Changing the role of the TBA to support facility-based delivery is feasible and acceptable. Further research is needed to see whether this is replicable and can be scaled-up. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  8. Growing Healthy Bodies: Nutrition Education for Day Care Providers.

    Science.gov (United States)

    Viebrock, Margaret A.; Berry, Holly

    This booklet discusses the important role that day care providers can play in ensuring that children eat healthy snacks and meals and learn good eating habits. Section one of the booklet examines snack foods, discusses the difference between nutritious and less-nutritious snacks, and recommends snack foods appropriate for different age groups.…

  9. Dental caries, age and anxiety: factors influencing sedation choice for children attending for emergency dental care.

    Science.gov (United States)

    Carson, P; Freeman, R

    2001-02-01

    The aim of the study was to examine how physical (dental caries) and psychosocial (age, dental anxiety and dental health behaviour) factors, associated with child and parent, influenced dentists' sedation choice when a child presents in pain. 600 parents whose children were aged between 5 and 11 years took part: 200 attended for routine dental care (RDC); the remaining 400 attended as emergency patients and were offered either dental general anaesthesia (DGA) or relative analgesia (RA). The subjects were approached and invited to take part. The researcher was blind as to the child's pattern of dental attendance and the type of sedation offered. All parents and children completed self-reported ratings of dental anxiety. The children's teeth were examined to determine past and present dental caries experience. The results showed that children who were offered DGA had greater experience of dentinal caries, were younger and dentally anxious. The children offered RA were older, had a higher frequency of brushing their teeth with fluoride toothpaste and were also dentally anxious. Discriminant analysis showed that 2 canonical functions provided clear categorisation of the three treatment groups. Function 1 was a physical (dental caries) factor, which was related to the child's experience of dentinal caries. Function 2 was a psychosocial factor, which was related to the child's age, dental anxiety and frequency of tooth brushing. A greater proportion of the variance in the treatment offered was explained by Function 1, suggesting that the most important factor in the decision to offer DGA was dentinal caries. Function 2 was of lesser importance. The findings have implications for the type of sedation offered to children presenting for emergency care. These children may not otherwise receive treatment and the need to provide less anxiety provoking forms of sedation must be promoted. By doing so, parents who have only brought their children when in pain may take advantage

  10. Care for overweight children attending the 5-year preventive child health examination in general practice.

    Science.gov (United States)

    Andersen, Merethe Kousgaard; Christensen, Bo; Søndergaard, Jens

    2013-02-01

    The purpose of this study was to analyse general practitioners' (GPs) care for children with a weight-for-height above normal based on the GPs' clinical evaluation, that is, 'GP-assessed overweight'. This study is a cross-sectional survey targeting GPs' care for children with GP-assessed overweight at the 5-year preventive child health examination (PCHE). Out of 1135 children attending the 5-year PCHE, 171 were assessed overweight by the GP. According to the Danish body mass index (kg/m(2)) growth charts, 147 children were overweight. The GPs addressed their concern about the child's weight to the parents in 58% of the 171 cases with GP-assessed overweight. The national guideline was reported consulted in 6% of the cases. Diet, physical activity and dispositions were evaluated by the GPs in 68%, 57% and 34% of cases, respectively. An appointment for a follow-up was made in 12% of cases. Various care activities were carried out for most children with GP-assessed overweight at the 5-year PCHE. However, the GP did not raise concern about the child's weight with the parents in almost one third of the children. It seems that there is a potential for improving the overweight care at the 5-year PCHE beginning with the involvement of the parents.

  11. SPECTRUM OF EXTRA PULMONARY TUBERCULAR PATIENTS ATTENDING A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Seema Dayal

    2013-01-01

    Full Text Available Background: Extra pulmonary tuberculosis is increasing day by day. Even it has reversed the epidemiological trend of pulmonary tuberculosis. Over the last several years reported EPTB was increasing in absolute numbers and in proportion of all reported cases of tuberculosis, however similar studies from high burden Etawah district with high prevalence of HIV are lacking .Therefore, we have conducted this study to investigate clinical and pathological features of EPTB. Material & Method: The study was conducted on 925 clinically suspective tubercular patients who attended pathology department. They were compared in terms of age, sex, and site. Result: Out of the 925 clinically suspective extra pulmonary tubercular patients, 900 was diagnosed as EPTB patients. Females had higher proportion (51.77% of EPTB than males (48.22%. EPTB was more common in young age (20-29 years in males, where as in females common in (40-49 years age group. Most common site was lymph node (58% followed by Abdominal (13% urogenital (13%osteoarticular (12%, miliary (2%, CNS (1% and skin(1%. Conclusion: Out data suggest that EPTB was relatively common in young age in males and in latter group in females gender. Lymph node tuberculosis was most common site in both males and females. Tuberculosis control programmed may targets these population for EPTB case finding.

  12. Premenstrual symptoms and remedies practiced by Malaysian women attending a rural primary care clinic

    Directory of Open Access Journals (Sweden)

    Khairani Omar

    2009-06-01

    Method: This was a cross-sectional study conducted at a rural primary care clinic situated in Hulu Langat, Malaysia. All women of reproductive age (18 to 44 years old attending the clinic during the study period and who fit the selection criteria were included. Premenstrual symptoms and severity were assessed using a self-report questionnaire, the Shortened Premenstrual Assessment Form (SPAF. It consists of 10 items that measure changes in mood, behaviour and physical symptoms. The respondents were also asked if they had used any remedy to relieve their symptoms. Results: A total of 158 women were included in the study. The majority of the respondents were Malay (70.3%, followed by Indian (16.5% and Chinese (10.8% women. About 75% of the women experienced at least one of the premenstrual symptoms. Approximately 7% of them reported experiencing severe symptoms in all three subscales of the SPAF. The frequently reported symptoms were body ache (75.3%, abdominal pain (75.3%, irritable feeling (63.9% and breast discomfort (61.4%. The symptom score was higher among Malay women (p = 0.034, and those with a higher household income (p = 0.037 and higher educational level (p = 0.01. There was no significant association between premenstrual symptoms and age, marital status, menstrual cycle and age of menarche. The common remedies used were vitamins (19%, a healthy diet (15.8% and analgesics (13.3%. Approximately 60% of the women did not use any remedy to reduce their premenstrual symptoms. Conclusion: Premenstrual symptoms were common among women attending the clinic. The symptoms affect them significantly both physically and emotionally. Thus, it is essential for primary care providers to take an active role in identifying, educating and managing premenstrual symptoms among women.

  13. Utilization of skilled birth attendants in public and private sectors in Vietnam.

    Science.gov (United States)

    Do, Mai

    2009-05-01

    The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women's decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women's household wealth, education, antenatal care and community's wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services.

  14. Viewpoints of the members of the workers' retirement centers in Tehran about elderly day care centers (2012

    Directory of Open Access Journals (Sweden)

    Hosein Rohani

    2014-02-01

    Full Text Available Background: There is no documented evidence regarding elderly day care centers in Iran. This needs analysis study was conducted to investigate the demand for elderly day care centers in Tehran. Methods: This cross-sectional study was conducted recruiting 210 participants aged over 60 who were members of the elderly retirement centers in Tehran in 2012. Data were gathered by Kansas state university questionnaire and analyzed using Mann-Whitney and Kruskal-Wallis tests. Results: About 80% of participants were men with the mean age of 67.5±5.23 years. Results showed that male (P<0.001, married (P=0.01 and literate elderly (P<0.001, and those living in rental homes (P<0.001 expressed a greater need for elderly day care centers. There was no statistically significant relationship between the lifestyle (P=0.051 and income (P=0.08 of the participants and demand for elderly day care centers. Conclusion: Given the rising population of the elderly and their high demand for day care centers, it is necessary to establish well-equipped day care centers for this group of people. Also, these centers may reduce the burden of care for the aged people on public services and family care givers.

  15. Young Children in Day and Night Care: Negotiating and Constructing Belonging during Daily Arrivals

    Science.gov (United States)

    Salonen, Eija; Laakso, Marja-Leena; Sevón, Eija

    2016-01-01

    The paper aims at understanding the processes related to young children's belonging during daily arrivals at day and night care. Two aspects of a child's belonging are considered: membership and sense of belonging. Data were gathered by ethnographic observation of 8 children aged from 20 to 36 months in two Finnish day care centres offering day…

  16. Understanding reasons for asthma outpatient (non)‐attendance and exploring the role of telephone and e‐consulting in facilitating access to care: exploratory qualitative study

    Science.gov (United States)

    van Baar, J D; Joosten, H; Car, J; Freeman, G K; Partridge, M R; van Weel, C; Sheikh, A

    2006-01-01

    Objective To understand factors influencing patients' decisions to attend for outpatient follow up consultations for asthma and to explore patients' attitudes to telephone and email consultations in facilitating access to asthma care. Design Exploratory qualitative study using in depth interviews. Setting Hospital outpatient clinic in West London. Participants Nineteen patients with moderate to severe asthma (12 “attenders” and 7 “non‐attenders”). Results Patients' main reasons for attending were the wish to improve control over asthma symptoms and a concern not to jeopardise the valued relationship with their doctor. Memory lapses, poor health, and disillusionment with the structure of outpatient care were important factors implicated in non‐attendance. The patients were generally sceptical about the suggestion that greater opportunity for telephone consulting might improve access to care. They expressed concerns about the difficulties in effectively communicating through non‐face to face media and were worried that clinicians would not be in a position to perform an adequate physical examination over the telephone. Email and text messaging were viewed as potentially useful for sending appointment reminders and sharing clinical information but were not considered to be acceptable alternatives to the face to face clinic encounter. Conclusions Memory lapses, impaired mobility due to poor health, and frustration with outpatient clinic organisation resulting in long waiting times and discontinuity of care are factors that deter patients from attending for hospital asthma assessments. The idea of telephone review assessments was viewed with scepticism by most study subjects. Particular attention should be given to explaining to patients the benefits of telephone consultations, and to seeking their views as to whether they would like to try them out before replacing face to face consultations with them. Email and text messaging may have a role in issuing

  17. The Preventable Admissions Care Team (PACT): A Social Work-Led Model of Transitional Care.

    Science.gov (United States)

    Basso Lipani, Maria; Holster, Kathleen; Bussey, Sarah

    2015-10-01

    In 2010, the Preventable Admissions Care Team (PACT), a social work-led transitional care model, was developed at Mount Sinai to reduce 30-day readmissions among high-risk patients. PACT begins with a comprehensive bedside assessment to identify the psychosocial drivers of readmission. In partnership with the patient and family, a patient-centered action plan is developed and carried out through phone calls, accompaniments, navigations and home visits, as needed, in the first 30 days following discharge. 620 patients were enrolled during the pilot from September 2010-August 2012. Outcomes demonstrated a 43% reduction in inpatient utilization and a 54% reduction in emergency department visits among enrollees. In addition, 93% of patients had a follow-up appointment within 7-10 days of discharge and 90% of patients attended the appointment. The success of PACT has led to additional funding from the Centers for Medicare and Medicaid Services under the Community-based Care Transitions Program and several managed care companies seeking population health management interventions for high risk members.

  18. Psychosocial impact of infertility among women attending Yusuf ...

    African Journals Online (AJOL)

    Psychosocial impact of infertility among women attending Yusuf Dantsoho Memorial ... support, along with a General Health Questionnaire and a family APGAR as ... inability to enjoy day to day activities (11.2%), lack of concentration at work ...

  19. Predictors of Antenatal Care, Skilled Birth Attendance, and Postnatal Care Utilization among the Remote and Poorest Rural Communities of Zambia: A Multilevel Analysis.

    Science.gov (United States)

    Jacobs, Choolwe; Moshabela, Mosa; Maswenyeho, Sitali; Lambo, Nildah; Michelo, Charles

    2017-01-01

    Optimal utilization of maternal health-care services is associated with reduction of mortality and morbidity for both mothers and their neonates. However, deficiencies and disparity in the use of key maternal health services within most developing countries still persist. We examined patterns and predictors associated with the utilization of specific indicators for maternal health services among mothers living in the poorest and remote district populations of Zambia. A cross-sectional baseline household survey was conducted in May 2012. A total of 551 mothers with children between the ages 0 and 5 months were sampled from 29 catchment areas in four rural and remote districts of Zambia using the lot quality assurance sampling method. Using multilevel modeling, we accounted for individual- and community-level factors associated with utilization of maternal health-care services, with a focus on antenatal care (ANC), skilled birth attendance (SBA), and postnatal care (PNC). Utilization rates of focused ANC, SBA, and PNC within 48 h were 30, 37, and 28%, respectively. The mother's ability to take an HIV test and receiving test results and uptake of intermittent preventive treatment for malaria were positive predictors of focused ANC. Receiving ANC at least once from skilled personnel was a significant predictor of SBA and PNC within 48 h after delivery. Women who live in centralized rural areas were more likely to use SBA than those living in remote rural areas. Utilization of maternal health services by mothers living among the remote and poor marginalized populations of Zambia is much lower than the national averages. Finding that women that receive ANC once from a skilled attendant among the remote and poorest populations are more likely to have a SBA and PNC, suggests the importance of contact with a skilled health worker even if it is just once, in influencing use of services. Therefore, it appears that in order for women in these marginalized communities to

  20. The effectiveness of vaccine day and educational interventions on influenza vaccine coverage among health care workers at long-term care facilities.

    Science.gov (United States)

    Kimura, Akiko C; Nguyen, Christine N; Higa, Jeffrey I; Hurwitz, Eric L; Vugia, Duc J

    2007-04-01

    We examined barriers to influenza vaccination among long-term care facility (LTCF) health care workers in Southern California and developed simple, effective interventions to improve influenza vaccine coverage of these workers. In 2002, health care workers at LTCFs were surveyed regarding their knowledge and attitudes about influenza and the influenza vaccine. Results were used to develop 2 interventions, an educational campaign and Vaccine Day (a well-publicized day for free influenza vaccination of all employees at the worksite). Seventy facilities were recruited to participate in an intervention trial and randomly assigned to 4 study groups. The combination of Vaccine Day and an educational campaign was most effective in increasing vaccine coverage (53% coverage; prevalence ratio [PR]=1.45; 95% confidence interval [CI]=1.24, 1.71, compared with 27% coverage in the control group). Vaccine Day alone was also effective (46% coverage; PR= 1.41; 95% CI=1.17, 1.71). The educational campaign alone was not effective in improving coverage levels (34% coverage; PR=1.18; 95% CI=0.93, 1.50). Influenza vaccine coverage of LTCF health care workers can be improved by providing free vaccinations at the worksite with a well-publicized Vaccine Day.

  1. Perceptions of focused prenatal care among women attending two tertiary centers in Nigeria.

    Science.gov (United States)

    Eleje, George U; Onwusulu, Daniel N; Ezeama, Chukwuemeka O; Afiadigwe, Evaristus A; Eke, Ahizechukwu C; Ikechebelu, Joseph I; Ugboaja, Joseph O; Okwuosa, Ayodele O

    2015-11-01

    To determine women's perceptions and expectations of focused prenatal care visits. The present questionnaire-based, cross-sectional survey was performed among pregnant women in their third trimester attending two tertiary health centers in southern Nigeria between January and March 2012. Obstetric data, histories, and information on preferences for prenatal visits were obtained using questionnaires. A total of 353 questionnaires were appropriately completed. Among 277 participants who stated a preference for the number of prenatal care visits, 241 (87.0%) reported a preference of more than four. Among 203 parous women, 132 (65.0%) had no previous negative obstetric experience. Only previous stillbirth (odds ratio [OR] 2.67, 95% confidence interval [CI] 1.05-6.77; P = 0.039) among multiparous women, and HIV/AIDS (OR 0.27, 95% CI 0.06-1.17; P = 0.048) among all women were significantly associated with a preference for more prenatal visits. Previous negative obstetric experiences did not generally affect preference for prenatal visits. However, pregnant women expressed dissatisfaction with a reduced number of visits. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  2. Home iv antibiotic therapy through a medical day care unit

    OpenAIRE

    Gourdeau, Marie; Deschênes, Louise; Caron, Martine; Desmarais, Marc

    1993-01-01

    An out-patient parenteral antibiotic therapy program provided through a medical day care unit was evaluated in a tertiary care hospital. From July 11, 1988 to December 31, 1990, 122 patients were treated either on site at the unit or at home with self-administered intravenous antibiotics. In all, 142 courses of parenteral antibiotics (mostly cephalosporins and clindamycin) were given for a total of 124 infections, mostly bone and soft tissue infections (67 of 124, 54%). The duration of out-pa...

  3. Ventilation, indoor air quality, and human health and comfort in dwellings and day-care centers

    Energy Technology Data Exchange (ETDEWEB)

    Ruotsalainen, R.

    1995-12-31

    The objective of the study was to assess the actual ventilation and indoor air quality in the Finnish building stock (dwellings and day-care centers) with special reference to the existing guideline values. Furthermore, the objective was to evaluate the occurrence of symptoms and perceptions among occupants (adult residents, children, workers) in relation to ventilation system, ventilation rate and dampness. The measurements of ventilation and indoor air quality in the dwellings and day-care centers included ventilation rate, CO{sub 2} concentration, and temperature and humidity. Self- and parent-administered questionnaires were distributed to the occupants inquiring their personal characteristics, occurrence of symptoms of interest, perceived indoor air quality and details of their home and work environments. Airflows and air change rates varied remarkably both in the dwellings and day-care centers. In the majority of the dwellings and day-care centers, the Finnish guideline values of ventilation rates were not achieved. No consistent associations were observed between the magnitude of mechanical ventilation rates and the occurrence of eye, respiratory, skin and general symptoms, that is, symptoms of sick building syndrome (SBS) among the day-care workers. The results indicate that there is much room for improvement in the ventilation and indoor air quality of Finnish dwellings and day-care centers. The control of ventilation, temperature and humidity and the prevention of water damage are important issues on which to concentrate in the future. There is need to improve the quality in all phases of construction: design, installation, adjustment, operation, and maintenance

  4. Ventilation, indoor air quality, and human health and comfort in dwellings and day-care centers

    Energy Technology Data Exchange (ETDEWEB)

    Ruotsalainen, R

    1996-12-31

    The objective of the study was to assess the actual ventilation and indoor air quality in the Finnish building stock (dwellings and day-care centers) with special reference to the existing guideline values. Furthermore, the objective was to evaluate the occurrence of symptoms and perceptions among occupants (adult residents, children, workers) in relation to ventilation system, ventilation rate and dampness. The measurements of ventilation and indoor air quality in the dwellings and day-care centers included ventilation rate, CO{sub 2} concentration, and temperature and humidity. Self- and parent-administered questionnaires were distributed to the occupants inquiring their personal characteristics, occurrence of symptoms of interest, perceived indoor air quality and details of their home and work environments. Airflows and air change rates varied remarkably both in the dwellings and day-care centers. In the majority of the dwellings and day-care centers, the Finnish guideline values of ventilation rates were not achieved. No consistent associations were observed between the magnitude of mechanical ventilation rates and the occurrence of eye, respiratory, skin and general symptoms, that is, symptoms of sick building syndrome (SBS) among the day-care workers. The results indicate that there is much room for improvement in the ventilation and indoor air quality of Finnish dwellings and day-care centers. The control of ventilation, temperature and humidity and the prevention of water damage are important issues on which to concentrate in the future. There is need to improve the quality in all phases of construction: design, installation, adjustment, operation, and maintenance

  5. Influence of the day care, home and neighbourhood environment on young children's physical activity and health

    DEFF Research Database (Denmark)

    Christian, Hayley; Maitland, Clover; Enkel, Stephanie

    2016-01-01

    to determine outdoor location of physical activity around the home and neighbourhood for a subsample (n=310). The day care environment will be objectively measured using a validated audit tool. Other potential individual, social and physical environmental influences on preschoolers' physical activity...... such as long day care. Research is required to determine how the design of day care outdoor (and indoor) spaces provides opportunities or constraints for physical activity. A significant evidence gap surrounds what objectively measured attributes of the home and neighbourhood environment influence preschoolers......' physical activity. The PLAY Spaces & Environments for Children's Physical Activity (PLAYCE) study will empirically investigate the relative and cumulative influence of the day care, home and neighbourhood environment on preschoolers' physical activity. METHODS AND ANALYSIS: The PLAYCE study is a cross...

  6. Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review.

    Science.gov (United States)

    Vieira, Claudia; Portela, Anayda; Miller, Tina; Coast, Ernestina; Leone, Tiziana; Marston, Cicely

    2012-01-01

    Improved access to skilled health personnel for childbirth is a priority strategy to improve maternal health. This study investigates interventions to achieve this where traditional birth attendants were providers of childbirth care and asks what has been done and what has worked? We systematically reviewed published and unpublished literature, searching 26 databases and contacting experts to find relevant studies. We included references from all time periods and locations. 132 items from 41 countries met our inclusion criteria and are included in an inventory; six were intervention evaluations of high or moderate quality which we further analysed. Four studies report on interventions to deploy midwives closer to communities: two studies in Indonesia reported an increase in use of skilled health personnel; another Indonesian study showed increased uptake of caesarean sections as midwives per population increased; one study in Bangladesh reported decreased risk of maternal death. Two studies report on interventions to address financial barriers: one in Bangladesh reported an increase in use of skilled health personnel where financial barriers for users were addressed and incentives were given to skilled care providers; another in Peru reported that use of emergency obstetric care increased by subsidies for preventive and maternity care, but not by improved quality of care. The interventions had positive outcomes for relevant maternal health indicators. However, three of the studies evaluate the village midwife programme in Indonesia, which limits the generalizability of conclusions. Most studies report on a main intervention, despite other activities, such as community mobilization or partnerships with traditional birth attendants. Many authors note that multiple factors including distance, transport, family preferences/support also need to be addressed. Case studies of interventions in the inventory illustrate how different countries attempted to address these

  7. Smartphone use during inpatient attending rounds: prevalence, patterns and potential for distraction.

    Science.gov (United States)

    Katz-Sidlow, Rachel J; Ludwig, Allison; Miller, Scott; Sidlow, Robert

    2012-10-01

    While there are numerous benefits of smartphone use for physicians, little is known about the negative effects of using these devices in the context of patient care. To assess resident and faculty smartphone use during inpatient attending rounds and its potential as a source of distraction during transfer of clinical information. Cross-sectional survey. University-affiliated public teaching hospital. All housestaff and inpatient faculty in the departments of Medicine and Pediatrics. Participants were asked about smartphone ownership, usage patterns during attending rounds, and whether team members had ever missed important data during rounds due to distraction from smartphones. Attendings were asked whether policies should be established for smartphone use during rounds. The overall response rate was 73%. Device ownership was prevalent (89% residents, 98% faculty), as was use of smartphones during inpatient rounds (57% residents, 28% attendings). According to self-reports, smartphones were used during rounds for patient care (85% residents, 48% faculty), reading/responding to personal texts/e-mails (37% residents, 12% faculty), and other non-patient care uses (15% residents, 0% faculty). Nineteen percent of residents and 12% of attendings believed they had missed important information because of distraction from smartphones. Residents and faculty agreed that smartphones "can be a serious distraction during attending rounds," and nearly 80% of faculty believed that smartphone policies should be established. Smartphone use during attending rounds is prevalent and can distract users during important information transfer. Attendings strongly favored the institution of formal policies governing appropriate smartphone use during inpatient rounds. Copyright © 2012 Society of Hospital Medicine.

  8. Effects of health insurance on non-working married women’s medical care use and bed days at home

    Science.gov (United States)

    2013-01-01

    Background This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual’s health insurance status. Method This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. Results The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. Conclusions In contrast to previous studies’ findings indicating that absences from work and medical care use among working males may be complements, this study’s results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements. PMID:23816313

  9. factors associated with late antenatal care attendance in selected

    African Journals Online (AJOL)

    Esem

    perception of no benefits derived from commencement of ... despite efforts to reverse the trend. ..... Table 4: Predictors of Late ANC attendance in Mpongwe and Ndola-logistic regression .... Institutional and Public Policy Factors Associated.

  10. Risk factors related to heartburn in pregnant women attending the antenatal care clinic, Rajavithi Hospital.

    Science.gov (United States)

    Kovavisarach, Ekachai; Phromsila, Raweewan

    2012-08-01

    To determine the risk factors related to heartburn in pregnant women attending the antenatal care clinic, Rajavithi Hospital. Self-reporting questionnaire about demographic data and risk factors related to heartburn in those pregnant women between May 1 and July 31, 2010. Heartburn was found in 55 out of 452 pregnant women (12.2%). There were no significant differences in demographic characteristics and risk factors between the heartburn and non-heartburn groups. Consumption of alcoholic drinks was a reversely significant risk factor of heartburn (OR 0.11, CI 0.01 to 0.78) (p = 0.005). Heartburn was not uncommon, and no associated factors were demonstrated.

  11. Salvadoran fathers' attendance at prenatal care, delivery, and postpartum care La presencia de los padres salvadoreños durante la atención prenatal, el parto y la atención posparto

    Directory of Open Access Journals (Sweden)

    Marion W. Carter

    2005-09-01

    Full Text Available OBJECTIVE: To provide a baseline perspective on the prevalence of Salvadoran men's attendance at prenatal care, delivery, and postpartum well-baby care and on sociodemographic factors associated with their attendance, with the goal of informing efforts to help men play more positive roles in maternal-child health. METHODS: The data came from the 2003 Salvadoran National Male Health Survey. The data focused on fathers (n = 418 and their most recent live-born child in the preceding five years. Factors associated with the fathers' participation in prenatal care visits, attendance at delivery, and participation in postnatal well-baby visits were explored using logistic and multinomial regression models. RESULTS: Ninety percent of the recent Salvadoran fathers who were surveyed participated in a prenatal care visit, attended the delivery, or participated in a postpartum well-baby care visit; 34% participated in all three of the activities. Attendance at delivery was most common, reported by 81% of fathers; the most common reason that subjects cited for not attending was that they had had to work. CONCLUSIONS: A large majority of the Salvadoran fathers participated in at least one prenatal care visit, delivery, or a postpartum well-baby care visit. While attendance alone does not necessarily indicate that men are supporting their partners, the results suggest that norms are in place for men to play positive roles in maternal-child health matters. Furthermore, the participation of fathers in these maternal and child health care activities may provide new opportunities to educate and further support men in both their own health and their family's health.OBJETIVO: Proporcionar información de base acerca de la frecuencia con la cual los hombres salvadoreños acuden a la atención prenatal, al parto y a la atención del bebé sano después del parto, así como acerca de los factores sociodemográficos que se asocian con su asistencia a esas actividades, a

  12. Weather and Tourism: Thermal Comfort and Zoological Park Visitor Attendance

    Directory of Open Access Journals (Sweden)

    David R. Perkins

    2016-03-01

    Full Text Available Weather events have the potential to greatly impact business operations and profitability, especially in outdoor-oriented economic sectors such as Tourism, Recreation, and Leisure (TRL. Although a substantive body of work focuses on the macroscale impacts of climate change, less is known about how daily weather events influence attendance decisions, particularly relating to the physiological thermal comfort levels of each visitor. To address this imbalance, this paper focuses on ambient thermal environments and visitor behavior at the Phoenix and Atlanta zoos. Daily visitor attendances at each zoo from September 2001 to June 2011, were paired with the Physiologically Equivalent Temperature (PET to help measure the thermal conditions most likely experienced by zoo visitors. PET was calculated using hourly atmospheric variables of temperature, humidity, wind speed, and cloud cover from 7 a.m. to 7 p.m. at each zoological park location and then classified based on thermal comfort categories established by the American Society of Heating and Air Conditioning Engineers (ASHRAE. The major findings suggested that in both Phoenix and Atlanta, optimal thermal regimes for peak attendance occurred within “slightly warm” and “warm” PET-based thermal categories. Additionally, visitors seemed to be averse to the most commonly occurring thermal extreme since visitors appeared to avoid the zoo on excessively hot days in Phoenix and excessively cold days in Atlanta. Finally, changes in the daily weather impacted visitor attendance as both zoos experienced peak attendance on days with dynamic changes in the thermal regimes and depressed attendances on days with stagnant thermal regimes. Building a better understanding of how weather events impact visitor demand can help improve our assessments of the potential impacts future climate change may have on tourism.

  13. Evaluation of employees in public day care centers knowledge about breastfeeding and complementary feeding

    OpenAIRE

    Souza, Joelânia Pires de O.; Prudente, Amanda Moura; Silva, Dyene Aparecida; Pereira, Leandro Alves; Rinaldi, Ana Elisa M.

    2013-01-01

    OBJECTIVE: To evaluate the knowledge of public day care centers employees about breastfeeding and complementary feeding. METHODS: A cross-sectional study was conducted in 15 public day care centers randomly selected in the city of Uberlandia, Southeast Brazil. A questionnaire applied to school principals, teachers, educators and general services assistants (GSA) included demographic and socioeconomic variables and questions about knowledge on breastfeeding, complementary feeding besides ...

  14. Socio-demographic determinants of skilled birth attendant at delivery in rural southern Ghana.

    Science.gov (United States)

    Manyeh, Alfred Kwesi; Akpakli, David Etsey; Kukula, Vida; Ekey, Rosemond Akepene; Narh-Bana, Solomon; Adjei, Alexander; Gyapong, Margaret

    2017-07-11

    Maternal mortality is the subject of the United Nations' fifth Millennium Development Goal, which is to reduce the maternal mortality ratio by three quarters from 1990 to 2015. The giant strides made by western countries in dropping of their maternal mortality ratio were due to the recognition given to skilled attendants at delivery. In Ghana, nine in ten mothers receive antenatal care from a health professional whereas only 59 and 68% of deliveries are assisted by skilled personnel in 2008 and 2010 respectively. This study therefore examines the determinants of skilled birth attendant at delivery in rural southern Ghana. This study comprises of 1874 women of reproductive age who had given birth 2 years prior to the study whose information were extracted from the Dodowa Health and Demographic Surveillance System. The univariable and multivariable associations between exposure variables (risk factors) and skilled birth attendant at delivery were explored using logistic regression. Out of a total of 1874 study participants, 98.29% of them receive antenatal care services during pregnancy and only 68.89% were assisted by skilled person at their last delivery prior to the survey. The result shows a remarkable influence of maternal age, level of education, parity, socioeconomic status and antenatal care attendance on skilled attendants at delivery. Although 69% of women in the study had skilled birth attendants at delivery, women from poorest households, higher parity, uneducated, and not attending antenatal care and younger women were more likely to deliver without a skilled birth attendants at delivery. Future intervention in the study area to bridge the gap between the poor and least poor women, improve maternal health and promote the use of skilled birth at delivery is recommended.

  15. The association of generalized anxiety disorder and Somatic Symptoms with frequent attendance to health care services: A cross-sectional study from the Northern Finland Birth Cohort 1966.

    Science.gov (United States)

    Kujanpää, Tero S; Jokelainen, Jari; Auvinen, Juha P; Timonen, Markku J

    2017-03-01

    Objective Generalized anxiety disorder is associated with higher rate of physical comorbities, unexplained symptoms, and health care utilization. However, the role of somatic symptoms in determining health care utilization is unclear. The present study aims to assess the association of frequent attendance of health care services between generalized anxiety disorder symptoms and somatic symptoms. Method This study was conducted cross-sectionally using the material of the 46-year follow-up survey of the Northern Finland Birth Cohort 1966. Altogether, 5585 cohort members responded to the questionnaires concerning health care utilization, illness history, physical symptoms, and generalized anxiety disorder-7 screening tool. Odds ratios belonging to the highest decile in health care utilization were calculated for generalized anxiety disorder symptoms and all (n = 4) somatic symptoms of Hopkins Symptom Checklist-25 controlled for confounding factors. Results Adjusted Odds ratios for being frequent attender of health care services were 2.29 (95% CI 1.58-3.31) for generalized anxiety disorder symptoms and 1.28 (95% CI 0.99-1.64), 1.94 (95% CI 1.46-2.58), 2.33 (95% CI 1.65-3.28), and 3.64 (95% CI 2.15-6.18) for 1, 2, 3, and 4 somatic symptoms, respectively. People with generalized anxiety disorder symptoms had on average a higher number of somatic symptoms (1.8) than other cohort members (0.9). Moreover, 1.6% of people without somatic symptoms tested positive for generalized anxiety disorder, meanwhile 22.6% of people with four somatic symptoms tested positive for generalized anxiety disorder. Conclusions Both generalized anxiety disorder symptoms and somatic symptoms are associated with a higher risk for being a health care frequent attender.

  16. Variables influencing delay in antenatal clinic attendance among ...

    African Journals Online (AJOL)

    A delay in deciding to seek antenatal care is predominant among pregnant teenagers in Lesotho. This subsequently leads to delay in reaching treatment and in receiving adequate treatment. Early antenatal care attendance plays a major role in detecting and treating complications of pregnancy and forms a good basis for ...

  17. Studies of Day Care Center Climate and Its Effect on Children's Social and Emotional Behavior.

    Science.gov (United States)

    Ekholm, Bodil; Hedin, Anna

    School climates at 12 day care centers in Sweden were compared to investigate effects of center climates on children's social and emotional behavior. Observations and interviews conducted at the day care centers revealed differences in center climates related to child-rearing patterns, patterns of interaction, the distribution of power, and in…

  18. Centre-based day care for children younger than five years of age in high-income countries.

    Science.gov (United States)

    van Urk, Felix C; Brown, Taylor W; Waller, Rebecca; Mayo-Wilson, Evan

    2014-09-23

    A large proportion of children younger than five years of age in high-income countries experience significant non-parental care. Centre-based day care services may influence the development of children and the economic situation of parents. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development and well-being of children and families in high-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, the Education Resources Information Center (ERIC) and eight other databases. We also searched two trials registers and the reference lists of relevant studies. We included randomised and quasi-randomised controlled trials of centre-based day care for children younger than five years of age. We excluded studies that involved co-interventions not directed toward children (e.g. parent programmes, home visits, teacher training). We included the following outcomes: child cognitive development (primary outcome), child psychosocial development, maternal and family outcomes and child long-term outcomes. Two review authors independently assessed the risk of bias and extracted data from the single included study. We contacted investigators to obtain missing information. We included in the review one trial, involving 120 families and 143 children. Risk of bias was high because of contamination between groups, as 63% of control group participants accessed day care services separate from those offered within the intervention. No evidence suggested that centre-based day care, rather than no treatment (care at home), improved or worsened children's cognitive ability (Griffiths Mental Development Scale, standardised mean difference (SMD) 0.34, 95% confidence interval (CI) -0.01 to 0.69, 127 participants, 1 study, very low-quality evidence) or psychosocial development (parental report of abnormal development, risk ratio (RR

  19. Strategies of day care center educators in dealing crying babies

    OpenAIRE

    Lígia Ebner Melchiori; Zélia Maria Mendes Biasoli Alves

    2004-01-01

    The purpose of this study is to explore the views of day care center educators on how they act when babies cry, if they are able to identify the causes of crying and what are the subjection reasons that make them take action or not. Twenty-one caretakers were interviewed about each of the ninety babies, aged 4 to 24 months, under their care, using a semi-structured guide. The results show that overall the proportion of babies that do not cry significantly increases with age. However, crying f...

  20. Why do they keep coming back? Persistent frequent attenders in primary care

    NARCIS (Netherlands)

    Smits, F.T.M.

    2014-01-01

    The background of frequent attenders (FAs) of the General Practitioner (GP) often remains unclear. This thesis examines persistent frequent attendance, the relationship with (medical) conditions, methods to treat FAs, the impact of FAs on the GP’s workload and costs of healthcare, which medical file

  1. Evolution of a 90-day model of care for bundled episodic payments for congestive heart failure in home care.

    Science.gov (United States)

    Feld, April; Madden-Baer, Rose; McCorkle, Ruth

    2016-01-01

    The Centers for Medicare and Medicaid Services Innovation Center's Episode-Based Payment initiatives propose a large opportunity to reduce cost from waste and variation and stand to align hospitals, physicians, and postacute providers in the redesign of care that achieves savings and improve quality. Community-based organizations are at the forefront of this care redesign through innovative models of care aimed at bridging gaps in care coordination and reducing hospital readmissions. This article describes a community-based provider's approach to participation under the Bundled Payments for Care Improvement initiative and a 90-day model of care for congestive heart failure in home care.

  2. Family Day Care in Australia: A Systematic Review of Research (1996-2010)

    Science.gov (United States)

    Bohanna, India; Davis, Elise; Corr, Lara; Priest, Naomi; Tan, Huong

    2012-01-01

    Family Day Care (FDC) is a distinctive form of child care chosen by many Australian families. However, there appears to be little empirical research on FDC conducted in Australia. The aim of this study was to systematically review the recent published literature on FDC research in Australia, assess its quality, and identify pertinent topics for…

  3. Financial Reporting and Cost Analysis Manual for Day Care Centers, Head Start, and Other Programs.

    Science.gov (United States)

    Bedger, Jean E.; And Others

    This manual is designed to provide fundamental directions for systematic financial reporting and cost analysis for the administrators, accountants, bookkeepers, and staff of day care, Project Head Start, and other programs. The major aims of the manual are to induce day care directors to adopt uniform bookkeeping procedures and to analyze costs…

  4. Full-Day Kindergarten Effects on Later Academic Success

    Directory of Open Access Journals (Sweden)

    Charles Milligan

    2012-01-01

    Full Text Available The purpose of this research was to investigate full-day kindergarten, as a means of improving later academic achievement. A total of 208 students who had continuous enrollment for three consecutive school years from a school district in southern California participated in the study. The sample contained 165 students who had attended the traditional half-day kindergarten program with 43 attending a hybrid all-day kindergarten program. All students were administered the California Standardized Testing and Reporting (STAR assessment and the California Achievement Test 6th Edition (CAT 6 survey exams. Using stepwise multiple regression, several independent variables were introduced into the regression equation to obtain a Prediction Model of Student Success. The English language arts and math scores of the California STAR Assessment were used as the dependent variable separately. A significant model was not developed. Using an independent-sample T Test procedure, comparing the two groups, was also preformed revealing that there were no significant differences in students who attended the all-day kindergarten program and students who attended a traditional kindergarten program.

  5. Out-of-Home Care and the Educational Achievement, Attendance, and Suspensions of Maltreated Children: A Propensity-Matched Study.

    Science.gov (United States)

    Maclean, Miriam J; Taylor, Catherine L; O'Donnell, Melissa

    2018-04-30

    To estimate the influence of out-of-home care on reading scores, attendance, and suspensions by comparing a matched sample of maltreated children who entered out-of-home care and maltreated children who remained at home. Linked administrative data for all children born in Western Australia between 1990 and 2010 was used, focusing on those with substantiated maltreatment before year 9 achievement tests (n = 3297). Propensity score modelling was used to address differences in preexisting risk factors (child, family, neighborhood characteristics, maltreatment history, and reading scores) and compare outcomes for children placed in out-of-home care and those remaining in in-home care. Both groups of maltreated children had poor educational outcomes. After accounting for group differences in risk characteristics, there was no difference in year 9 reading achievement for the out-of-home care and in-home care groups. There was no difference in suspensions for the groups. The only significant difference was children in out-of-home care had fewer school absences than children in in-home care. Out-of-home care was not found to be a significant factor in the adverse educational outcomes of these children; however, there is a clear need for further educational support to address poor outcomes for children involved with child protection services. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. [Dietary status of preschool children from day-care kindergartens in six cites of China].

    Science.gov (United States)

    Yin, Shian; Su, Yixiang; Liu, Qipei; Zhang, Maoyu

    2002-10-01

    In order to highlight nutrients of potential concern on deficiency for the age groups under study, the dietary status of preschool children were studied in the kindergartens of Beijing, Shanghai, Guangzhou, Chengdu, Changsha and Dalian in 1998-1999. All the children who regularly attended the kindergarten, who were in the age range of 3-6 year old and generally health were considered eligible for enrollment in this study. The final results included a total of 1170 children, with 583 boys and 587 girls. Food weighing method was used in consecutive three-day dietary survey by recording breakfast, lunch and afternoon refreshments in kindergarten. Questionnaire form was applied to record the other food consumption outside of the kindergarten. Nutrient intakes of per child were calculated according to the Chinese Food composition Table. The average energy, protein, iron, selenium, vitamin A, vitamin E, thiamin, riboflavin, and nicotinic acid intakes were adequate in each group. The dietary energy provided by fat was near to the high marginal (30%), which indicated that more fat intake should be avoided in these children. The ratio of energy provided by each meal per day was lower in the breakfast and higher in the dinner and foods consumed at home. The average ratio of calcium to phosphorus for 3-6 years was 0.63. A deficiency of calcium is rather common, and the intake of calcium accounted for only 61.6% of the recommended nutrient intake(RNI). Salt intake was relatively higher than that of adequate intake recommended by Chinese Nutritional Society. The zinc intake reached 62.9% of RNIs. Vitamin C intakes from each age of groups did not meet their RNI. The present study indicates that the deficiencies of some trace nutrients in the diets for preschool children in day-care kindergartens is probably related to that the body weight and height of preschool children have not achieved a "satisfactory" level.

  7. Attending Unintended Transformations of Health Care Infrastructure

    DEFF Research Database (Denmark)

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

    Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theor......Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background...

  8. Barriers to Skilled Birth Attendance: A Survey among Mothers in ...

    African Journals Online (AJOL)

    More than seventy percent of the participants gave birth attended by a traditional birth attendant, but only 27% had intended to give birth at home. Sixty-four percent had made advance arrangements for the childbirth. Only 22% were informed about expected time of birth during antenatal care. Our findings suggest that the ...

  9. Caring teaching practices in multiethnic mathematics classrooms: attending to health and well-being

    Science.gov (United States)

    Averill, Robin

    2012-06-01

    Factors that contribute to strong teacher-student relationships are vital to understand because of the influence these relationships have on achievement and motivation, particularly for minority group students. This article draws from a substantial quantity of empirical data, grounded in a wide theoretical and cultural base, regarding aspects of caring teacher practice to discuss mathematics teacher behaviours in relation to an existing model of health and well-being that encompasses cognitive, social, spiritual, and physical dimensions. Drawing from 100 Year 10 mathematics lesson observations involving six teachers and their classes across three urban schools, evidence emerged that for many indigenous (Māori), New Zealand Pacific, and New Zealand European students, caring teacher behaviours important for student engagement and achievement both include, and range beyond, traditional teaching practices. Examples include capitalising on student reactions and shared endeavours within the context of mathematics learning, expecting mathematical progress, showing respect for students and for their mathematics learning, being explicit about practice and expectations, incorporating one-to-one interactions, making opportunities within mathematics learning for sharing personal identities, and incorporating movement. This research illustrates how mathematics educators can attend to the specific and holistic mathematical learning needs of their students, including those often marginalised.

  10. ATTAINMENT OF TREATMENT TARGETS AMONG TYPE 2 DIABETIC PATIENTS FIRST ATTENDING A TERTIARY CARE SETTING IN SUBURBAN KERALA

    Directory of Open Access Journals (Sweden)

    Sajeeth Kumar

    2016-03-01

    Full Text Available BACKGROUND Type 2 diabetes is growing in epidemic proportions worldwide, particularly in Asian subcontinent and especially in India. The disease takes a toll on the health system of a country, especially the developing nations. AIMS AND OBJECTIVES To study the attainment of metabolic and anthropometric goals of individuals with type 2 diabetes attending a tertiary care centre. MATERIALS AND METHODS i Informed consents were obtained. ii The study subjects were subjected to a detailed clinical, anthropometrical and biochemical evaluation at baseline by a dedicated diabetologist. iii These data were collected using a structured questionnaire and were analysed using EPI INFO (Ver 3.4.1. RESULTS A total of 350 cases were studied. Overall, 76.3% of patients could not achieve ADA A1c goal and 36.3% had very poor glycaemic control as evidenced by A1c >9%. CONCLUSIONS Despite the increasing awareness of type 2 diabetes both among attending physicians and patients, attainment of treatment targets still is a challenge even at a tertiary care setting. The lifestyle and dietary habits may be a main contributing factor for this situation. More focus needs to be given to nutritional aspects and physical exercise in not only in patients with type 2 diabetes mellitus, but also in apparently healthy individuals of the productive age group so that the disease can be delayed if not prevented.

  11. Influence of education on HIV infection among pregnant women attending their antenatal care in Sekondi-Takoradi metropolis, Ghana.

    Science.gov (United States)

    Orish, Verner N; Onyeabor, Onyekachi S; Boampong, Johnson N; Afoakwah, Richmond; Nwaefuna, Ekene; Acquah, Samuel; Orish, Esther O; Sanyaolu, Adekunle O; Iriemenam, Nnaemeka C

    2014-08-01

    This study investigated the influence of the level of education on HIV infection among pregnant women attending antenatal care in Sekondi-Takoradi, Ghana. A cross-sectional study was conducted at four hospitals in the Sekondi-Takoradi metropolis. The study group comprised 885 consenting pregnant women attending antenatal care clinics. Questionnaires were administered and venous blood samples were screened for HIV and other parameters. Multivariable logistic regression analyses were performed to determine the association between the level of education attained by the pregnant women and their HIV statuses. The data showed that 9.83% (87/885) of the pregnant women were HIV seropositive while 90.17% (798/885) were HIV seronegative. There were significant differences in mean age (years) between the HIV seropositive women (27.45 ± 5.5) and their HIV seronegative (26.02 ± 5.6) counterparts (p = .026) but the inference disappeared after adjustment (p = .22). Multivariable logistic regression analysis revealed that pregnant women with secondary/tertiary education were less likely to have HIV infection compared with those with none/primary education (adjusted OR, 0.53; 95% CI, 0.30-0.91; p = .022). Our data showed an association with higher level of education and HIV statuses of the pregnant women. It is imperative to encourage formal education among pregnant women in this region.

  12. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2010-07-19

    ...] Lunch and Centers Breakfast supper \\1\\ Snack Contingous States: Paid 0.26 0.26 0.06 Reduced Price 1.18 2... adjustments to the national average payment rates for meals and snacks served in child care centers, outside... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates...

  13. How Does Counselling in a Stationary Health Care Setting Affect the Attendance in a Standardised Sports Club Programme? Process Evaluation of a Quasi-Experimental Study

    Directory of Open Access Journals (Sweden)

    Sylvia Titze

    2018-01-01

    Full Text Available Actions in partnership across sectors is one principle for the promotion of health behaviours. The objective of this study was to describe the participation in a sports club-based exercise programme—named JACKPOT—following an intervention in a health care setting. Focus was given to the recruitment into JACKPOT, the attendance level, and whether the different programme elements were implemented as intented. The practicability of the project was also retrospectively rated. Participants were 238 inactive people (50% women between 30 and 65 years of age who attended a health resort. Of these, 77% were assigned to the intervention group (IG. The recruitment into the 12 JACKPOT sessions and the attendance levels were recorded via attendance lists. The implementation of the intervention standards was assessed with structured interviews and participatory observation. The Pragmatic Explanatory Continuum Indicator Summary (PRECIS-2 tool served to rate the practicability of the project. Almost 50% of the IG subjects attended JACKPOT sessions at least once and 54% of the attenders visited ≥75% of the 12 sessions. Some of the programme elements were not delivered fully. The process evaluation results showed that the project worked in a real-world setting, and also uncovered potential reasons such as incomplete information delivery for the moderate recruitment and attendance level.

  14. Day Care and Children's Conceptions of Moral and Social Rules.

    Science.gov (United States)

    Siegal, Michael; Storey, Rebecca McDonald

    1985-01-01

    Day care has a significant effect on children's conceptions of social rules that is not related to egocentrism or a lack of stimulus familiarity. Moral transgressions were regarded as equally serious by veterans and newly enrolled, while the distinction between morality and convention was unclear for the newly enrolled. (RH))

  15. Comparison of the Reynell Developmental Language Scale II and the Galker test of word-recognition-in-noise in Danish day-care children

    DEFF Research Database (Denmark)

    Lous, Jørgen; Glenn Lauritsen, Maj Britt

    2018-01-01

    Objective: To search for predictive factors for language development measured by two receptive language tests for children, the Galker test (a word-recognition-in-noise test) testing hearing and vocabulary, and the Danish version of Reynell Developmental Language Scale (2nd revision, RDLS II) test...... in terms of the degree to which variables were able to predict test scores at the age of three to five years. Methods: All children aged three and five years attending 20 day-care centres for children without cognitive development issues from the Municipality of Hillerød, Denmark, were invited......, a language comprehension test. The study analysed if information about background variables and parents and pre-school teachers was predictive for test scores; if earlier middle ear disease, actual hearing loss and tympanometry was important for language development; and if the two receptive tests differed...

  16. Contribution of traditional birth attendants to the formal health system in Ethiopia: the case of Afar region.

    Science.gov (United States)

    Temesgen, Tedla Mulatu; Umer, Jemal Yousuf; Buda, Dawit Seyoum; Haregu, Tilahun Nigatu

    2012-01-01

    Traditional birth attendants (TBAs) have been a subject of discussion in the provision of maternal and newborn health care. The objective of this study was to assess the role of trained traditional birth attendants in maternal and newborn health care in Afar Regional State of Ethiopia. A qualitative study was used where 21 in-depth interviews and 6 focus group discussions were conducted with health service providers, trained traditional birth attendants, mothers, men, kebele leaders and district health personnel. The findings of this study indicate that trained traditional birth attendants are the backbone of the maternal and child health development in pastoralist communities. However, the current numbers are inadequate and cannot meet the needs of the pastoralist communities including antenatal care, delivery, postnatal care and family planning. In addition to service delivery, all respondents agreed on multiple contributions of trained TBAs, which include counselling, child care, immunisation, postnatal care, detection of complication and other social services. Without deployment of adequate numbers of trained health workers for delivery services, trained traditional birth attendants remain vital for the rural community in need of maternal and child health care services. With close supportive supervision and evaluation of the trainings, the TBAs can greatly contribute to decreasing maternal and newborn mortality rates.

  17. Inequalities in Dental Attendance throughout the Life-course

    Science.gov (United States)

    2012-01-01

    The purpose of this study was to identify socio-economic inequalities in regular dental attendance throughout the life-course. The analyses relied on data from SHARE (waves 1 to 3 of the Survey of Health, Ageing, and Retirement in Europe), which includes retrospective information on life-course dental attendance of 26,525 persons currently aged 50 years or greater from 13 European countries (Austria, Poland, Spain, Italy, the Netherlands, Belgium, Greece, the Czech Republic, France, Denmark, Switzerland, Germany, and Sweden). Inequalities in dental attendance were assessed by means of Concentration Indices. Socio-economic disparities in regular dental attendance were identified as early as childhood. Moreover, higher educational attainment resulted in increased probabilities of regular dental attendance throughout subsequent life-years in all nations. In most countries, inequality levels remained relatively inelastic throughout the life-course. These findings suggest that a considerable proportion of inequalities in dental care use is already established at childhood and persists throughout the life-course. PMID:22699676

  18. Unilateral collaboration: The practices and understandings of traditional birth attendants in southeastern Nigeria.

    Science.gov (United States)

    Ohaja, Magdalena; Murphy-Lawless, Jo

    2017-08-01

    Despite the promotion of hospital-based maternity care as the safest option, for less developed countries, many women particularly those in the rural areas continue to patronise indigenous midwives or traditional birth attendants. Little is known about traditional birth attendants' perspectives regarding their pregnancy and birth practices. To explore traditional birth attendants' discourses of their pregnancy and birthing practices in southeast Nigeria. Hermeneutic phenomenology guided by poststructural feminism was the methodological approach. Individual face to face semi-structured interviews were conducted with five traditional birth attendants following consent. Participants' narratives of their pregnancy and birth practices are organised into two main themes namely: 'knowing differently,' and 'making a difference.' Their responses demonstrate evidence of expertise in sustaining normal birth, safe practice including hygiene, identifying deviation from the normal, willingness to refer women to hospital when required, and appropriate use of both traditional and western medicines. Inexpensive, culturally sensitive, and compassionate care were the attributes that differentiate traditional birth attendants' services from hospital-based maternity care. The participants provided a counter-narrative to the official position in Nigeria about the space they occupy. They responded in ways that depict them as committed champions of normal birth with ability to offer comprehensive care in accordance with the individual needs of women, and respect for cultural norms. Professional midwives are therefore challenged to review their ways of practice. Emphasis should be placed on what formal healthcare providers and traditional birth attendants can learn from each other. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  19. Effect of mHealth in improving antenatal care utilization and skilled birth attendance in low- and middle-income countries: a systematic review protocol.

    Science.gov (United States)

    Abraha, Yosef G; Gebrie, Serebe A; Garoma, Desalegn A; Deribe, Fasil M; Tefera, Mamuye H; Morankar, Sudhakar

    2017-07-01

    The objective of this review is to identify and synthesize the best available evidence on the effect of mobile health (mHealth) interventions in antenatal care utilization and skilled birth attendance in low- and middle-income countries.More specifically, the review questions are as follows.

  20. Demographic and practice factors predicting repeated non-attendance in primary care: a national retrospective cohort analysis

    Directory of Open Access Journals (Sweden)

    David A Ellis, PhD

    2017-12-01

    Full Text Available Summary: Background: Addressing the causes of low engagement in health care is a prerequisite for reducing health inequalities. People who miss multiple appointments are an under-researched group who might have substantial unmet health needs. Individual-level patterns of missed general practice appointments might thus provide a risk marker for vulnerability and poor health outcomes. We sought to ascertain the contributions of patient and practice factors to the likelihood of missing general practice appointments. Methods: For this national retrospective cohort analysis, we extracted UK National Health Service general practice data that were routinely collected across Scotland between Sept 5, 2013, and Sept 5, 2016. We calculated the per-patient number of missed appointments from individual appointments and investigated the risk of missing a general practice appointment using a negative binomial model offset by number of appointments made. We then analysed the effect of patient-level factors (including age, sex, and socioeconomic status and practice-level factors (including appointment availability and geographical location on the risk of missing appointments. Findings: The full dataset included information from 909 073 patients, of whom 550 083 were included in the analysis after processing. We observed that 104 461 (19·0% patients missed more than two appointments in the 3 year study period. After controlling for the number of appointments made, patterns of non-attendance could be differentiated, with patients who were aged 16–30 years (relative risk ratio [RRR] 1·21, 95% CI 1·19–1·23 or older than 90 years (2·20, 2·09–2·29, and of low socioeconomic status (Scottish Index of Multiple Deprivation decile 1: RRR 2·27, 2·22–2·31 significantly more likely to miss multiple appointments. Men missed fewer appointments overall than women, but were somewhat more likely to miss appointments

  1. Attending unintended transformations of health care infrastructure

    Directory of Open Access Journals (Sweden)

    Helle Wentzer

    2007-11-01

    Full Text Available Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure. These relations and levels are synthesized into a framework for identifying tensions and potential problems in the mediation of health care with the IT system. These problems are also known as unexpected adverse consequences, UACs, from IT implementation into clinical health care practices. Results: This paper develops a conceptual framework for addressing transformations of communication and workflow in health care as a result of implementing IT. Conclusion and discussion: The purpose of the conceptual framework is to support the attention to and continuous screening for errors and unintended consequences of IT implementation into health care practices and outcomes.

  2. Prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Teaching Hospital in 2014, northwest Ethiopia.

    Science.gov (United States)

    Asrie, Fikir; Enawgaw, Bamlaku; Getaneh, Zegeye

    2017-01-01

    Thrombocytopenia is a common hematologic abnormality during pregnancy. Pregnant women with thrombocytopenia have a higher risk of bleeding excessively during or after childbirth, particularly if they need to have a cesarean section or other surgical intervention during pregnancy, labor or in the puerperium. The main aim of this study was to determine the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Hospital, northwest Ethiopia. A cross-sectional study was used to assess the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Hospital from January to April 2015. A total of 217 pregnant women were included in the study and a structured pretested questionnaire was used to obtain sociodemographic information, nutritional factors, obstetrics and gynecological factors, history and clinical condition. Blood samples were collected for platelet count and other platelet parameters, which were determined by using SysmexKX 21 automation. The data were entered to Epi info version 6 software and analyzed using SPSS version 20 software. Bivariable and multivariable statistical analyses were used to evaluate the effect of independent variable over the dependent variable. A p -value of women receiving antenatal care service at Gondar University Hospital participated in the study. Thrombocytopenia among 19 pregnant women showed a prevalence of 8.8%. The mean ± standard deviation platelet count was 238.85×10 9 /L (±74.57). Thrombocytopenia was significantly associated with patients who lived rurally (crude odds ratio =4.3, 95% confidence interval 1.48-12.76). The prevalence of thrombocytopenia was 8.8% predominantly with mild type of thrombocytopenia. Thrombocytopenia was higher among pregnant women who lived rurally. Therefore, health care providers should screen routinely for thrombocytopenia to avoid excessive bleeding during pregnancy, especially in women who live

  3. [Day-care mother--a successful model of child rearing?].

    Science.gov (United States)

    Schetelig, H

    1977-02-17

    The scientific reports published so far on the project "day care mothering" do not allow to draw scientific conclusions, whether this educational model can achieve nearly equal results as family education. The author critisises, that such a clame is made. It seems necessary, to pay more importance to the function of the mother for her children, to give the children a sound emotional basis for their future development.

  4. Variables influencing delay in antenatal clinic attendance among ...

    African Journals Online (AJOL)

    Although antenatal care is provided at different levels, Lesotho still has a ... This shortage of health care personnel and the impact of HIV/Aids result in ... of early attendance, denial of the pregnancy by the boyfriend, the fact that sex outside of ..... “My parents were still negotiating with ... want him to pay for the damage he did.

  5. Survival and detection of rotaviruses on environmental surfaces in day care centers.

    Science.gov (United States)

    Keswick, B H; Pickering, L K; DuPont, H L; Woodward, W E

    1983-01-01

    Previously, we demonstrated that children in day care centers commonly experience diarrhea due to rotavirus, giardia, and bacterial pathogens. Multiple agents frequently coexist, and the environment is heavily contaminated with enteric bacteria during outbreaks. A study of environmental surface contamination with rotavirus was performed during three non-outbreak periods. Of 25 samples collected from environmental surfaces and teachers hands at a day care center, 4 (16%) were positive for rotavirus antigen when a fluorescence assay was used. We also examined the survival of two animal viruses, rotavirus SA-11 and poliovirus type 1, and bacteriophage 12 on similar environmental surfaces in a laboratory. Poliovirus type 1 and bacteriophage f2 were more resistant to drying than rotavirus SA-11 and could be recovered after a 90-min exposure on a dry surface. Rotavirus SA-11 could be detected for 30 min. All three viruses survived longer when they were suspended in fecal material than when they were suspended in distilled water. These data suggest that several agents, including rotavirus, can remain viable on contaminated surfaces long enough to be transmitted to susceptible children. This finding helps explain why rotavirus shows a mode of spread like that of parasitic and bacterial agents within day care center settings. PMID:6314896

  6. Knowledge, attitude and practice of patients attending primary care ...

    African Journals Online (AJOL)

    Background: Extracellular calcium is vital for the functioning of many metabolic processes and neuromuscular activities. Awareness and practice of patients with vitamin D deficiency are very important. Objective: To explore knowledge, attitude and practice of patients receiving vitamin D supplement and attending primary ...

  7. Understanding reasons for asthma outpatient (non)-attendance and exploring the role of telephone and e-consulting in facilitating access to care: exploratory qualitative study.

    NARCIS (Netherlands)

    Baar, J.D. van; Joosten, H.; Car, J.; Freeman, G.; Partridge, M.R.; Weel, C. van; Sheikh, A.

    2006-01-01

    OBJECTIVE: To understand factors influencing patients' decisions to attend for outpatient follow up consultations for asthma and to explore patients' attitudes to telephone and email consultations in facilitating access to asthma care. DESIGN: Exploratory qualitative study using in depth interviews.

  8. Does the Janani Suraksha Yojana cash transfer programme to promote facility births in India ensure skilled birth attendance? A qualitative study of intrapartum care in Madhya Pradesh

    Directory of Open Access Journals (Sweden)

    Sarika Chaturvedi

    2015-07-01

    Full Text Available Background: Access to facility delivery in India has significantly increased with the Janani Suraksha Yojana (JSY cash transfer programme to promote facility births. However, a decline in maternal mortality has only followed secular trends as seen from the beginning of the decade well before the programme began. We, therefore, examined the quality of intrapartum care provided in facilities under the JSY programme to study whether it ensures skilled attendance at birth. Design: 1 Non-participant observations (n=18 of intrapartum care during vaginal deliveries at a representative sample of 11 facilities in Madhya Pradesh to document what happens during intrapartum care. 2 Interviews (n=10 with providers to explore reasons for this care. Thematic framework analysis was used. Results: Three themes emerged from the data: 1 delivery environment is chaotic: delivery rooms were not conducive to safe, women-friendly care provision, and coordination between providers was poor. 2 Staff do not provide skilled care routinely: this emerged from observations that monitoring was limited to assessment of cervical dilatation, lack of readiness to provide key elements of care, and the execution of harmful/unnecessary practices coupled with poor techniques. 3 Dominant staff, passive recipients: staff sometimes threatened, abused, or ignored women during delivery; women were passive and accepted dominance and disrespect. Attendants served as ‘go-betweens’ patients and providers. The interviews with providers revealed their awareness of the compromised quality of care, but they were constrained by structural problems. Positive practices were also observed, including companionship during childbirth and women mobilising in the early stages of labour. Conclusions: Our observational study did not suggest an adequate level of skilled birth attendance (SBA. The findings reveal insufficiencies in the health system and organisational structures to provide an

  9. Does the Janani Suraksha Yojana cash transfer programme to promote facility births in India ensure skilled birth attendance? A qualitative study of intrapartum care in Madhya Pradesh.

    Science.gov (United States)

    Chaturvedi, Sarika; De Costa, Ayesha; Raven, Joanna

    2015-01-01

    Access to facility delivery in India has significantly increased with the Janani Suraksha Yojana (JSY) cash transfer programme to promote facility births. However, a decline in maternal mortality has only followed secular trends as seen from the beginning of the decade well before the programme began. We, therefore, examined the quality of intrapartum care provided in facilities under the JSY programme to study whether it ensures skilled attendance at birth. 1) Non-participant observations (n=18) of intrapartum care during vaginal deliveries at a representative sample of 11 facilities in Madhya Pradesh to document what happens during intrapartum care. 2) Interviews (n=10) with providers to explore reasons for this care. Thematic framework analysis was used. Three themes emerged from the data: 1) delivery environment is chaotic: delivery rooms were not conducive to safe, women-friendly care provision, and coordination between providers was poor. 2) Staff do not provide skilled care routinely: this emerged from observations that monitoring was limited to assessment of cervical dilatation, lack of readiness to provide key elements of care, and the execution of harmful/unnecessary practices coupled with poor techniques. 3) Dominant staff, passive recipients: staff sometimes threatened, abused, or ignored women during delivery; women were passive and accepted dominance and disrespect. Attendants served as 'go-betweens' patients and providers. The interviews with providers revealed their awareness of the compromised quality of care, but they were constrained by structural problems. Positive practices were also observed, including companionship during childbirth and women mobilising in the early stages of labour. Our observational study did not suggest an adequate level of skilled birth attendance (SBA). The findings reveal insufficiencies in the health system and organisational structures to provide an 'enabling environment' for SBA. We highlight the need to ensure

  10. 7 CFR 226.19a - Adult day care center provisions.

    Science.gov (United States)

    2010-01-01

    ... snack. Reimbursement may not be claimed for more than two meals and one snack, or one snack and two... price meals in accordance with § 226.23(e)(1). (9) Each adult day care center must maintain daily records of time of service meal counts by type (breakfast, lunch, supper, and snacks) served to enrolled...

  11. 24/7 pediatric radiology attending coverage: times are changing

    Energy Technology Data Exchange (ETDEWEB)

    Donaldson, James S. [Feinberg School of Medicine at Northwestern University, Department of Medical Imaging, Ann and Robert H. Lurie Children' s Hospital of Chicago, IL (United States); Thakrar, Kiran H. [University of Chicago Pritzker School of Medicine, Body Imaging, NorthShore University HealthSystem, Chicago, IL (United States)

    2017-06-15

    The job of the pediatric radiologist long ago ceased to be an 8-to-5 role. Many practices have adopted evening shifts of in-house attending radiologists to cover the busy evening activity. With the ever-increasing role of imaging in clinical decisions and patient management, there is a need - if not a demand - to further extend attending pediatric radiology coverage. In this article, we discuss the needs and justification for extending pediatric radiology coverage at a tertiary-care children's hospital. We also describe the approach we took toward implementing 24/7 attending in-house coverage of pediatric radiology. (orig.)

  12. Kajian TerapanElemen Interior Ruang Pre-Schoolpada Angels N I Children Day Care Di Surabaya

    OpenAIRE

    Hindiarto, Fransisca

    2015-01-01

    One of the many ways to improve the quality of Human Resource is to also improve our education quality. Children Day Care is a form of non-formal pre-school program with the basis focusing to physical and mental development such as character, behaviour, knowledge, soft skills, and creativity to provide the child enough provision to succeed later in life. The day care also function as a second family and home for a certain time in a day where parents have to work. The goal of the research is t...

  13. Prevalence and associated factors of domestic violence among pregnant women attending routine antenatal care in Nepal.

    Science.gov (United States)

    Rishal, Poonam; Pun, Kunta Devi; Darj, Elisabeth; Joshi, Sunil Kumar; Bjørngaard, Johan Håkon; Swahnberg, Katarina; Schei, Berit; Lukasse, Mirjam

    2017-08-01

    The primary aim of this study was to assess the prevalence of domestic violence (DV) and its associated factors among pregnant women in Nepal. The secondary aims were to investigate disclosure of DV by women to health-care personnel and to assess whether health-care personnel had asked women about their experience of DV. This cross-sectional study included 2004 pregnant women between 12 and 28 weeks of gestation attending routine antenatal care at two hospitals in Nepal from August 2014 to November 2015. In this study, DV was defined as fear of a family member and/or an experience of physical, emotional or sexual violence. Associated risk factors were analysed using logistic regression analyses. Twenty-one per cent of the women had experienced DV; 12.5% experienced fear only, 3.6% violence only and 4.9% experienced both violence and fear. Less than 2% per cent reported physical violence during pregnancy. This study found that just 17.7% had ever been asked by health-care personnel about DV, and of the women who had reported DV, only 9.5% had disclosed their experience to health-care personnel. Women of young age and low socio-economic status were more likely to have experienced DV. Women who reported having their own income and the autonomy to use it were at significantly lower risk of DV compared to women with no income. A substantial proportion of women reported having experienced DV. Victims had rarely disclosed their experience of DV to health-care personnel. This study underlines the importance of integrating systematic assessment of DV in antenatal care.

  14. Understanding Cortisol Reactivity across the Day at Child Care: The Potential Buffering Role of Secure Attachments to Caregivers

    Science.gov (United States)

    Badanes, Lisa S.; Dmitrieva, Julia; Watamura, Sarah Enos

    2012-01-01

    Full-day center-based child care has been repeatedly associated with rising cortisol across the child care day. This study addressed the potential buffering role of attachment to mothers and lead teachers in 110 preschoolers while at child care. Using multi-level modeling and controlling for a number of child, family, and child care factors,…

  15. Residential aged care residents and components of end of life care in an Australian hospital.

    Science.gov (United States)

    Leong, Laurence Jee Peng; Crawford, Gregory Brian

    2018-06-09

    With ageing of Australians, the numbers of residential aged care (RAC) residents is rising. This places a spotlight on decisions about appropriate care for this population, including hospitalisation and end-of-life (EOL) care. The aim was to study a sample of RAC residents who attended and died in hospital, to quantify measurable components of EOL care so as to describe the extent of palliative care required. A retrospective case-note review of hospital records was conducted in Adelaide, Australia. Participants were 109 RAC residents who attended from July 2013 to June 2014 and died in hospital. Measurements were advance care planning, health care input from the RAC facilities to hospital and components of EOL care. Residents with and without advanced dementia were compared. Advance care directives (ACDs) were present from 11 to 50%, and advance care plans (ACPs) at 60%. There were more ACPs, resuscitation orders (for/against) and do-not-hospitalise orders in residents with advanced dementia than those without. General practitioner (GP) and extended care paramedic (ECP) input on decisions for hospital transfer were 30% and 1 %. Mean hospital stay to death was 5.2 days. For residents admitted under non-palliative care teams, specialist palliative care (SPC) was needed for phone advice in 5%, consultation in 45%, transfer to palliative care unit in 37%, and takeover by SPC team in 19%. Mean number of documented goals-of-care discussions with family/caregiver was 1.7. In the last 3 days of life, the mean daily number of doses of EOL medications was 4.2. Continuous subcutaneous infusion was commenced in 35%. Staff in RAC need to be adequately resourced to make complex decisions about whether to transfer to hospital. RAC nurses are mainly making these decisions as GP and ECP input were suboptimal. Ways to support nurses and optimise decision-making are needed. Advance care planning can be improved, especially documentation of EOL wishes and hospitalisation orders. By

  16. Determinants of skilled birth attendants for delivery in Nepal.

    Science.gov (United States)

    Baral, Y R; Lyons, K; Skinner, J; van Teijlingen, E R

    2010-01-01

    This review is to explore the factors affecting the uptake of skilled birth attendants for delivery and the issues associated with women's role and choices of maternal health care service for delivery in Nepal. Literature was reviewed across the globe and discussed in a Nepalese context. Delivery by Skilled Birth Attendance serves as an indicator of progress towards reducing maternal mortality worldwide, the fifth Millennium Development Goal. Nepal has committed to reducing its maternal mortality by 75% by 2015 through ensuring accessibility to the availability and utilisation of skilled care at every birth. The literature suggests that several socio-economic, cultural and religious factors play a significant role in the use of Skilled Birth Attendance for delivery in Nepal. Availability of transportation and distance to the health facility; poor infrastructure and lack of services; availability and accessibility of the services; cost and convenience; staff shortages and attitudes; gender inequality; status of women in society; women's involvement in decision making; and women's autonomy and place of residence are significant contributing factors for uptake of Skilled Birth Attendance for delivery in Nepal. The review found more quantitative research studies exploring the determinants of utilisation of the maternal health services during pregnancy in Nepal than qualitative studies. Findings of quantitative research show that different social demographic, economic, socio-cultural and religious factors are responsible for the utilisation of maternal health services but very few studies discussed how and why these factors are responsible for utilisation of skilled birth attendants in pregnancy. It is suggested that there is need for more qualitative research to explore the women's role and choice regarding use of skilled birth attendants services and to find out how and why these factors are responsible for utilisation of skilled birth attendants for delivery

  17. Management of a Cryptosporidium hominis Outbreak in a Day- care Center

    NARCIS (Netherlands)

    Vandenberg, Olivier; Robberecht, Françoise; Dauby, Nicolas; Moens, Catherine; Talabani, Hana; Dupont, Eddy; Menotti, Jean; van Gool, Tom; Levy, Jack

    2012-01-01

    Background: Cryptosporidium outbreaks in day-care centers (DCCs) occur commonly. However, controlling spread of infection in these settings is difficult, and data about effectiveness of different control strategies are sparse. In this study, a Cryptosporidium outbreak in a large DCC located in

  18. Residents' and attendings' perceptions of a night float system in an internal medicine program in Canada.

    Science.gov (United States)

    Saxena, Anurag; Desanghere, Loni; Skomro, Robert P; Wilson, Thomas W

    2015-01-01

    The Night Float system (NFS) is often used in residency training programs to meet work hour regulations. The purpose of this study was to examine resident and attendings' perceptions of the NFS on issues of resident learning, well-being, work, non-educational activities and the health care system (patient safety and quality of care, inter-professional teams, workload on attendings and costs of on-call coverage). A survey questionnaire with closed and open-ended questions (26 residents and eight attendings in an Internal Medicine program), informal discussions with the program and moonlighting and financial data were collected. The main findings included, (i) an overall congruency in opinions between resident and attendings across all mean comparisons, (ii) perceptions of improvement for most aspects of resident well-being (e.g. stress, fatigue) and work environment (e.g. supervision, support), (iii) a neutral effect on the resident learning environment, except resident opinions on an increase in opportunities for learning, (iv) perceptions of improved patient safety and quality of care despite worsened continuity of care, and (v) no increases in work-load on attendings or the health care system (cost-neutral call coverage). Patient safety, handovers and increased utilization of moonlighting opportunities need further exploration.

  19. Number needed to eat: pizza and resident conference attendance.

    Science.gov (United States)

    Cosimini, Michael J; Mackintosh, Liza; Chang, Todd P

    2016-12-01

    The didactic conference is a common part of the resident education curriculum. Given the demands of clinical responsibilities and restrictions on duty hours, maximising education is a challenge faced by all residency programmes. To date, little research exists with respect to how the provision of complimentary food affects physician and resident conference attendance. The objective of this study was to determine whether complimentary food improves resident arrival times and attendance at educational conferences and, furthermore, to test whether this provision is a potentially cost-effective tool for improving education. A retrospective review of 36 resident educational Friday noon conferences, including 1043 resident arrivals, was performed. Data were analysed for total attendance, arrival times, number needed to eat (NNE) and the percentage of residents arriving on time, and compared between days on which food was and was not provided. Median attendance was 3.7% higher (p = 0.04) on days on which food was provided, at a cost of US$46 for each additional resident in attendance. Arrival times were also statistically significantly improved when food was provided, with a median improvement of 0.7 minutes (p = 0.02) and an 11.0% increase in on-time arrivals (p < 0.001). The NNE was 10.6. Complimentary food improves both attendance and arrival times by a small, but statistically significant, degree. The provision of complimentary food can be considered as an incentive for attendance and on-time arrival at didactic educational sessions, although more cost-effective modalities may exist. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  20. Risk factors for syphilis and hiv infection in pregnant women attending a tertiary care public sector hospital

    International Nuclear Information System (INIS)

    Batool, K.; Bano, K.A.; Sherwani, M.I.K.

    2010-01-01

    Background: Syphilis, a sexually transmitted disease which seemed to have disappeared or had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. Appropriate treatment of pregnant women often prevents such complications. Aims: To study the frequency of syphilis in pregnant women attending a tertiary care public sector hospital, and see the positivity for HIV/AIDS among syphilis positive women. Patients and Methods: This cross sectional and interventional study was conducted among pregnant women attending Sir Ganga Ram hospital for antenatal care at PMRC Research Centre, Fatima Jinnah Medical College, Lahore. Blood samples from 2000 women were collected after taking consent. The blood was tested for syphilis by Treponema Pallidum Haemagglutination. History of the subjects for risks factors was also taken. Syphilis positive women were further screened for human immunodeficiency virus positivity. Results: The treponemal antibodies were detected in less than one percent (9) pregnant women. The highest positivity was observed among age group of 21-26 years. Women in third trimester were significantly more infected with syphilis. Risk factors included husband's history with frequent traveling and drug abuse. All husbands of syphilis positive women were also positive. All syphilis positive women and their husbands were negative for Human immunodeficiency virus /Acquired immune deficiency syndrome. Conclusions: Less than 1% of pregnant women were infected with syphilis, and most of the spouses of these positive women were either travelers or drug addicts.(author)

  1. Snoring habits among healthy persons attending a tertiary care center in Chittagong, Bangladesh: A questionnaire-based study

    Directory of Open Access Journals (Sweden)

    Rajat Sanker Roy Biswas

    2017-01-01

    Full Text Available Introduction: Snoring is a common health condition which is unexplored in the context of Bangladesh. Hence, the objective of the present study is to find out the frequency of snoring among the healthy Bangladeshi people attending tertiary care center in Chittagong using a questionnaire. Methods: It was a single center, cross-sectional study conducted in the Department of Internal Medicine of a tertiary care hospital of Bangladesh among 119 apparently healthy adults who were the attendants of patients. A “Snore Survey” questionnaire adopted from an Indian study which was based on Berlin questionnaire was used. Results: With a 88.1% valid response rate, present study included 63 (52.94% male and 56 (47.06% female. Among all, 47.9% of (57 individuals were <30 years of age. Majority (82.4% were recruited from urban locality. Frequency of snoring was 28 (23.5% of total individuals. Nearly 33.3% of males and 12.5% of females were snorers. The frequency of snoring ranged from daily (25.0% to monthly (28.6% episodes. Some had very loud (25.0% sound during sleep, and others had variable loudness. Male snorers were significantly taller, weighed more and had broader neck circumference than female (P < 0.05. Conclusion: Snoring is not an uncommon medical condition among healthy young people in Bangladesh. Considering the population of Bangladesh, the sample size is very small and a large scale study would certainly help create awareness among the patients as well as healthcare professionals about this neglected but very significant health problem.

  2. Why don't some women attend antenatal and postnatal care services?: a qualitative study of community members' perspectives in Garut, Sukabumi and Ciamis districts of West Java Province, Indonesia.

    Science.gov (United States)

    Titaley, Christiana R; Hunter, Cynthia L; Heywood, Peter; Dibley, Michael J

    2010-10-12

    Antenatal, delivery and postnatal care services are amongst the recommended interventions aimed at preventing maternal and newborn deaths worldwide. West Java is one of the provinces of Java Island in Indonesia with a high proportion of home deliveries, a low attendance of four antenatal services and a low postnatal care uptake. This paper aims to explore community members' perspectives on antenatal and postnatal care services, including reasons for using or not using these services, the services received during antenatal and postnatal care, and cultural practices during antenatal and postnatal periods in Garut, Sukabumi and Ciamis districts of West Java province. A qualitative study was conducted from March to July 2009 in six villages in three districts of West Java province. Twenty focus group discussions (FGDs) and 165 in-depth interviews were carried out involving a total of 295 respondents. The guidelines for FGDs and in-depth interviews included the topics of community experiences with antenatal and postnatal care services, reasons for not attending the services, and cultural practices during antenatal and postnatal periods. Our study found that the main reason women attended antenatal and postnatal care services was to ensure the safe health of both mother and infant. Financial difficulty emerged as the major issue among women who did not fulfil the minimum requirements of four antenatal care services or two postnatal care services within the first month after delivery. This was related to the cost of health services, transportation costs, or both. In remote areas, the limited availability of health services was also a problem, especially if the village midwife frequently travelled out of the village. The distances from health facilities, in addition to poor road conditions were major concerns, particularly for those living in remote areas. Lack of community awareness about the importance of these services was also found, as some community members perceived

  3. Impact of a 2-Day Critical Care Ultrasound Course during Fellowship Training: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Vi Am Dinh

    2015-01-01

    Full Text Available Objectives. Despite the increasing utilization of point-of-care critical care ultrasonography (CCUS, standards establishing competency for its use are lacking. The purpose of this study was to evaluate the effectiveness of a 2-day CCUS course implementation on ultrasound-naïve critical care medicine (CCM fellows. Methods. Prospective evaluation of the impact of a two-day CCUS course on eight CCM fellows’ attitudes, proficiency, and use of CCUS. Ultrasound competency on multiple organ systems was assessed including abdominal, pulmonary, vascular, and cardiac systems. Subjects served as self-controls and were assessed just prior to, within 1 week after, and 3 months after the course. Results. There was a significant improvement in CCM fellows’ written test scores, image acquisition ability, and pathologic image interpretation 1 week after the course and it was retained 3 months after the course. Fellows also had self-reported increased confidence and usage of CCUS applications after the course. Conclusions. Implementation of a 2-day critical care ultrasound course covering general CCUS and basic critical care echocardiography using a combination of didactics, live models, and ultrasound simulators is effective in improving critical care fellows’ proficiency and confidence with ultrasound use in both the short- and long-term settings.

  4. Utilization of health care services by depressed patients attending ...

    African Journals Online (AJOL)

    2011-06-15

    Jun 15, 2011 ... all patients attending the general out‑patient department from 16 years of age and above and those who consented to participate. Excluded were patients who abuse alcohol or drugs, patients with past history of psychiatric illness other than depression, patients with altered sensorium and those who failed ...

  5. Anaemia among HIV infected children attending care and treatment ...

    African Journals Online (AJOL)

    Introduction: Anaemia is common among HIV infected patients; causes of anaemia in these patients are multifactorial. Anemia is noted as one of important predictors of outcome in HIV infected patients. Tis study was carried out to determine the prevalence of anaemia among HIV infected children attending HIV clinic at ...

  6. [Profitability of a day hospital: analysis of activity, cost and effectiveness].

    Science.gov (United States)

    Hernando Ortiz, Lili; Hinojosa Mena-Bernal, Carmen; González Sarmiento, Enrique; González Guilabert, Isabel; Arana Ruiz, Jorge; Muñoz Moreno, M Fe

    2012-01-01

    Day hospitals are an alternative to conventional hospital care. We analyzed the functioning and profitability of the day hospital of Hospital Clínico de Valladolid, Spain, in 2009. Profitability is expressed as the provision of identical health coverage at a lower cost than that generated by conventional hospital care and with adequate quality indicators. We performed a retrospective, observational and descriptive study of the information obtained on each patient attended in the day hospital from January 1 to December 31, 2009. We studied four quality indicators: cancellation of meetings, the rate of transfusion reactions, the out-patient rate and the satisfaction index. The estimated savings for each process was calculated as the difference in the average cost of hospitalization minus the average cost of the process in the day hospital. The most frequent diseases were systemic and connective tissue diseases, accounting for 25.4% of the processes treated; of these, 17.1% corresponded to rheumatoid arthritis. Patient satisfaction was 93%. Meetings cancellations and the rate of transfusion reactions were 0%. The out-patient rate was 26%. Day hospital costs were 8.6% of conventional hospital costs, with savings of 78,390.69 euros. The day hospital is cost effective due to savings compared with conventional hospitalization and has a satisfactory quality index. Copyright © 2011 SESPAS. Published by Elsevier España, S.L. All rights reserved.

  7. The Geriatric Day Hospital: Preliminary Data on an Innovative Model of Care in Brazil for Older Adults at Risk of Hospitalization.

    Science.gov (United States)

    Aliberti, Márlon J R; Suemoto, Claudia K; Fortes-Filho, Sileno Q; Melo, Juliana A; Trindade, Carolina B; Kasai, Juliana Y T; Altona, Marcelo; Apolinario, Daniel; Jacob-Filho, Wilson

    2016-10-01

    Older adults have a greater risk of experiencing functional decline and iatrogenic complications during hospitalization than younger individuals. Geriatric day hospitals (GDHs) have been implemented mainly for rehabilitation. The goal of the current study was to expand the GDH spectrum of care to prevent hospital admissions in this population. This study details an innovative model of GDH care that offers short-term, nonrehabilitative treatment to older adults who have experienced an acute event, those with a decompensated chronic disease, or those in need of a minor procedure that would be unattainable in a regular outpatient setting. During the 6-hour visits made weekly for up to 2 months, participants receive integrated evaluations of their various health domains, education, and rapid access to examinations and procedures based on a multidisciplinary approach. In the first 6 years, 2,322 individuals attended the GDH. The analysis of a representative sample (n = 645) revealed that 81% were treated in the GDH without the need for another type of hospital care. This percentage was high for the different reasons for referral (infection, 71%; delirium, 73%; decompensated chronic disease, 81%). Between baseline and discharge, participants maintained their functional status, and their self-reported health improved. This study represents the first step in describing the role of the GDH as a possible alternative to emergency department use or hospitalization for older adults. Future studies are needed to determine the optimal individual for this model of care and to ensure its cost-effectiveness. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  8. Lead and polycyclic aromatic hydrocarbons (PAHs) in surface soil from day care centres in the city of Bergen, Norway

    International Nuclear Information System (INIS)

    Haugland, Toril; Ottesen, Rolf Tore; Volden, Tore

    2008-01-01

    Surface soil (0-2 cm) quality in 87 day care centres in the city of Bergen, Norway has been studied. Approximately 45% of the day care centres contained Pb and PAH values above recommended action levels. There are clear variations between different areas of the city. The old central part of the city hosts most of the contaminated day care centres. In suburban areas most of the day care centres have Pb and PAH concentrations below action levels. City fires, gas work emission, lead-based paint, and traffic are probably important anthropogenic contamination sources, together with uncontrolled transportation of soil from contaminated to clean areas. Geological or other natural sources are probably not an important contributor to the high levels of lead and PAH. - Surface soil in 45% of the studied day care centres was contaminated by lead and PAH

  9. Child-to-Teacher Ratio and Day-Care Teacher Sickness Absenteeism

    DEFF Research Database (Denmark)

    Andersson, Elvira; Gørtz, Mette

    2013-01-01

    -to-teacher ratio, i.e. the number of children per teacher in an institution, affects teacher sickness absenteeism. We control for individual teacher characteristics, workplace characteristics, and family background characteristics of the children in the day-care institutions. Our estimation results indicate...... that the child-to-teacher ratio is positively related to sickness absence for 2005-2006, but not for 2002-2004....

  10. Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic

    DEFF Research Database (Denmark)

    Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

    2015-01-01

    INTRODUCTION: Non-attendance is a global health-care problem. The aim of the present study was 1) to investigate if a telephone reminder could reduce the non-attendance rate, 2) to study reasons for non-attendance and 3) to evaluate if a permanent implementation would be economically advantageous......,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost-benefit analysis was made...

  11. Availability and Price of High Quality Day Care and Female Employment

    DEFF Research Database (Denmark)

    Simonsen, Marianne

    In this paper I analyse to what degree availability and price of high quality publicly subsidised childcare affects female employment for women living in couples following maternity leave. The results show that unrestricted access to day care has a significantly positive effct on female employment.......The price effect is significantly negative: An increase in the price of child care of C=1 will decrease the female employment with 0.08% corresponding to a price elasticity of −0.17. This effect prevails during the first 12 months after childbirth....

  12. Contraceptive‑seeking Behavior of Women Attending Antenatal ...

    African Journals Online (AJOL)

    Contraceptive‑seeking Behavior of Women Attending Antenatal Care in a Developing Country: A Veritable Tool for Slowing Population Growth. ... Background: The use of modern contraceptives has been embraced by developed nations as a means of achieving controlled growth rate. Nigeria, Africa's most populous nation ...

  13. The impact of daycare attendance on outdoor free play in young children.

    Science.gov (United States)

    Carsley, S; Liang, L Y; Chen, Y; Parkin, P; Maguire, J; Birken, C S

    2017-03-01

    Outdoor free play is important for healthy growth and development in early childhood. Recent studies suggest that the majority of time spent in daycare is sedentary. The objective of this study was to determine whether there was an association between daycare attendance and parent-reported outdoor free play. Healthy children aged 1-5 years recruited to The Applied Research Group for Kids! (TARGet Kids!), a primary care research network, were included. Parents reported daycare use, outdoor free play and potential confounding variables. Multivariable linear regression was used to determine the association between daycare attendance and outdoor free play, adjusted for age, sex, maternal ethnicity, maternal education, neighborhood income and season. There were 2810 children included in this study. Children aged 1 to <3 years (n = 1388) and ≥3 to 5 years (n = 1284) who attended daycare had 14.70 min less (95% CI -20.52, -8.87; P < 0.01) and 9.44 min less (95% CI -13.67, -5.20; P < 0.01) per day of outdoor free play compared with children who did not attend daycare, respectively. Children who spend more time in daycare have less parent-reported outdoor free play. Parents may be relying on daycare to provide opportunity for outdoor free play and interventions to promote increased active play opportunities outside of daycare are needed. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. The effect of community maternal and newborn health family meetings on type of birth attendant and completeness of maternal and newborn care received during birth and the early postnatal period in rural Ethiopia.

    Science.gov (United States)

    Barry, Danika; Frew, Aynalem Hailemichael; Mohammed, Hajira; Desta, Binyam Fekadu; Tadesse, Lelisse; Aklilu, Yeshiwork; Biadgo, Abera; Buffington, Sandra Tebben; Sibley, Lynn M

    2014-01-01

    Maternal and newborn deaths occur predominantly in low-resource settings. Community-based packages of evidence-based interventions and skilled birth attendance can reduce these deaths. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) used community-level health workers to conduct prenatal Community Maternal and Newborn Health family meetings to build skills and care-seeking behaviors among pregnant women and family caregivers. Baseline and endline surveys provided data on a random sample of women with a birth in the prior year. An intention-to-treat analysis, plausible net effect calculation, and dose-response analysis examined increases in completeness of care (mean percentage of 17 maternal and newborn health care elements performed) over time and by meeting participation. Regression models assessed the relationship between meeting participation, completeness of care, and use of skilled providers or health extension workers for birth care-controlling for sociodemographic and health service utilization factors. A 151% increase in care completeness occurred from baseline to endline. At endline, women who participated in 2 or more meetings had more complete care than women who participated in fewer than 2 meetings (89% vs 76% of care elements; P care completeness (P care were nearly 3 times more likely to have used a skilled provider or health extension worker for birth care. Women who had additionally attended 2 or more meetings with family members were over 5 times as likely to have used these providers, compared to women without antenatal care and who attended fewer than 2 meetings (odds ratio, 5.19; 95% confidence interval, 2.88-9.36; P care by engaging women and family caregivers in self-care and care-seeking, resulting in greater completeness of care and more highly skilled birth care. © 2014 by the American College of Nurse-Midwives.

  15. Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: observational cohort study

    Science.gov (United States)

    Robinson, Emily J; Power, Geraldine S; Nolan, Jerry; Soar, Jasmeet; Spearpoint, Ken; Gwinnutt, Carl; Rowan, Kathryn M

    2016-01-01

    Background Internationally, hospital survival is lower for patients admitted at weekends and at night. Data from the UK National Cardiac Arrest Audit (NCAA) indicate that crude hospital survival was worse after in-hospital cardiac arrest (IHCA) at night versus day, and at weekends versus weekdays, despite similar frequency of events. Objective To describe IHCA demographics during three day/time periods—weekday daytime (Monday to Friday, 08:00 to 19:59), weekend daytime (Saturday and Sunday, 08:00 to 19:59) and night-time (Monday to Sunday, 20:00 to 07:59)—and to compare the associated rates of return of spontaneous circulation (ROSC) for >20 min (ROSC>20 min) and survival to hospital discharge, adjusted for risk using previously developed NCAA risk models. To consider whether any observed difference could be attributed to differences in the case mix of patients resident in hospital and/or the administered care. Methods We performed a prospectively defined analysis of NCAA data from 27 700 patients aged ≥16 years receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a resuscitation (2222) call in 146 UK acute hospitals. Results Risk-adjusted outcomes (OR (95% CI)) were worse (p20 min 0.88 (0.81 to 0.95); hospital survival 0.72 (0.64 to 0.80)), and night-time (ROSC>20 min 0.72 (0.68 to 0.76); hospital survival 0.58 (0.54 to 0.63)) compared with weekday daytime. The effects were stronger for non-shockable than shockable rhythms, but there was no significant interaction between day/time of arrest and age, or day/time of arrest and arrest location. While many daytime IHCAs involved procedures, restricting the analyses to IHCAs in medical admissions with an arrest location of ward produced results that are broadly in line with the primary analyses. Conclusions IHCAs attended by the hospital-based resuscitation team during nights and weekends have substantially worse outcomes than during

  16. Foot care knowledge and practices and the prevalence of peripheral neuropathy among people with diabetes attending a secondary care rural hospital in southern India.

    Science.gov (United States)

    George, Hanu; Rakesh, Ps; Krishna, Manjunath; Alex, Reginald; Abraham, Vinod Joseph; George, Kuryan; Prasad, Jasmin H

    2013-01-01

    Diabetes mellitus is a multifaceted disease and foot ulceration is one of its most common complications. Poor foot care knowledge and practices are important risk factors for foot problems among people with diabetes. To assess the knowledge and practices regarding foot care and to estimate the proportion of people with peripheral neuropathy among people with diabetes. The cross-sectional study was conducted in 212 consecutive diabetes patients attending the out-patient department of a rural secondary care hospital. A questionnaire which included demographic details, knowledge questionnaire, and Nottingham assessment of functional foot care was administered. The Michigan Neuropathy Screening Instrument was used to identify peripheral neuropathy. Descriptive analysis with frequency distribution for knowledge and practice scores, univariate analysis, and multiple logistic regressions to find significant variables associated with good knowledge and practice scores. About 75% had good knowledge score and 67% had good foot care practice score. Male gender (OR 2.36, 95% CI 1.16-4.79), poor education status (OR 2.40, 95% CI 1.19-4.28), and lesser duration of diabetes (OR 2.24, 95% CI 1.15-4.41) were significantly associated with poor knowledge on foot care. Poor knowledge was associated with poor foot care practices (OR 3.43, 95% CI 1.75-6.72). The prevalence of neuropathy was 47% (95% CI 40.14-53.85) and it was associated with longer duration of the disease (OR 2.18, 95% CI 1.18-4.04). There exist deficiencies in knowledge and practices regarding foot care. Male gender, low education, and lesser duration of diabetes are associated with poor knowledge scores. The prevalence of diabetic peripheral neuropathy is high.

  17. Communication between residents and attending doctors on call after hours.

    Science.gov (United States)

    Novoselsky Persky, Michal A; Yinnon, Amos M; Freier-Dror, Yossi; Henshke-Bar-Meir, Ruth

    2013-12-01

    Off-hours medical care in hospitals is provided by residents, while attendings on call are available for assistance. This study evaluated the gap between residents' expectations and professional guidelines' requirements of attendings on call and what actually occurs during night shifts, while comparing surgical and medical specialties. Two questionnaires based on professional guidelines were filled by residents. The first queried about residents' expectations of attendings on call, and the second asked about communication with the attendings during actual night shifts. While 91 (100%) of residents expected the attending on call to be available by phone during the shift, only 44 (48%) expected the attending to initiate contact, and only 17 (19%) expected the attending to visit the ward or emergency department (ED) without being requested to do so. In 127 shifts (84%), some form of communication occurred. Residents called their attendings during 105 shifts (70%). However, attendings initiated contact with residents at the beginning or during the shift in only 67 (44%) and 62 (41%) shifts, respectively, and initiated a visit to the ward/ED during the shift in only 41 cases (27%). Surgical attendings initiated contact in these three ways significantly more frequently than medical attendings [21 (28%) versus 46 (61%), 20 (26%) versus 42 (56%) and 4 (5%) versus 37 (50%), respectively; P communication during night shifts between residents and attendings occurs in most shifts, attendings initiate far less contact with residents than is required by the guidelines. © 2013 John Wiley & Sons Ltd.

  18. Everyday Ethics in Dementia Day Care: Narratives of Crossing the Line.

    Science.gov (United States)

    Hasselkus, Betty Risteen

    1997-01-01

    Examines the ethical aspects of the experience of providing day care to dementia patients. Results, based on telephone interviews (N=40), indicate that ethical challenges arise in everyday incidents when participants, staff, or family members "cross the line" of acceptable behavior. Staff responses ranged from benign manipulation to…

  19. Physician-Pharmacist Collaborative Care for Dyslipidemia Patients: Knowledge and Skills of Community Pharmacists

    Science.gov (United States)

    Villeneuve, Julie; Lamarre, Diane; Lussier, Marie-Therese; Vanier, Marie-Claude; Genest, Jacques; Blais, Lucie; Hudon, Eveline; Perreault, Sylvie; Berbiche, Djamal; Lalonde, Lyne

    2009-01-01

    Introduction: In a physician-pharmacist collaborative-care (PPCC) intervention, community pharmacists were responsible for initiating lipid-lowering pharmacotherapy and adjusting the medication dosage. They attended a 1-day interactive workshop supported by a treatment protocol and clinical and communication tools. Afterwards, changes in…

  20. Intestinal Parasites in Children Attending Day Care Centers in Jos ...

    African Journals Online (AJOL)

    Two hundred and twenty-one children (57.8%) of the 384 children studied had intestinal parasites. Ascaris lumbricoides, Ancylostoma duodenale and Trichuris trichura were the commonest parasites found. The relationship between intestinal parasite infestation and diarrhea in past 2 months (X =19.5, df = 1, p< 0.001 ...

  1. An Assesment of Emergency Contraception Knowledge of Women Attending the Primary Health Care Center in Umraniye

    Directory of Open Access Journals (Sweden)

    M. Fatih Onsuz

    2008-10-01

    Full Text Available BACKGROUND: The aim of the study was to determined the knowledge of women who were in reproductive age that were attending to a primary health care center which was having family planning service in Umraniye. METHODS: This descriptive research has been performed at a primary health care center in Umraniye, between 18-20 December 2006. In our study study sample isn’t selected and we include women of reproductive age who are attending to the primary health care with any cause in the study dates. Study has been performed at 241 women (89.9% that has been interwieved of 268. Study data has been collected by a three part questionnaire which has 33 question. The data has been evaluated by chi square and Fisher exact tests. RESULTS: The median age of the participants was 28 (25p-75p. Small part of participants have heard emergency contraception (13.7%. There was a significant relationship between hearing the method, being nullipar and high education level (p<0.05. The participants who were hearing the method just 60.6% of them also knew the aim of the method (8.3% of the all participants. In the same group of the participants only 36.4% knew correctly of taking time of the pills and 9.0% of them knew correctly of taking piece of tablet after an unprotected sexual intercourse. Only one of the women who were determining of hearing the method also ever used it. There was a statistically significant difference between young age and high education level and knowing correctly of the aim of the method. Also there was a statisticaly significant difference between high education level and knowing correctly of taking time of the method after an unprotected sexual intercourse (p<0.05. CONCLUSION: Although awareness of emergency contraception is at an apparent level the using rate of the method is at a very low level. Giving education about the aim, taking time and how taking of the method to the women who are living at the study area is providing of giving shape

  2. Risks for upper respiratory infections in infants during their first months in day care included environmental and child-related factors.

    Science.gov (United States)

    Laursen, Rikke Pilmann; Larnkjaer, Anni; Ritz, Christian; Hojsak, Iva; Michaelsen, Kim; Mølgaard, Christian

    2018-03-14

    We examined the frequency and potential risk factors for respiratory infections, diarrhoea and absences in infants during their first months in day care. This prospective cohort study comprised 269 Danish infants aged eight months to 14 months and was part of a study that examined how probiotics affected absences from day care due to respiratory and gastrointestinal infections. The risk factors examined were the household, child characteristics and type of day care facility. Parents registered upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), diarrhoea and day care absences on web-based questionnaires. Over a mean of 5.6 months in day care, 36% and 20% of the infants had at least one URTI or LRTI, and 60% had diarrhoeal episodes. The risk of at least one URTI was increased by previous respiratory infections, with an odds ratio (OR) of 2.65, but was inversely associated with having a pet (OR: 0.43), being cared for by registered child minders compared to day care centres (OR: 0.36), birthweight (OR 0.40) and age at day care enrolment (OR: 0.64). No significant risk factors for LRTIs and diarrhoea were found. Infection risks were associated with environmental factors and factors related to the child. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  3. A regional multilevel analysis: can skilled birth attendants uniformly decrease neonatal mortality?

    Science.gov (United States)

    Singh, Kavita; Brodish, Paul; Suchindran, Chirayath

    2014-01-01

    Globally 40 % of deaths to children under-five occur in the very first month of life with three-quarters of these deaths occurring during the first week of life. The promotion of delivery with a skilled birth attendant (SBA) is being promoted as a strategy to reduce neonatal mortality. This study explored whether SBAs had a protective effect against neonatal mortality in three different regions of the world. The analysis pooled data from nine diverse countries for which recent Demographic and Health Survey data were available. Multilevel logistic regression was used to understand the influence of skilled delivery on two outcomes-neonatal mortality during the first week of life and during the first day of life. Control variables included age, parity, education, wealth, residence (urban/rural), geographic region (Africa, Asia and Latin America/Caribbean), antenatal care and tetanus immunization. The direction of the effect of skilled delivery on neonatal mortality was dependent on geographic region. While having a SBA at delivery was protective against neonatal mortality in Latin America/Caribbean, in Asia there was only a protective effect for births in the first week of life. In Africa SBAs were associated with higher neonatal mortality for both outcomes, and the same was true for deaths on the first day of life in Asia. Many women in Africa and Asia deliver at home unless a complication occurs, and thus skilled birth attendants may be seeing more women with complications than their unskilled counterparts. In addition there are issues with the definition of a SBA with many attendants in both Africa and Asia not actually having the needed training and equipment to prevent neonatal mortality. Considerable investment is needed in terms of training and health infrastructure to enable these providers to save the youngest lives.

  4. Internação domiciliar: o perfil dos pacientes assistidos pelo Programa HU em Casa Home care: profile of patients attended by a home care program

    Directory of Open Access Journals (Sweden)

    Daniella Reis Barbosa Martelli

    2011-01-01

    medical records from May 2005 to May 2008. Of the 137 analyzed patients, 75 were females (54.7% and 62 males (45.3%. Concerning age, the 61-80 year group was the most prevalent (37.2% and 73% lived and was attended in the peripheral districts of Montes Claros city. Among the most important diseases in the first admission, the most prevalent was pneumonia (22 cases, 16.1%. Most patients were referred to the HU em Casa Home Care Program for the medical clinic (84.7% with a range of higher prevalence of 2 to 3 admissions (42.4%. Of the total patients, 120 (87.6% stayed in hospital for 16 to 30 days. Referring to resolutivity, 130 (94.9% patients were discharged to the program on the first admission. The PID proved to be a high-solving program, attended mainly elderly women with low income and with periods of relatively short hospitalization.

  5. [Nutrition in childhood--demands and reality. Outcomes of the nutrition and catering situation in Saxon day-care centers].

    Science.gov (United States)

    Wolfram, N; Hillger, C; Jüttler, G; Müller, C; Benterbusch, R; Kirch, W

    2007-10-01

    The aim of this research project was to compile a significant database and information about the nutritional and catering situation concerning children aged between 4 and 6 years in Saxony. The project focused on the range of foods available in day-care centers. The actual food consumption was not assessed. Standardized interviews of the management of day-care centers were undertaken. Furthermore standardized questionnaires, which included a three-day-recall of the contents of the children's lunch boxes, were used to interview parents (n = 4082, response rate 49 %). In order to evaluate the lunch catering, the menus were analysed for 4 weeks. Hot lunches were delivered to the day-care centers. For the most part caterers and day-care center management did not translate the recommendations of an optimized mixed diet. Meat dishes were too often part of the menus. Salt-water fish was offered irregularly and the preparation did not fulfill the recommendations. Potatoes, fresh fruits, uncooked vegetarian food or salads were seldom offered on the menus. Regardless of the monthly household budget most children have lunch in day-care centers. The meal offerings, not only lunches, showed potential for improvement concerning a balanced energy and nutrient provision. Therefore all persons involved in providing children's meals should take on full responsibility.

  6. Syllabus Outline on Child Care for Day Care Teachers at Family Life Teacher Training Centre in Somalia. African Studies in Curriculum Development and Evaluation No. 103.

    Science.gov (United States)

    Ahmed, Mumina M.

    Five day care centers in Mogadiscio, the capital city of Somalia, were studied to (1) identify problems encountered in teaching a course in child care; (2) observe teaching methods and assess their effectiveness; (3) ascertain reasons for the lack of preservice training for day care teachers; and (4) develop a new syllabus for a course in child…

  7. Gestational diabetes mellitus: The prevalence, associated factors and foeto-maternal outcome of women attending antenatal care.

    Directory of Open Access Journals (Sweden)

    Mohd Azahadi Bin Omar

    2017-08-01

    Full Text Available Objective: The aim of the study is to determine the prevalence of gestational diabetes mellitus (GDM, its associated risk factors, foeto-maternal outcomes and prevalence of postnatal diabetes mellitus (DM. Methods: This is a cross-sectional study using retrospective data from existing antenatal records of new antenatal women who registered at 72 public health clinics in Selangor in January 2014. Results: A total of 745 antenatal records were reviewed. The prevalence of GDM women was 27.9% (n = 184. GDM risks were higher in women aged 35 years old and above and in those with maternal obesity. GDM women had a higher risk of having a non-spontaneous vaginal delivery compared to non-GDM women. The prevalence of postnatal DM among GDM mother was 12.1%. Working GDM mothers were at higher risk of developing postnatal DM. Conclusion: The prevalence of GDM among newly registered women attending antenatal public health care in Selangor was higher than previous studies. Health care personnel need to be vigilant in screening women with risk factors.

  8. Practice versus politics in Danish day-care centers

    DEFF Research Database (Denmark)

    Clasen, Line; Jensen de López, Kristine M.

    2016-01-01

    It is essential that early educators in day-care services possess adequate pedagogical tools for supporting children’s communicative development. Early literacy programmes (ELPs) are potential tools. However, studies investigating the effects of ELPs seldom address implementation processes......’ (NNS) political statements on early learning. This study presents results from 18 pre-programme interviews with pedagogues and illustrates their daily practices prior to the ELP implementation. Results suggest that: (1) there is a potential gap between practice and politics concerning Danish practices...... for promoting early learning; and (2) certain aspects related to existing pedagogical practices may be foreseen as potential challenges for the implementation of structured ELPs....

  9. Obstetric complications: does training traditional birth attendants make a difference?

    Directory of Open Access Journals (Sweden)

    Patricia E. Bailey

    2002-01-01

    Full Text Available Objective. To assess the effect that a training intervention for traditional birth attendants (TBAs in Guatemala had on the detection of obstetric complications, the referral of patients with complications to the formal health care system, and, ultimately, those patients' utilization of essential obstetric care services. Methods. Using a quasi-experimental design, a surveillance system of births was implemented to collect population-based information from 3 518 women between 1990 and 1993. All women were interviewed postpartum by physicians. There were three key independent variables in our study: 1 geographical area (intervention community and non-intervention community, 2 time in relation to the training intervention (before or after, and 3 presence or absence of a TBA at the time of the complication. The key dependent variables for women interviewed were 1 development of an obstetric complication, 2 detection of the problem by the TBA, 3 referral to a health facility, 4 compliance with referral, and 5 use of services. Results. The incidence of postpartum complications decreased after the intervention, controlling for intervention community. On the other hand, after the intervention TBAs were less likely to recognize most maternal complications, and referral rates did not increase significantly. The likelihood of using health care services increased six-fold among women who were not attended by TBAs, and no increase was observed among those who were attended by TBAs. Conclusion. Training TBAs may have had a positive effect on the rate, detection, and referral of postpartum complications. However, the evidence is less convincing for overall increases in the detection of complications, in referral to the formal health care system, and in the utilization of essential obstetric services among women attended by TBAs.

  10. Examining the Relationship Between Perceived Quality of Care and Actual Quality of Care as Measured by 30-Day Readmission Rates.

    Science.gov (United States)

    Salinas, Stanley R

    To test the relationship between patient experience, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and actual quality of care, as measured by 30-day readmission rates. Both HCAHPS data and outcome data reported to the Centers of Medicare & Medicaid Services (CMS). This secondary, nationwide (N = 4060), hospital-level study focused only on acute care hospitals. HCAHPS question 22 "Would you recommend this hospital to your friends and family?" was used to determine level of overall satisfaction, and 30-day readmission rates, as reported to the CMS, was used as a proxy for actual quality of care. A statistically significant relationship was found between patient experience and actual quality outcomes. The results of this study reinforce the inclusion of patient experience in Medicare's Value Based Purchasing program as a matter of good public policy.

  11. Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China.

    Science.gov (United States)

    Li, Man; Zhong, Renyao; Zhu, Shanwen; Ramsay, Lauren C; Li, Fen; Coyte, Peter C

    2018-06-06

    Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1) explore regional differences in community living infrastructure; and (2) to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015)”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.

  12. Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China

    Directory of Open Access Journals (Sweden)

    Man Li

    2018-06-01

    Full Text Available Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1 explore regional differences in community living infrastructure; and (2 to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.

  13. Association of type of birth attendant and place of delivery on infant ...

    African Journals Online (AJOL)

    panding health care services during the 1970s and 1980s, increasing ... aging prenatal care and family planning services after delivery, assisting with ..... World Socialist Web Site. 2008. ... ditional birth attendants with formal health systems.

  14. Should Attendance Be Required in Lecture Classrooms in Dental Education? Two Viewpoints: Viewpoint 1: Attendance in the Lecture Classroom Should Be Required and Viewpoint 2: Attendance Should Not Be Required in the Lecture Classroom.

    Science.gov (United States)

    Cutler, Christopher W; Parise, Mary; Seminario, Ana Lucia; Mendez, Maria Jose Cervantes; Piskorowski, Wilhelm; Silva, Renato

    2016-12-01

    This Point/Counterpoint discusses the long-argued debate over whether lecture attendance in dental school at the predoctoral level should be required. Current educational practice relies heavily on the delivery of content in a traditional lecture style. Viewpoint 1 asserts that attendance should be required for many reasons, including the positive impact that direct contact of students with faculty members and with each other has on learning outcomes. In lectures, students can more easily focus on subject matter that is often difficult to understand. A counter viewpoint argues that required attendance is not necessary and that student engagement is more important than physical classroom attendance. This viewpoint notes that recent technologies support active learning strategies that better engage student participation, fostering independent learning that is not supported in the traditional large lecture classroom and argues that dental education requires assimilation of complex concepts and applying them to patient care, which passing a test does not ensure. The two positions agree that attendance does not guarantee learning and that, with the surge of information technologies, it is more important than ever to teach students how to learn. At this time, research does not show conclusively if attendance in any type of setting equals improved learning or ability to apply knowledge.

  15. Healthy incentive scheme in the Irish full-day-care pre-school setting.

    LENUS (Irish Health Repository)

    Molloy, C Johnston

    2013-12-16

    A pre-school offering a full-day-care service provides for children aged 0-5 years for more than 4 h\\/d. Researchers have called for studies that will provide an understanding of nutrition and physical activity practices in this setting. Obesity prevention in pre-schools, through the development of healthy associations with food and health-related practices, has been advocated. While guidelines for the promotion of best nutrition and health-related practice in the early years\\' setting exist in a number of jurisdictions, associated regulations have been noted to be poor, with the environment of the child-care facility mainly evaluated for safety. Much cross-sectional research outlines poor nutrition and physical activity practice in this setting. However, there are few published environmental and policy-level interventions targeting the child-care provider with, to our knowledge, no evidence of such interventions in Ireland. The aim of the present paper is to review international guidelines and recommendations relating to health promotion best practice in the pre-school setting: service and resource provision; food service and food availability; and the role and involvement of parents in pre-schools. Intervention programmes and assessment tools available to measure such practice are outlined; and insight is provided into an intervention scheme, formulated from available best practice, that was introduced into the Irish full-day-care pre-school setting.

  16. Traditional Birth Attendant Training and Local Birthing Practices in India

    Science.gov (United States)

    Saravanan, Sheela; Turrell, Gavin; Johnson, Helen; Fraser, Jenny; Patterson, Carla

    2011-01-01

    Training birth attendants (TBAs) to provide essential maternal and infant health care services during delivery and ongoing community care in developing countries. Despite inadequate evidence of relevance and effectiveness of TBA training programmes, there has been a policy shift since the 1990s in that many donor agencies funding TBA training…

  17. Attendance and Utilization of Antenatal Care (ANC) Services: Multi-Center Study in Upcountry Areas of Uganda.

    Science.gov (United States)

    Kawungezi, Peter Chris; AkiiBua, Douglas; Aleni, Carol; Chitayi, Michael; Niwaha, Anxious; Kazibwe, Andrew; Sunya, Elizabeth; Mumbere, Eliud W; Mutesi, Carol; Tukei, Cathy; Kasangaki, Arabat; Nakubulwa, Sarah

    2015-03-01

    Globally every year 529,000 maternal deaths occur, 99% of this in developing countries. Uganda has high maternal and neonatal morbidity and mortality ratios, typical of many countries in sub-Saharan Africa. Recent findings reveal maternal mortality ratio of 435:100,000 live births and neonatal mortality rate of 29 deaths per 1000 live births in Uganda; these still remain a challenge. Women in rural areas of Uganda are two times less likely to attend ANC than the urban women. Most women in Uganda have registered late ANC attendance, averagely at 5.5 months of pregnancy and do not complete the required four visits. The inadequate utilization of ANC is greatly contributing to persisting high rates of maternal and neonatal mortality in Uganda. This study was set to identify the factors associated with late booking and inadequate utilization of Antenatal Care services in upcountry areas of Uganda. Cross-sectional study design with mixed methods of interviewer administered questionnaires, focus group discussions and key informant interviews. Data was entered using Epidata and analyzed using Stata into frequency tables using actual tallies and percentages. Ethical approval was sought from SOM-REC MakCHS under approval number "#REC REF 2012-117" before conducting the study. A total of four hundred one were enrolled with the majority being in the age group 20 - 24 years (mean age, 25.87 ± 6.26). Health workers played a great role (72.04%), followed by the media (15.46%) and friends (12.50%) in creating awareness about ANC. A significant number of respondents went to TBAs with reasons such as "near and accessible", "my husband decided", and "they are the only people I know". 37.63% of the respondents considered getting an antenatal Card as an importance of ANC. 71 (19.67%) respondents gave a wrong opinion (late) on booking time with reasons like demands at work, no problems during pregnancy, advised by friends, just to get a card, long distance and others didn't know

  18. Management of severe childhood pneumonia by day care approach in developing countries

    Directory of Open Access Journals (Sweden)

    Yasmin Jahan

    2018-01-01

    Full Text Available Background: Background: Pneumonia is a major cause of child mortality among children under 5 years, worldwide. Pneumonia infection may be caused by bacteria, viruses, or fungi in single or in both lungs. According to recent criteria developed by the World Health Organization(WHO in September (2013, pneumonia can be classified into severe pneumonia, pneumonia and no pneumonia. Most of the deaths occur from severe pneumonia.Methods: Disease management of severe childhood pneumonia requires early identification,prompt referral and the availability of intensive quality care. Under 5 years old children with severe pneumonia should receive day care, with antibiotic treatment, feeding, and supportive care with similar 24-hour hospital treatment.Discussion: Considering that difficulties, International Centre for Diarrheal Disease Research,Bangladesh (ICDDR, B initiated Day Care Approach (DCA model, as an innovative, safe,effective and less expensive alternative to hospital management of severe childhood pneumonia.A 24 months old girl came to the health care center with severe breathing difficulty, cough,history of fever and head nodding. The management described below was continued daily until there was clinical improvement; no fever, no fast breathing, no lower chest wall in drawing, no danger signs, no rales on auscultation, and no hypoxemia. Conclusion: Considering the WHO case management protocol for severe pneumonia, DCA recommends that diagnosis of severe pneumonia should be based primarily on visible clinical parameters. On that basis, severe childhood pneumonia can be successfully managed at daycare clinics including for children with hypoxemia who is required prolong (4-6 hours oxygen therapy.

  19. In-center hemodialysis attendance: patient perceptions of risks, barriers, and recommendations.

    Science.gov (United States)

    Chenitz, Kara B; Fernando, Michael; Shea, Judy A

    2014-04-01

    Missed hemodialysis treatments lead to increased morbidity and mortality in the end-stage renal disease population. Little is known about why patients have difficulty attending their scheduled in-center dialysis treatments. Semistructured interviews with 15 adherent and 15 nonadherent hemodialysis patients were conducted to determine patients' attitudes about dialysis, health beliefs and risk perception regarding missed treatments, barriers and facilitators to hemodialysis attendance, and recommendations to improve the system to facilitate dialysis attendance. Average time on dialysis was 2.5 years for the nonadherent group and 7.3 years in the adherent group. In both groups, patients felt that dialysis is life-saving and a necessity. A substantial number of patients in both groups understood that missing hemodialysis treatments is dangerous and several patients could clearly communicate the risk of skipping. The most common barriers to hemodialysis were inadequate or unreliable transportation (mentioned in both groups) and a lack of motivation to get to dialysis or that dialysis is not a priority (typically mentioned by the nonadherent group). Facilitators to hemodialysis attendance included explanations from the health care team regarding the risk of skipping and relationships with other dialysis patients. Patient recommendations to improve dialysis attendance included continued education about the risk of poor attendance and more accessible transportation. Patients did not feel that home dialysis would improve adherence. Hemodialysis patients must adhere to a complex and burdensome regimen. Through the elucidation of barriers and facilitators to hemodialysis attendance and through specific patient recommendations, at least three interventions may be further investigated to improve hemodialysis attendance: Improvement of the transportation system, education and supportive encouragement from the health care team, and peer support mentorship. © 2014 International

  20. Risks for upper respiratory infections in infants during their first months in day care included environmental and child-related factors

    DEFF Research Database (Denmark)

    Laursen, Rikke Pilmann; Larnkjær, Anni; Ritz, Christian

    2018-01-01

    AIM: We examined the frequency and potential risk factors for respiratory infections, diarrhoea and absences in infants during their first months in day care. METHODS: This prospective cohort study comprised 269 Danish infants aged 8-14 months and was part of a study that examined how probiotics...... affected absences from day care due to respiratory and gastrointestinal infections. The risk factors examined were the household, child characteristics and type of day care facility. Parents registered upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), diarrhoea and day...... care absences on web-based questionnaires. RESULTS: Over a mean of 5.6 months in day care, 36% and 20% of the infants had at least one URTI or LRTI and 60% had diarrhoeal episodes. The risk of at least one URTI was increased by previous respiratory infections, with an odds ratio (OR) of 2...

  1. Foot care knowledge and practices and the prevalence of peripheral neuropathy among people with diabetes attending a secondary care rural hospital in southern India

    Directory of Open Access Journals (Sweden)

    Hanu George

    2013-01-01

    Full Text Available Background: Diabetes mellitus is a multifaceted disease and foot ulceration is one of its most common complications. Poor foot care knowledge and practices are important risk factors for foot problems among people with diabetes. Aims: To assess the knowledge and practices regarding foot care and to estimate the proportion of people with peripheral neuropathy among people with diabetes. Settings and Design: The cross-sectional study was conducted in 212 consecutive diabetes patients attending the out-patient department of a rural secondary care hospital Materials and Methods: A questionnaire which included demographic details, knowledge questionnaire, and Nottingham assessment of functional foot care was administered. The Michigan Neuropathy Screening Instrument was used to identify peripheral neuropathy. Statistical Analysis Used: Descriptive analysis with frequency distribution for knowledge and practice scores, univariate analysis, and multiple logistic regressions to find significant variables associated with good knowledge and practice scores. Results: About 75% had good knowledge score and 67% had good foot care practice score. Male gender (OR 2.36, 95% CI 1.16-4.79, poor education status (OR 2.40, 95% CI 1.19-4.28, and lesser duration of diabetes (OR 2.24, 95% CI 1.15-4.41 were significantly associated with poor knowledge on foot care. Poor knowledge was associated with poor foot care practices (OR 3.43, 95% CI 1.75-6.72. The prevalence of neuropathy was 47% (95% CI 40.14-53.85 and it was associated with longer duration of the disease (OR 2.18, 95% CI 1.18-4.04. Conclusion: There exist deficiencies in knowledge and practices regarding foot care. Male gender, low education, and lesser duration of diabetes are associated with poor knowledge scores. The prevalence of diabetic peripheral neuropathy is high.

  2. Did professional attendance at home births improve early neonatal survival in Indonesia?

    Science.gov (United States)

    Hatt, Laurel; Stanton, Cynthia; Ronsmans, Carine; Makowiecka, Krystyna; Adisasmita, Asri

    2009-07-01

    BACKGROUND Early neonatal mortality has been persistently high in developing countries. Indonesia, with its national policy of home-based, midwife-assisted birth, is an apt context for assessing the effect of home-based professional birth attendance on early neonatal survival. METHODS We pooled four Indonesian Demographic and Health Surveys and used multivariate logistic regression to analyse trends in first-day and early neonatal mortality. We measured the effect of the context of delivery, including place and type of provider, and tested for changes in trend when the 'Midwife in the Village' programme was initiated. RESULTS Reported first-day mortality did not decrease significantly between 1986 and 2002, whereas early neonatal mortality decreased by an average of 3.2% annually. The rate of the decline did not change over the time period, either in 1989 when the Midwife in the Village programme was initiated, or in any year following when uptake of professional care increased. In simple and multivariate analyses, there were no significant differences in first-day or early neonatal death rates comparing home-based births with or without a professional midwife. Early neonatal mortality was higher in public facilities, likely due to selection. Biological determinants (twin births, male sex, short birth interval, previous early neonatal loss) were important for both outcomes. CONCLUSIONS Decreasing newborn death rates in Indonesia are encouraging, but it is not clear that these decreases are associated with greater uptake of professional delivery care at home or in health facilities. This may suggest a need for improved training in immediate newborn care, strengthened emergency referral, and continued support for family planning policies.

  3. Poor thermal care practices among home births in Nepal: further analysis of Nepal Demographic and Health Survey 2011.

    Science.gov (United States)

    Khanal, Vishnu; Gavidia, Tania; Adhikari, Mandira; Mishra, Shiva Raj; Karkee, Rajendra

    2014-01-01

    Hypothermia is a major factor associated with neonatal mortality in low and middle income countries. Thermal care protection of newborn through a series of measures taken at birth and during the initial days of life is recommended to reduce the hypothermia and associated neonatal mortality. This study aimed to identify the prevalence of and the factors associated with receiving 'optimum thermal care' among home born newborns of Nepal. Data from the Nepal Demographic and Health Surveys (NDHS) 2011 were used for this study. Women who reported a home birth for their most recent childbirth was included in the study. Factors associated with optimum thermal care were examined using Chi-square test followed by logistic regression. A total of 2464 newborns were included in the study. A total of 57.6 % were dried before the placenta was delivered; 60.3% were wrapped; 24.5% had not bathing during the first 24 hours, and 63.9% were breastfed within one hour of birth. Overall, only 248 (10.7%; 95% CI (8.8 %, 12.9%)) newborns received optimum thermal care. Newborns whose mothers had achieved higher education (OR 2.810; 95% CI (1.132, 6.976)), attended four or more antenatal care visits (OR 2.563; 95% CI (1.309, 5.017)), and those whose birth were attended by skilled attendants (OR 2.178; 95% CI (1.428, 3.323)) were likely to receive optimum thermal care. The current study showed that only one in ten newborns in Nepal received optimum thermal care. Future newborn survival programs should focus on those mothers who are uneducated; who do not attend the recommended four or more attend antenatal care visits; and those who deliver without the assistance of skilled birth attendants to reduce the risk of neonatal hypothermia in Nepal.

  4. Poor thermal care practices among home births in Nepal: further analysis of Nepal Demographic and Health Survey 2011.

    Directory of Open Access Journals (Sweden)

    Vishnu Khanal

    Full Text Available INTRODUCTION: Hypothermia is a major factor associated with neonatal mortality in low and middle income countries. Thermal care protection of newborn through a series of measures taken at birth and during the initial days of life is recommended to reduce the hypothermia and associated neonatal mortality. This study aimed to identify the prevalence of and the factors associated with receiving 'optimum thermal care' among home born newborns of Nepal. METHODS: Data from the Nepal Demographic and Health Surveys (NDHS 2011 were used for this study. Women who reported a home birth for their most recent childbirth was included in the study. Factors associated with optimum thermal care were examined using Chi-square test followed by logistic regression. RESULTS: A total of 2464 newborns were included in the study. A total of 57.6 % were dried before the placenta was delivered; 60.3% were wrapped; 24.5% had not bathing during the first 24 hours, and 63.9% were breastfed within one hour of birth. Overall, only 248 (10.7%; 95% CI (8.8 %, 12.9% newborns received optimum thermal care. Newborns whose mothers had achieved higher education (OR 2.810; 95% CI (1.132, 6.976, attended four or more antenatal care visits (OR 2.563; 95% CI (1.309, 5.017, and those whose birth were attended by skilled attendants (OR 2.178; 95% CI (1.428, 3.323 were likely to receive optimum thermal care. CONCLUSION: The current study showed that only one in ten newborns in Nepal received optimum thermal care. Future newborn survival programs should focus on those mothers who are uneducated; who do not attend the recommended four or more attend antenatal care visits; and those who deliver without the assistance of skilled birth attendants to reduce the risk of neonatal hypothermia in Nepal.

  5. Seroprevalence of venereal disease among pregnant women attending antenatal care (ANC) in Onitsha, Anambra State, Southeast, Nigeria.

    Science.gov (United States)

    Mbamara, S U; Obiechina, N J A

    2011-01-01

    Venereal Syphilis if not properly and timely treated has been noted to have devastating effects on the fetus and baby. Of all the sexually transmitted infections, however, venereal syphilis is one of the most commonly screened among antenatal women. This screening is usually limited to the tertiary institutions thereby leaving the women who attend private hospitals to a disadvantage. This current research is to determine the seroprevalence of venereal disease among women attending ANC in an Onitsha specialist private hospital and to ascertain the acceptability, and the feasibility of conducting the screening in a private setup. This cross sectional prospective study was conducted among women, who were on their first ANC visit at Grace Specialist Hospital, Nkpor, Southeast Nigeria. They were offered VDRL test by ELISA method and TPHA confirmation test to those who were seropositive to VDRL test. Two thousand nine hundred and ninety six women attended antenatal care during the study period but 1393 women took part in this study giving an uptake rate of 46.5%. The seroprevalence rate to venereal syphilis was 0.6%. Three out of the 8 seropositive results were confirmed with TPHA test. This gives a TPHA/VDRL ratio of 0.43. The highest range of occurrence was 25 29years. There was neither a significant association between age distribution and VDRL screening result (chi2 = 1.13; df =5; p = 0.951) nor between parity distribution and VDRL screening result (chi2 = 6.2; df = 6; p = 0.4007). Although the seroprevalence of venereal syphilis is low but routine universal screening of Venereal syphilis is possible in private hospitals and its establishment should be encouraged.

  6. Postpartum Visit Attendance Increases the Use of Modern Contraceptives.

    Science.gov (United States)

    Masho, Saba W; Cha, Susan; Charles, RaShel; McGee, Elizabeth; Karjane, Nicole; Hines, Linda; Kornstein, Susan G

    2016-01-01

    Background. Delays in postpartum contraceptive use may increase risk for unintended or rapid repeat pregnancies. The postpartum care visit (PPCV) is a good opportunity for women to discuss family planning options with their health care providers. This study examined the association between PPCV attendance and modern contraceptive use using data from a managed care organization. Methods. Claims and demographic and administrative data came from a nonprofit managed care organization in Virginia (2008-2012). Information on the most recent delivery for mothers with singleton births was analyzed ( N = 24,619). Routine PPCV (yes, no) and modern contraceptive use were both dichotomized. Descriptive analyses provided percentages, frequencies, and means. Multiple logistic regression was conducted and ORs and 95% CIs were calculated. Results. More than half of the women did not attend their PPCV (50.8%) and 86.9% had no modern contraceptive use. After controlling for the effects of confounders, women with PPCV were 50% more likely to use modern contraceptive methods than women with no PPCV (OR = 1.50, 95% CI = 1.31, 1.72). Conclusions. These findings highlight the importance of PPCV in improving modern contraceptive use and guide health care policy in the effort of reducing unintended pregnancy rates.

  7. Postpartum Visit Attendance Increases the Use of Modern Contraceptives

    Directory of Open Access Journals (Sweden)

    Saba W. Masho

    2016-01-01

    Full Text Available Background. Delays in postpartum contraceptive use may increase risk for unintended or rapid repeat pregnancies. The postpartum care visit (PPCV is a good opportunity for women to discuss family planning options with their health care providers. This study examined the association between PPCV attendance and modern contraceptive use using data from a managed care organization. Methods. Claims and demographic and administrative data came from a nonprofit managed care organization in Virginia (2008–2012. Information on the most recent delivery for mothers with singleton births was analyzed (N = 24,619. Routine PPCV (yes, no and modern contraceptive use were both dichotomized. Descriptive analyses provided percentages, frequencies, and means. Multiple logistic regression was conducted and ORs and 95% CIs were calculated. Results. More than half of the women did not attend their PPCV (50.8% and 86.9% had no modern contraceptive use. After controlling for the effects of confounders, women with PPCV were 50% more likely to use modern contraceptive methods than women with no PPCV (OR = 1.50, 95% CI = 1.31, 1.72. Conclusions. These findings highlight the importance of PPCV in improving modern contraceptive use and guide health care policy in the effort of reducing unintended pregnancy rates.

  8. Reported Church Attendance at the Time of Entry into HIV Care is Associated with Viral Load Suppression at 12 Months.

    Science.gov (United States)

    Van Wagoner, Nicholas; Elopre, Latesha; Westfall, Andrew O; Mugavero, Michael J; Turan, Janet; Hook, Edward W

    2016-08-01

    The Southeast has high rates of church attendance and HIV infection rates. We evaluated the relationship between church attendance and HIV viremia in a Southeastern US, HIV-infected cohort. Viremia (viral load ≥200 copies/ml) was analyzed 12 months after initiation of care. Univariate and multivariable logistic regression models were fit for variables potentially related to viremia. Of 382 patients, 74 % were virally suppressed at 12 months. Protective variables included church attendance (AOR 0.5; 95 % CI 0.2, 0.9), being on antiretroviral therapy (AOR 0.01; 95 % CI 0.004, 0.04), CD4(+) T lymphocyte count 200-350 cells/mm(3) at care entry (AOR 0.3; 95 % 0.1, 0.9), and education (AOR 0.5; 95 % CI 0.2, 0.9). Variables predicting viremia included black race (AOR 3.2; 95 % CI 1.4, 7.4) and selective disclosure of HIV status (AOR 2.7; 95 % CI 1.2, 5.6). Church attendance may provide needed support for patients entering HIV care for the first time. El Sur Este de los Estados Unidos tiene tasas altas de visitas a iglesias y de infección por VIH. Evaluamos la relación entre visitas a iglesias y viremia por VIH en una cohorte de pacientes infectados con VIH en el Sur Este de los EEUU. La viremia (carga viral ≥ 200 copias/ml) fue analizada a los 12 meses de iniciar el cuidado médico. Los modelos de regresión logística univariado y multivariado fueron ajustados para variables potencialmente relacionadas a viremia. De 382 pacientes, 75 % tuvieron supresión virológica a los 12 meses. Variables que ofrecieron protección fueron visitas a iglesias (AOR 0.5; IC95 % 0.2-0.9), recibir terapia antiretroviral (AOR 0.01; IC95 % 0.004,0.04), recuento de linfocitos T CD4 + 200-350 al iniciar cuidado médico (AOR 0.3; IC95 % 0.1,09), y educación (AOR 0.5; IC95 % 0.2,0.9). Las variables que predijeron viremia incluyeron raza negra (AOR 3.2; IC95 % 1.4,7.4) y la comunicación selectiva del diagnóstico de VIH a otras personas (AOR 2.7; 95 % IC 1

  9. Advancing Care Within an Adult Mental Health Day Hospital: Program Re-Design and Evaluation.

    Science.gov (United States)

    Taube-Schiff, Marlene; Mehak, Adrienne; Marangos, Sandy; Kalim, Anastasia; Ungar, Thomas

    2017-11-13

    Day hospital mental health programs provide alternate care to individuals of high acuity that do not require an inpatient psychiatric stay. Ensuring provision of best practice within these programs is essential for patient stabilization and recovery. However, there is scant literature to review when creating such a program. This paper provides an overview of the steps an acute care hospital took when designing and implementing new programming within a day hospital program. Qualitative data was collected following initial program rollout. This data helped to inform the ongoing modification of groups offered, group scheduling and content, as well as ensuring patient satisfaction and adequate skill delivery during the rollout period and beyond. The goal of this paper is to inform health service delivery for other programs when attempting to build or re-design a day hospital program.

  10. Boosting antenatal care attendance and number of hospital deliveries among pregnant women in rural communities: a community initiative in Ghana based on mobile phones applications and portable ultrasound scans.

    Science.gov (United States)

    Amoah, Benjamin; Anto, Evelyn A; Osei, Prince K; Pieterson, Kojo; Crimi, Alessandro

    2016-06-14

    The World Health Organization has recommended at least four antenatal care (ANC) visits and skilled attendants at birth. Most pregnant women in rural communities in low-income countries do not achieve the minimum recommended visits and deliver without skilled attendants. With the aim of increasing number of ANC visits, reducing home deliveries, and supplementing care given by ANC clinics, a proposed system based on low-cost mobile phones and portable ultrasound scan machines was piloted. A sample of 323 pregnant women from four rural communities in the Central Region of Ghana were followed within a 11-month project. In each community, at least one health worker was trained and equipped with a mobile phone to promote ANC and hospital deliveries in her own community. If women cannot attend ANC, technicians acquired scans by using portable ultrasound machines in her community directly and sent them almost in real time to be analyzed by a gynecologist in an urban hospital. A preliminary survey to assess ANC status preceding the pilot study was conducted. During this, one hundred women who had had pregnancies within five years prior to the study were interviewed. The preliminary survey showed that women who attended ANC were less likely to have a miscarriage and more likely to have delivery at hospital or clinic than those who did not, and women who attained at least four ANC visits were less likely to practice self-medication. Among the women involved in the project, 40 gave birth during the period of observation. The proposed prenatal care approach showed that 62.5 % of pregnant women who gave birth during the observation period included in the project (n=40) had their labor attended in clinics or hospitals as against 37.5 % among the cases reported in the pre-survey. One case of ectopic and two cases of breech pregnancies were detected during the pilot through the proposed approach, and appropriate medical interventions were sought. Our results show that the proposed

  11. Perceptions of antenatal care services by pregnant women attending government health centres in the Buea Health District, Cameroon: a cross sectional study.

    Science.gov (United States)

    Edie, Gregory Edie Halle Ekane; Obinchemti, Thomas Egbe; Tamufor, Emmanuel Njuma; Njie, Martin Mafany; Njamen, Theophile Nana; Achidi, Eric Akum

    2015-01-01

    User'sperception of quality of ANC services crucially impacts continuity of use of these services and hence pregnancy outcome. However in our community, ANC user's perceptions of quality are not known. An observational analytic cross-sectional study was carried out amongst pregnant women attending selected government health centres in the Buea Health District. We recruited 385 consenting pregnant women for the study. Demographic and clinical data were collected using structured questionnaires. The data was entered into Microsoft Excel and exported toEpi-Info (Version 3.5.1) for analysis. Geographical accessibility and perceived quality of care were the predominant reasons for choosing or changing a site for ANC. One third of respondents (30.1%) attended a health centre out of their catchment health area with Buea Town health centre receiving the highest proportion of women out of the health area (56.8% of attendees). Knowledge about antenatal care varied and majority of respondents (96.4%) were satisfied with the antenatal services received. However, there were elements of dissatisfaction with health centre services, poor sitting facilities, amenities, few health education talks and poor nursing skills. High educational level (high school and university) (X(2) = 8.714; p = 0.01) and first time pregnancy(X(2)= 4.217; p= 0.04) were significantly associated with poor satisfaction. Policy makers should implement changes in the health care delivery system taking into account the users' preferences, more so in the light of increasing female education in Cameroon.

  12. Computer-based intervention in HIV clinical care setting improves antiretroviral adherence: the LifeWindows Project.

    Science.gov (United States)

    Fisher, Jeffrey D; Amico, K Rivet; Fisher, William A; Cornman, Deborah H; Shuper, Paul A; Trayling, Cynthia; Redding, Caroline; Barta, William; Lemieux, Anthony F; Altice, Frederick L; Dieckhaus, Kevin; Friedland, Gerald

    2011-11-01

    We evaluated the efficacy of LifeWindows, a theory-based, computer-administered antiretroviral (ARV) therapy adherence support intervention, delivered to HIV + patients at routine clinical care visits. 594 HIV + adults receiving HIV care at five clinics were randomized to intervention or control arms. Intervention vs. control impact in the intent-to-treat sample (including participants whose ARVs had been entirely discontinued, who infrequently attended care, or infrequently used LifeWindows) did not reach significance. Intervention impact in the On Protocol sample (328 intervention and control arm participants whose ARVs were not discontinued, who attended care and were exposed to LifeWindows regularly) was significant. On Protocol intervention vs. control participants achieved significantly higher levels of perfect 3-day ACTG-assessed adherence over time, with sensitivity analyses maintaining this effect down to 70% adherence. This study supports the utility of LifeWindows and illustrates that patients on ARVs who persist in care at clinical care sites can benefit from adherence promotion software.

  13. Prevalence of sexually transmitted infections in women attending ...

    African Journals Online (AJOL)

    Objective. To determine the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and syphilis in pregnant women. Methods. A cross-sectional study was conducted among women attending antenatal care clinics (ANCs). Blood samples were tested for syphilis using the rapid plasma reagin (RPR) and

  14. School absenteeism among school-aged children with medically attended acute viral respiratory illness during three influenza seasons, 2012-2013 through 2014-2015.

    Science.gov (United States)

    McLean, Huong Q; Peterson, Siri H; King, Jennifer P; Meece, Jennifer K; Belongia, Edward A

    2017-05-01

    Acute respiratory illnesses (ARIs) are common in school-aged children, but few studies have assessed school absenteeism due to specific respiratory viruses. To evaluate school absenteeism among children with medically attended ARI due to common viruses. We analyzed follow-up surveys from children seeking care for acute respiratory illness who were enrolled in the influenza vaccine effectiveness study at Marshfield Clinic during the 2012-2013 through 2014-2015 influenza seasons. Archived influenza-negative respiratory swabs were retested using multiplex RT-PCR to detect 16 respiratory virus targets. Negative binomial and logistic regression models were used to examine the association between school absence and type of respiratory viruses; endpoints included mean days absent from school and prolonged (>2 days) absence. We examined the association between influenza vaccination and school absence among children with RT-PCR-confirmed influenza. Among 1027 children, 2295 days of school were missed due to medically attended ARIs; influenza accounted for 39% of illness episodes and 47% of days missed. Mean days absent were highest for influenza (0.96-1.19) and lowest for coronavirus (0.62). Children with B/Yamagata infection were more likely to report prolonged absence than children with A/H1N1 or A/H3N2 infection [OR (95% CI): 2.1 (1.0, 4.5) and 1.7 (1.0, 2.9), respectively]. Among children with influenza, vaccination status was not associated with prolonged absence. School absenteeism due to medically attended ARIs varies by viral infection. Influenza B infections accounted for the greatest burden of absenteeism. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  15. Mobile Phone-Based Mood Ratings Prospectively Predict Psychotherapy Attendance.

    Science.gov (United States)

    Bruehlman-Senecal, Emma; Aguilera, Adrian; Schueller, Stephen M

    2017-09-01

    Psychotherapy nonattendance is a costly and pervasive problem. While prior research has identified stable patient-level predictors of attendance, far less is known about dynamic (i.e., time-varying) factors. Identifying dynamic predictors can clarify how clinical states relate to psychotherapy attendance and inform effective "just-in-time" interventions to promote attendance. The present study examines whether daily mood, as measured by responses to automated mobile phone-based text messages, prospectively predicts attendance in group cognitive-behavioral therapy (CBT) for depression. Fifty-six Spanish-speaking Latino patients with elevated depressive symptoms (46 women, mean age=50.92years, SD=10.90years), enrolled in a manualized program of group CBT, received daily automated mood-monitoring text messages. Patients' daily mood ratings, message response rate, and delay in responding were recorded. Patients' self-reported mood the day prior to a scheduled psychotherapy session significantly predicted attendance, even after controlling for patients' prior attendance history and age (OR=1.33, 95% CI [1.04, 1.70], p=.02). Positive mood corresponded to a greater likelihood of attendance. Our results demonstrate the clinical utility of automated mood-monitoring text messages in predicting attendance. These results underscore the value of text messaging, and other mobile technologies, as adjuncts to psychotherapy. Future work should explore the use of such monitoring to guide interventions to increase attendance, and ultimately the efficacy of psychotherapy. Copyright © 2017. Published by Elsevier Ltd.

  16. Risk factors for anaemia among HIV infected children attending care ...

    African Journals Online (AJOL)

    There is paucity of data describing the risk factors for anaemia among HIV infected children in Tanzania. This cross sectional study was carried out to determine the contributing factors for anaemia among HIV-infected children attending Muhimbili National Hospital in Dar es Salaam. Both univariate and multivariate logistic ...

  17. Migrant Home Attendants: Regulation and Practice in 7 Countries

    Science.gov (United States)

    Garms-Homolová, Vjenka; Bentwich, Miriam

    2013-01-01

    We compared regulation and working and living conditions of foreign home attendants in 7 countries (Canada, Germany, Israel, Singapore, Spain, United Kingdom, United States). We conducted a literature search in the PSYCinfo, MEDLINE, and Google Scholar databases for 2002 to 2012. We found substantial between-country differences in the legal status of migrant caregivers and regulations regarding working and living conditions and drew 3 conclusions. Improving regulations will likely improve not only the well-being of foreign home attendants but also the care they provide. Countries in which many foreign home attendants work without specific legal entry programs should rethink their policies. Finally, requiring an employer’s recommendation to obtain permanent residency may constrain foreign workers from registering complaints or leaving suboptimal employment situations. PMID:24134377

  18. Personality traits affect teaching performance of attending physicians: results of a multi-center observational study

    NARCIS (Netherlands)

    Scheepers, Renée A.; Lombarts, Kiki M. J. M. H.; van Aken, Marcel A. G.; Heineman, Maas Jan; Arah, Onyebuchi A.

    2014-01-01

    Worldwide, attending physicians train residents to become competent providers of patient care. To assess adequate training, attending physicians are increasingly evaluated on their teaching performance. Research suggests that personality traits affect teaching performance, consistent with studied

  19. Plasmodium falciparum malaria in pregnancy: prevalence of peripheral parasitaemia, anaemia and malaria care-seeking behaviour among pregnant women attending two antenatal clinics in Edo State, Nigeria

    NARCIS (Netherlands)

    Enato, E. F. O.; Mens, P. F.; Okhamafe, A. O.; Okpere, E. E.; Pogoson, E.; Schallig, H. D. F. H.

    2009-01-01

    SUMMARY: This study evaluated malaria care-seeking behaviour, as well as the prevalence of parasitaemia and anaemia among pregnant women attending antenatal clinics of two tertiary healthcare facilities in Edo State, Nigeria. Malaria was highly prevalent in the study group (20% by microscopy and

  20. EURISWEB – Web-based epidemiological surveillance of antibiotic-resistant pneumococci in Day Care Centers

    Directory of Open Access Journals (Sweden)

    Sanches Ilda Santos

    2003-07-01

    Full Text Available Abstract Background EURIS (European Resistance Intervention Study was launched as a multinational study in September of 2000 to identify the multitude of complex risk factors that contribute to the high carriage rate of drug resistant Streptococcus pneumoniae strains in children attending Day Care Centers in several European countries. Access to the very large number of data required the development of a web-based infrastructure – EURISWEB – that includes a relational online database, coupled with a query system for data retrieval, and allows integrative storage of demographic, clinical and molecular biology data generated in EURIS. Methods All components of the system were developed using open source programming tools: data storage management was supported by PostgreSQL, and the hypertext preprocessor to generate the web pages was implemented using PHP. The query system is based on a software agent running in the background specifically developed for EURIS. Results The website currently contains data related to 13,500 nasopharyngeal samples and over one million measures taken from 5,250 individual children, as well as over one thousand pre-made and user-made queries aggregated into several reports, approximately. It is presently in use by participating researchers from three countries (Iceland, Portugal and Sweden. Conclusion An operational model centered on a PHP engine builds the interface between the user and the database automatically, allowing an easy maintenance of the system. The query system is also sufficiently adaptable to allow the integration of several advanced data analysis procedures far more demanding than simple queries, eventually including artificial intelligence predictive models.

  1. Digi-Bags on the Go: Childminders’ Expectations and Experiences of a Tablet-Based Mobile Learning Environment in Family Day Care

    Directory of Open Access Journals (Sweden)

    Kaisa Pihlainen

    2018-01-01

    Full Text Available The use of mobile technologies is playing an increasingly important role in early childhood education (ECE settings. However, although technologies are often integrated in ECE provided in day care centres, technology use in other ECE settings, such as in family day care, is rare. In this paper, we describe the Digi-bag, a tablet-based mobile learning environment deployed at several family day care homes, and present the expectations and first experiences of family day care personnel regarding the pedagogical use of Digi-bags together with 1- to 5-year-old children as well as their experiences of training to use the digital technology. The results of the pilot study indicate that the deployment of Digi-bags facilitates the pedagogical, creative, and regular use of digital technology with small children. The study also underlines the importance of providing opportunities to family day care personnel for peer support and peer learning in natural settings besides professional training in the use of digital technologies.

  2. The Effects of Adult Day Services on Family Caregivers’ Daily Stress, Affect, and Health: Outcomes From the Daily Stress and Health (DaSH) Study

    Science.gov (United States)

    Zarit, Steven H.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Klein, Laura C.

    2014-01-01

    Purpose: We examine the effects of use of adult day service (ADS) by caregivers of individuals with dementia (IWD) on daily stressors, affect, and health symptoms. Participants were interviewed for 8 consecutive days. On some days, the IWD attended an ADS program and on the other days caregivers provide most or all of the care at home. Methods: Participants were 173 family caregivers of IWDs using an ADS program. Daily telephone interviews assessed care-related stressors, noncare stressors, positive events, affect, and health symptoms. Multilevel models with data nested within persons were used to examine effects of ADS use on daily stressor exposure, affect, and health symptoms. Results: Caregivers had lower exposure to care-related stressors on ADS days, more positive experiences, and more noncare stressors. ADS use lowered anger and reduced the impact of noncare stressors on depressive symptoms. Implications: The findings demonstrate that stressors on caregivers are partly lowered, and affect is improved on ADS days, which may provide protection against the effects of chronic stress associated with caregiving. PMID:23690056

  3. The characteristics and effects of motivational music in exercise settings: the possible influence of gender, age, frequency of attendance, and time of attendance.

    Science.gov (United States)

    Priest, D L; Karageorghis, C I; Sharp, N C C

    2004-03-01

    The purpose of the present study was to investigate the characteristics and effects of motivational music in British gymnasia. The secondary purpose was to determine whether the characteristics and effects of motivational music were invariant in relation to gender, age, frequency of gymnasium attendance, and the time of day at which exercise participants attended gymnasia. Participants (n=532) from 29 David Lloyd Leisure exercise facilities across Britain responded to a questionnaire that was designed to assess music preferences during exercise via 2 open-ended questions and 1 scaled-response item. A content analysis of the questionnaire data yielded 45 analytic properties that were grouped into the following categories: specific music factors, general music factors, music programme factors, delivery factors, televisual factors, personal factors, contextual factors, and psychophysical response factors. The relative incidence of these analytic properties across gender groups (male/female), age groups (16-26 y, 27-34 y, 35-45 y, 46+ y), frequency of attendance groups (low, medium, high), and time of attendance groups (morning, afternoon, evening) was tested by use of chi(2) analyses. Of the personal variables tested, age exerted the greatest influence on musical preference during exercise; older participants expressed a preference for quieter, slower, and generally less overtly stimulative music. Music programmes that are prescribed to accompany exercise should be varied in terms of musical idiom and date of release. Such programmes will account for the preferences of different groups of exercise participants that attend gymnasia at different times of the day. Further, the music chosen should be characterised by a strong rhythmical component.

  4. Networked learning in children's transition from day-care to school: Connections between contexts

    DEFF Research Database (Denmark)

    Odgaard, Ane Bjerre

    This paper reports on a socioculturally informed design-based study concerning young children's use of tablets within the educational contexts constituting their transition from day-care to school. The study explores tablet-mediated and dialogical activities as potential means for negotiating...... connections between the different contexts which the children traverse during this transition. At several occasions, the participating 5- to 7-year-old children are invited to use tablets for producing photos, photo-collages and e-books about their everyday institutional environments, thus aiming at mediating...... these contexts are pivots of dialogue. Networked learning is thus conceptualized as a matter of networked situations and contexts for young children during their transition from day-care to primary school, and technological artefacts are viewed as potential means for mediating children's meaning making about...

  5. Comparing performance of 30-day readmission risk classifiers among hospitalized primary care patients.

    Science.gov (United States)

    Garrison, Gregory M; Robelia, Paul M; Pecina, Jennifer L; Dawson, Nancy L

    2017-06-01

    Hospital readmission within 30 days of discharge occurs in almost 20% of US Medicare patients and may be a marker of poor quality inpatient care, ineffective hospital to home transitions, or disease severity. Within a patient centered medical home, care transition interventions may only be practical from cost and staffing perspectives if targeted at patients with the greatest risk of readmission. Various scoring algorithms attempt to predict patients at risk for 30-day readmission, but head-to-head comparison of performance is lacking. Compare published scoring algorithms which use generally available electronic medical record data on the same set of hospitalized primary care patients. The LACE index, the LACE+ index, the HOSPITAL score, and the readmission risk score were computed on a consecutive cohort of 26,278 hospital admissions. Classifier performance was assessed by plotting receiver operating characteristic curves comparing the computed score with the actual outcome of death or readmission within 30 days. Statistical significance of differences in performance was assessed using bootstrapping techniques. Correct readmission classification on this cohort was moderate with the following c-statistics: Readmission risk score 0.666; LACE 0.680; LACE+ 0.662; and HOSPITAL 0.675. There was no statistically significant difference in performance between classifiers. Logistic regression based classifiers yield only moderate performance when utilized to predict 30-day readmissions. The task is difficult due to the variety of underlying causes for readmission, nonlinearity, and the arbitrary time period of concern. More sophisticated classification techniques may be necessary to increase performance and allow patient centered medical homes to effectively focus efforts to reduce readmissions. © 2016 John Wiley & Sons, Ltd.

  6. Traditional Birth Attendants in Rural Northern Uganda: Policy, Practice, and Ethics.

    Science.gov (United States)

    Rudrum, Sarah

    2016-01-01

    The current emphasis on skilled attendants as a means to reduce maternal mortality contributes to a discouraging policy environment for traditional birth attendants (TBAs). They continue to attend a significant number of births, however, such that their role and the policies and practices affecting their work remain important to understanding maternity health care and maternal health in the global South. In this article, I examine the policies and practices governing community elders practicing as TBAs in rural northern Uganda. This discussion is relevant to health workers in developing countries and to scholars in fields such as women's studies, sociology, and public health.

  7. Time to Surgery Is Associated with Thirty-Day and Ninety-Day Mortality After Proximal Femoral Fracture

    DEFF Research Database (Denmark)

    Nyholm, Anne Marie; Gromov, Kirill; Palm, Henrik

    2015-01-01

    than twenty-four hours (odds ratio, 1.23; p = 0.04). An education level of the surgeon below that of an attending surgeon increased the risk of thirty-day mortality (odds ratio, 1.28; p = 0.035) and ninety-day mortality (odds ratio, 1.26; p = 0.016). Increasing American Society of Anesthesiologists...

  8. Positively essential: traditional birth attendants in Malawi.

    Science.gov (United States)

    Stronge, Shirley

    2011-06-01

    One of the biggest challenges for healthcare professionals working in developing countries is the lack of trained personnel to carry out much needed health care provision. Shirley Stronge worked as a nurse/midwife tutor in a rural area in the north of Malawi. Millennium Development Goals four and five have focused our attention on the care required by mothers and newborns. Shirley has chosen to reflect on the role of Traditional Birth Attendants in the north of Malawi and their positive impact on maternity services in this area.

  9. Impact of Attendance Policies on Course Attendance among College Students

    Science.gov (United States)

    Chenneville, Tiffany; Jordan, Cary

    2008-01-01

    The purpose of this study was twofold: (a) to investigate whether having a graded attendance policy would have an effect on course attendance among college students, and (b) to examine beliefs about education and attendance policies among college students. Results support the utility of graded attendance policies for increasing class attendance…

  10. Quality of family planning counseling among women attending prenatal care at a hospital in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Teshome, Abel; Birara, Malede; Rominski, Sarah D

    2017-05-01

    To assess the quality of family planning counseling among women attending a prenatal clinic in Addis Ababa, Ethiopia. In a descriptive cross-sectional study conducted between February and April, 2015, at the prenatal care clinic of Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia, pregnant women in their third trimester were interviewed about their experience of family planning counseling. Data were collected via a questionnaire. Logistic regression was used to assess predictors of satisfaction with the counseling service. During the study period, 400 women were interviewed. Only 139 women (34.8%) were counseled about family planning. Among those counseled, 126 (90.6%) decided to use a contraceptive method after delivery and 46 (36.7%) decided to use an injectable contraceptive. Women were more likely to report high satisfaction when their provider asked about their partner's attitude toward contraceptive methods (adjusted odds ratio 6.6; Pfamily planning methods (adjusted odds ratio 5.1; Pfamily planning counseling to improve satisfaction and quality of care. © 2017 International Federation of Gynecology and Obstetrics.

  11. Preoperative fasting in the day care patient population at a tertiary care, teaching institute: A prospective, cross-sectional study

    Directory of Open Access Journals (Sweden)

    Merlin Shalini Ruth

    2018-01-01

    Full Text Available Context: Patients are fasting for inappropriately long duration preoperatively despite the American Society of Anesthesiologists (ASA recommendations for liberal fasting guidelines. There is paucity of data on preoperative fasting duration in the day care patient population from India; hence, we studied the preoperative fasting status in the day care patient population. Aims: This study aims to study the preoperative fasting duration for solids and clear fluids and to compare the fasting times in the patients posted for the morning slot and the afternoon slot. Settings and Design: This was a prospective, observational, cross-sectional study at a tertiary care, teaching institute. Subjects and Methods: All Consenting adults, ASA grade 1 or 2, of either gender, presenting for day care surgery were included in the study. Data collected included the demographic profile, duration of fasting for solids, and clear fluids. The patients rated their hunger and thirst on a ten point numeric rating scale. We compared the fasting durations for solids and clear fluids in the patients presenting for the morning slot and afternoon slot for surgery. Statistical Analysis Used: T-test was used for analysis of continuous data with normal distribution and Mann–Whitney U-test for data with nonnormal distribution. Chi-square test was performed for categorical variables. Differences were considered significant at P < 0.05. Results: The mean duration of preoperative fasting for solids was 12.58 ± 2.70 h and for clear fluids was 9.02 ± 3.73 h. The mean fasting duration for solids in the patients presenting for the afternoon slot was significantly longer (P < 0.0001 than those presenting for the morning slot. The mean preoperative fasting duration for clear fluids was comparable among these patient groups (P = 0.0741. Conclusions: Patients are following inappropriately prolonged fasting routines, and there is a need to enforce liberal preoperative fasting guidelines

  12. Ostomate-for-a-Day: A Novel Pedagogy for Teaching Ostomy Care to Baccalaureate Nursing Students.

    Science.gov (United States)

    Kerr, Noël

    2015-08-01

    The literature describing successful pedagogies for teaching ostomy care to baccalaureate nursing students is limited. This qualitative study investigated the potential benefits of participating in an immersive simulation that allowed baccalaureate nursing students to explore the physical and psychosocial impact of ostomy surgery. Junior-level nursing students attended a 2-hour interactive session during which they learned about preoperative stoma site marking and practiced the maneuvers on a peer. Students then wore an ostomy appliance for the next 24 hours, completed tasks simulating ostomy self-care, and submitted a three- to four-page reflection on the experience. These data were coded using the iterative process of constant comparison described by Glaser. Six major themes were identified: Accommodation for Activities of Daily Living, Coping with Annoyances, Body Image and Feelings, Disclosure, Insights for Teaching, and Empathy. Each participant affirmed the value of the experience. Suggestions for future research studies are discussed. Copyright 2015, SLACK Incorporated.

  13. Use of ecological momentary assessment to determine which structural factors impact perceived teaching quality of attending rounds.

    Science.gov (United States)

    Willett, Lisa; Houston, Thomas K; Heudebert, Gustavo R; Estrada, Carlos

    2012-09-01

    Providing high-quality teaching to residents during attending rounds is challenging. Reasons include structural factors that affect rounds, which are beyond the attending's teaching style and control. To develop a new evaluation tool to identify the structural components of ward rounds that most affect teaching quality in an internal medicine (IM) residency program. The authors developed a 10-item Ecological Momentary Assessment (EMA) tool and collected daily evaluations for 18 months from IM residents rotating on inpatient services. Residents ranked the quality of teaching on rounds that day, and questions related to their service (general medicine, medical intensive care unit, and subspecialty services), patient census, absenteeism of team members, call status, and number of teaching methods used by the attending. Residents completed 488 evaluation cards over 18 months. This found no association between perceived teaching quality and training level, team absenteeism, and call status. We observed differences by service (P service, census was no longer significant. Use of a larger variety of teaching methods was associated with higher perceived teaching quality, regardless of service or census (P for trend quality, but the results were also influenced by the type of teaching service. We found that, regardless of census or teaching service, attendings can improve their teaching by diversifying the number of methods used in daily rounds.

  14. Psychological distress as a predictor of frequent attendance in family practice: a cohort study

    DEFF Research Database (Denmark)

    Vedsted, Peter; Fink, Per; Olesen, Frede

    2001-01-01

    In cross-sectional studies, psychological distress has been associated with frequent health care utilization. However, there is a need for prospective studies to confirm these findings. This cohort study evaluated whether psychological distress predicted frequent attendance in family practice.......16 [0.99-1.36] for SCL and OR 1.31 [1.05-1.65] for Whiteley). Psychological distress involved an increased risk of future frequent attendance among adult patients consulting family practice in the daytime about an illness........ In 1990, 185 consecutive adults who consulted their primary care physician (PCP) about an illness were rated on two psychometric scales (Hopkins Symptom Check List [SCL-8] and Whiteley-7), and their annual number of face-to-face contacts with a family practice was followed until 1996. Frequent attenders...

  15. Prueba de Aptitud para el Aprendizaje de Lenguas Extranjeras (PAPALE) Language Aptitude Test (LAT) (First and Second Versions). English for Special Purposes. Emergency Care Attendant.

    Science.gov (United States)

    Muro, Gertrude

    This book contains two versions of the Language Aptitude Test. It is part of a package of materials developed for use in an English for Special Purposes project, which offers classes in reading, grammar, and emergency care attendant training for limited English proficient students. Introductory material describes the parts of two versions and…

  16. Beyond Care Avoidance and Care Paralysis : Theorizing Public Mental Health Care

    NARCIS (Netherlands)

    Schout, Gert; de Jong, Gideon; Zeelen, Jacques

    Care avoidance refers to the condition wherein clients do not seek assistance and do not attend appointments although they are in need of help. Care avoidance is linked to another phenomenon, the inability to help clients with multiple and complex problems by social services and care facilities, in

  17. Predictors of Medication Adherence and Blood Pressure Control among Saudi Hypertensive Patients Attending Primary Care Clinics: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Sarah M Khayyat

    Full Text Available To assess the level of medication adherence and to investigate predictors of medication adherence and blood pressure control among hypertensive patients attending primary healthcare clinics in Makkah, Saudi Arabia.Hypertensive patients meeting the eligibility criteria were recruited from eight primary care clinics between January and May 2016 for this study. The patients completed Arabic version of Morisky Medication Adherence Scale (MMAS-8, an eight-item validated, self-reported measure to assess medication adherence. A structured data collection form was used to record patients' sociodemographic, medical and medication data.Two hundred and four patients, of which 71.6% were females, participated in the study. Patients' mean age was 59.1 (SD 12.2. The mean number of medication used by patients was 4.4 (SD 1.89. More than half (110; 54% of the patients were non-adherent to their medications (MMAS score 65 years (OR 2.0 [95% CI: 1.0-4.2; P = 0.04], and being diabetic (OR 0.25 [95% CI: 0.1-0.6; P = 0.04] were found to be independent predictors of medication adherence.Medication adherence is alarmingly low among hypertensive patients attending primary care clinics in Saudi Arabia which may partly explain observed poor blood pressure control. There is a clear need to educate patients about the importance of medication adherence and its impact on improving clinical outcomes. Future research should identify barriers to medication adherence among Saudi hypertensive patients.

  18. Food Sanitation and Safety Self-assessment Instrument for Family Day-Care Homes.

    Science.gov (United States)

    1990

    This self-assessment instrument for family day care providers is designed to help caregivers provide safe food to children. The eight sections of the instrument, presented in checklist format, concern: (1) personal hygiene; (2) purchasing and inspecting of food; (3) food storage; (4) kitchen equipment; (5) food preparation; (6) infant food…

  19. A Four-Session Sleep Intervention Program Improves Sleep for Older Adult Day Health Care Participants: Results of a Randomized Controlled Trial.

    Science.gov (United States)

    Martin, Jennifer L; Song, Yeonsu; Hughes, Jaime; Jouldjian, Stella; Dzierzewski, Joseph M; Fung, Constance H; Rodriguez Tapia, Juan Carlos; Mitchell, Michael N; Alessi, Cathy A

    2017-08-01

    To test the effectiveness of a 4-week behavioral Sleep Intervention Program (SIP: sleep compression, modified stimulus control, and sleep hygiene) compared to a 4-week information-only control (IC) among older adults attending a VA Adult Day Health Care (ADHC) program in a double-blind, randomized, clinical trial. Forty-two individuals (mean age: 77 years, 93% male) enrolled in a VA ADHC program were randomized to receive SIP or IC. All completed in-person sleep and health assessments at baseline, post-treatment and 4-months follow-up that included 3 days/nights of wrist actigraphy, the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). Mixed repeated measures analysis was used to compare sleep outcomes at post-treatment and 4-months follow-up, with baseline values as covariates. SIP participants (n = 21) showed significant improvement on actigraphy sleep efficiency (p = .007), number of nighttime awakenings (p = .016), and minutes awake at night (p = .001) at post-treatment, compared to IC participants (n = 21). Benefits were slightly attenuated but remained significant at 4-month follow-up (all p's sleep time between groups. There was significant improvement on PSQI factor 3 (daily disturbances) at 4-month follow-up (p = .016), but no differences were observed between SIP and IC on other PSQI components or ISI scores at post-treatment or 4-month follow-up. A short behavioral sleep intervention may have important benefits in improving objectively measured sleep in older adults participating in ADHC. Future studies are needed to study implementation of this intervention into routine clinical care within ADHC. Published by Oxford University Press on behalf of Sleep Research Society (SRS) 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  20. Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: observational cohort study.

    Science.gov (United States)

    Robinson, Emily J; Smith, Gary B; Power, Geraldine S; Harrison, David A; Nolan, Jerry; Soar, Jasmeet; Spearpoint, Ken; Gwinnutt, Carl; Rowan, Kathryn M

    2016-11-01

    Internationally, hospital survival is lower for patients admitted at weekends and at night. Data from the UK National Cardiac Arrest Audit (NCAA) indicate that crude hospital survival was worse after in-hospital cardiac arrest (IHCA) at night versus day, and at weekends versus weekdays, despite similar frequency of events. To describe IHCA demographics during three day/time periods-weekday daytime (Monday to Friday, 08:00 to 19:59), weekend daytime (Saturday and Sunday, 08:00 to 19:59) and night-time (Monday to Sunday, 20:00 to 07:59)-and to compare the associated rates of return of spontaneous circulation (ROSC) for >20 min (ROSC>20 min) and survival to hospital discharge, adjusted for risk using previously developed NCAA risk models. To consider whether any observed difference could be attributed to differences in the case mix of patients resident in hospital and/or the administered care. We performed a prospectively defined analysis of NCAA data from 27 700 patients aged ≥16 years receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a resuscitation (2222) call in 146 UK acute hospitals. Risk-adjusted outcomes (OR (95% CI)) were worse (p20 min 0.88 (0.81 to 0.95); hospital survival 0.72 (0.64 to 0.80)), and night-time (ROSC>20 min 0.72 (0.68 to 0.76); hospital survival 0.58 (0.54 to 0.63)) compared with weekday daytime. The effects were stronger for non-shockable than shockable rhythms, but there was no significant interaction between day/time of arrest and age, or day/time of arrest and arrest location. While many daytime IHCAs involved procedures, restricting the analyses to IHCAs in medical admissions with an arrest location of ward produced results that are broadly in line with the primary analyses. IHCAs attended by the hospital-based resuscitation team during nights and weekends have substantially worse outcomes than during weekday daytimes. Organisational or care differences at

  1. Social environment and frequent attendance in Danish general practice

    DEFF Research Database (Denmark)

    Vedsted, Peter; Olesen, Frede

    2005-01-01

    inequalities in health or whether social factors in themselves determine the use of general practice. AIM: To examine if social factors are associated with frequent attendance in general practice after adjusting for physical and psychological health variables. DESIGN OF STUDY: Population-based cross......BACKGROUND: A lack of social support is associated with increased morbidity and mortality and a decreased effect of prevention. Frequent attenders to primary care are characterised by poorer social conditions than other patients in general practice, but we do not know whether this is due to social...... during the period November 1997-October 1998. A questionnaire about physical, psychological and social factors was sent to the patients. The associations between social factors and frequent attendance were adjusted for physical and psychological health and tendency towards somatisation. RESULTS: A total...

  2. Social capital and frequent attenders in general practice: a register-based cohort study.

    Science.gov (United States)

    Pasgaard, Alexander A; Mæhlisen, Maiken H; Overgaard, Charlotte; Ejlskov, Linda; Torp-Pedersen, Christian; Bøggild, Henrik

    2018-03-02

    Frequent attendance to primary care constitutes a large use of resources for the health care system. The association between frequent attendance and illness-related factors has been examined in several studies, but little is known about the association between frequent attendance and individual social capital. The aim of this study is to explore this association. The analysis is conducted on responders to the North Denmark Region Health Profile 2010 (n = 23,384), individually linked with information from administrative registers. Social capital is operationalized at the individual level, and includes cognitive (interpersonal trust and norms of reciprocity) as well as structural (social network and civic engagement) dimensions. Frequent attendance is defined as the upper-quartile of the total number of measured consultations with a general practitioner over a period of 148 weeks. Using multiple logistic regression, we found that frequent attendance was associated with a lower score in interpersonal trust [OR 0.86 (0.79-0.94)] and social network [OR 0.88 (0.79-0.98)] for women, when adjusted for age, education, income and SF12 health scores. Norms of reciprocity and civic engagement were not significantly associated with frequent attendance for women [OR 1.05 (0.99-1.11) and OR 1.01 (0.92-1.11) respectively]. None of the associations were statistically significant for men. This study suggests that for women, some aspects of social capital are associated with frequent attendance in general practice, and the statistically significant dimensions belonged to both cognitive and structural aspects of social capital. This association was not seen for men. This indicates a multifaceted and heterogeneous relationship between social capital and frequent attendance among genders.

  3. A chart review of morbidity patterns among adult patients attending primary care setting in urban Odisha, India: An International Classification of Primary Care experience

    Directory of Open Access Journals (Sweden)

    Subhashisa Swain

    2017-01-01

    Full Text Available Introduction: Disease burden estimations based on sound epidemiological research provide the foundation for designing health services. Patients visiting a primary care often present with symptoms and signs. Understanding the burden is crucial for developing countries including India. The project aimed to record the reasons for encounter (RFE at primary care settings for estimating the burden at the health-care facility. Methodology: This cross-sectional study was undertaken at four urban health dispensaries of Bhubaneswar, Odisha, with the aim to explore the prevailing patterns of diseases among patients attending these facilities. Data collection spanned from May to October 2012. At each center, patients' information on age, sex, religion, and presenting illness was extracted from the outpatient records over these time period. Data were entered and analyzed in SPSS version 20, and the International Classification of Primary Care-2 was used for coding the illnesses. Results: In total, 2249 patient's records were extracted over 12 weeks. Out of them, 1241 (55.2% were male with mean age of 41.8 (±15.8 years vis-à -vis 38.2 (±14.1 years for females. Around 151 (6.7% had 2 or more symptoms or conditions. Overall, the most common categories were general and unspecified followed by digestive-related symptoms in both sexes. The most common symptoms among males were fever (11.4%, heart burn (8.1%, and vertigo or dizziness (3.6%. Similar pattern was seen among females. Respiratory (17.0% and cardiovascular (10.2% problems were the most common RFEs among males and females. The most common RFEs for acute care among males and females were fever, allergic rhinitis, upper respiratory tract infection, and acute bronchitis. Leading RFEs for chronic care among males were hypertension uncomplicated, heart burn, low back pain, whereas among females, hypertension and heartburn were mostly seen. Conclusion: Primary care settings are experiencing both communicable

  4. Role of traditional birth attendants (TBAs) in provision of antenatal and perinatal care at home amongst the urban poor in Delhi, India.

    Science.gov (United States)

    Singh, Samiksha; Chhabra, Pragti; Sujoy, Rachna

    2012-01-01

    More than 80% of deliveries amongst the urban poor are conducted at home, mostly by traditional birth attendants (TBAs). In all, 29 eligible TBAs in the study area were identified and interviewed to assess their knowledge and practices regarding antenatal and perinatal care. Their knowledge about complications in antenatal and perinatal period was inadequate. The majority provided inadequate advice to the mothers. Over seventy-nine percent (79.3%) gave injections of oxytocin. Sixteen (55.2%) did not wait or waited for less than 10 minutes for the mother to expel the placenta. Fourteen (48.3%) encountered excessive vaginal bleeding, but none knew how to manage it. Overall knowledge and care provided by the TBAs was poor.

  5. Thyroid Status in Patients with Type 2 Diabetes Attending a Tertiary Care Hospital in Eastern India.

    Science.gov (United States)

    Pramanik, Subhodip; Ghosh, Sujoy; Mukhopadhyay, Pradip; Bhattacharjee, Rana; Mukherjee, Bidisha; Mondal, Samim Ali; Ghosh, Ipsita; Bari, Ranajit; Chowdhury, Subhankar

    2018-01-01

    Type 2 diabetes mellitus and thyroid dysfunction (TD) are two major public health endocrine problem, but the prevalence of TD and iodine status in patients with T2 DM in India is less studied. The study objective was to explore the prevalence of TD and to evaluate iodine health in type 2 diabetes patients attending a tertiary care center in Eastern India. Consecutive 100 patients with diabetes attending outpatient department were evaluated clinically and biochemically (thyrotropin [TSH], free thyroxine, anti-TPO antibody, and urinary iodine). We excluded pregnant women or patients taking drugs that can alter thyroid function. Subclinical hypothyroid and overt hypothyroidism were diagnosed as per standard definitions. Out of 100 patients were analyzed, 51 (51%) were male. Mean (±standard deviation) age was 45.4 ± 11.2 years, body mass index 24.1 ± 4.28 kg/m 2 , and duration of diabetes 7.76 ± 5.77 years. The prevalence of subclinical hypothyroidism and overt hypothyroidism was 23/100 (23%) and 3/100 (3%), respectively. Thyroid autoantibody was positive in 13 (13.1%) patients. All patients were iodine sufficient. A trend toward increased neuropathy ( r = 0.45) and nephropathy ( r = -0.29) was associated with rising TSH. Almost one in four people living with diabetes are suffering from TD. Thus, routine screening should be implemented. Salt iodination program is a huge success in this part of the country.

  6. Thyroid status in patients with Type 2 diabetes attending a Tertiary Care Hospital in Eastern India

    Directory of Open Access Journals (Sweden)

    Subhodip Pramanik

    2018-01-01

    Full Text Available Objective: Type 2 diabetes mellitus and thyroid dysfunction (TD are two major public health endocrine problem, but the prevalence of TD and iodine status in patients with T2 DM in India is less studied. The study objective was to explore the prevalence of TD and to evaluate iodine health in type 2 diabetes patients attending a tertiary care center in Eastern India. Methods: Consecutive 100 patients with diabetes attending outpatient department were evaluated clinically and biochemically (thyrotropin [TSH], free thyroxine, anti-TPO antibody, and urinary iodine. We excluded pregnant women or patients taking drugs that can alter thyroid function. Subclinical hypothyroid and overt hypothyroidism were diagnosed as per standard definitions. Results: Out of 100 patients were analyzed, 51 (51% were male. Mean (±standard deviation age was 45.4 ± 11.2 years, body mass index 24.1 ± 4.28 kg/m2, and duration of diabetes 7.76 ± 5.77 years. The prevalence of subclinical hypothyroidism and overt hypothyroidism was 23/100 (23% and 3/100 (3%, respectively. Thyroid autoantibody was positive in 13 (13.1% patients. All patients were iodine sufficient. A trend toward increased neuropathy (r = 0.45 and nephropathy (r = −0.29 was associated with rising TSH. Conclusion: Almost one in four people living with diabetes are suffering from TD. Thus, routine screening should be implemented. Salt iodination program is a huge success in this part of the country.

  7. Parental stress response to sexual abuse and ritualistic abuse of children in day-care centers.

    Science.gov (United States)

    Kelley, S J

    1990-01-01

    The purpose of this study was to examine the stress responses of parents to the sexual and ritualistic abuse of their children in day-care centers. Sixty-five mothers and 46 fathers of children sexually abused in day-care centers completed the Symptom Checklist-90-Revised (SCL-90-R), a measure of psychological distress. These scores were compared with a carefully matched comparison group of parents of 67 nonabused children. Parents of abused children also completed the Impact of Event Scale (IES), a measure which indexes symptoms that characterize posttraumatic stress disorder. Parents of sexually abused children reported significantly more psychological distress than parents of nonabused children, with parents of ritually abused children displaying the most severe psychological distress. Parents of abused children reported symptom profiles on the SCL-90-R and IES consistent with posttraumatic stress disorder.

  8. Toward High Quality Family Day Care for Infants and Toddlers. Final Report.

    Science.gov (United States)

    Rauch, Marian D.; Crowell, Doris C.

    Reported were the results of a project which established a cluster of family day care homes in Hawaii in which caregivers were selected, trained, and provided with supportive services and salaries. The primary objective of the program was to provide a replicable, high quality program for preschool children that would maximize social, emotional,…

  9. Minor injury attendance times to the ED.

    LENUS (Irish Health Repository)

    Conlon, Ciaran

    2009-07-01

    The Health Service Executive (HSE) highlights the need for effective patient throughput and management, whilst providing appropriate staffing and therapeutic interventions. It acknowledges that patient need is integral to the development of a nurse led service and advocates planning staffing levels to reflect arrival times of patients. An observational study of all patients who presented to the emergency department in July 2005 and February 2006 was undertaken (n=7768). The study identified 1577 patients suitable for treatment by the Advanced Nurse Practitioner (ANP) in these two months, which represents 20% of all patient attendances to the ED in this time period. A data collection tool was devised collectively by the ANPs to identify appropriate patients. The findings of the study revealed that 73% of patients suitable for the ANP service presented between the hours of 0800 and 2000, of which 54% attended between 0800 and 1600 h. Sunday emerged as the busiest day in July 2005 whereas Monday was found to be the busiest day in February 2006. Friday was found to be consistently busy for both months.

  10. Early Results of Medicare's Bundled Payment Initiative for a 90-Day Total Joint Arthroplasty Episode of Care.

    Science.gov (United States)

    Iorio, Richard; Clair, Andrew J; Inneh, Ifeoma A; Slover, James D; Bosco, Joseph A; Zuckerman, Joseph D

    2016-02-01

    In 2011 Medicare initiated a Bundled Payment for Care Improvement (BPCI) program with the goal of introducing a payment model that would "lead to higher quality, more coordinated care at a lower cost to Medicare." A Model 2 bundled payment initiative for Total Joint Replacement (TJR) was implemented at a large, tertiary, urban academic medical center. The episode of care includes all costs through 90 days following discharge. After one year, data on 721 Medicare primary TJR patients were available for analysis. Average length of stay (LOS) was decreased from 4.27 days to 3.58 days (Median LOS 3 days). Discharges to inpatient facilities decreased from 71% to 44%. Readmissions occurred in 80 patients (11%), which is slightly lower than before implementation. The hospital has seen cost reduction in the inpatient component over baseline. Early results from the implementation of a Medicare BPCI Model 2 primary TJR program at this medical center demonstrate cost-savings. IV economic and decision analyses-developing an economic or decision model. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Early Full-Time Day Care, Mother-Child Attachment, and Quality of the Home Environment in Chile: Preliminary Findings

    Science.gov (United States)

    Cárcamo, Rodrigo A.; Vermeer, Harriet J.; van der Veer, René; van IJzendoorn, Marinus H.

    2016-01-01

    Research Findings: Two longitudinal studies are reported examining the effects of full-time day care in Mapuche and non-Mapuche families in Chile. First, the Magellan-Leiden Childcare Study (MLCS) used a sample of 95 mothers with children younger than 1 year old (n = 36 in day care). Second, we partially cross-validated our results in a large and…

  12. What Factors are Associated With 90-day Episode-of-care Payments for Younger Patients With Total Joint Arthroplasty?

    Science.gov (United States)

    Pathak, Shweta; Ganduglia, Cecilia M; Awad, Samir S; Chan, Wenyaw; Swint, John M; Morgan, Robert O

    2017-11-01

    Total joint arthroplasty (TJA) has been identified as a procedure with substantial variations in inpatient and postacute care payments. Most studies in this area have focused primarily on the Medicare population and rarely have characterized the younger commercially insured populations. Understanding the inpatient and postdischarge care service-component differences across 90-day episodes of care and factors associated with payments for younger patients is crucial for successful implementation of bundled payments in TJA in non-Medicare populations. (1) To assess the mean total payment for a 90-day primary TJA episode, including the proportion attributable to postdischarge care, and (2) to evaluate the role of procedure, patient, and hospital-level factors associated with 90-day episode-of-care payments in a non-Medicare patient population younger than 65 years. Claims data for 2008 to 2013 from Blue Cross Blue Shield of Texas were obtained for primary TJAs. A total of 11,131 procedures were examined by aggregating payments for the index hospital stay and any postacute care including rehabilitation services and unplanned readmissions during the 90-day postdischarge followup period. A three-level hierarchical model was developed to determine procedure-, patient-, and hospital-level factors associated with 90-day episode-of-care payments. The mean total payment for a 90-day episode for TJA was USD 47,700 adjusted to 2013 USD. Only 14% of 90-day episode payments in our population was attributable to postdischarge-care services, which is substantially lower than the percentage estimated in the Medicare population. A prolonged length of stay (rate ratio [RR], 1.19; 95% CI, 1.15-1.23; p ≤ 0.001), any 90-day unplanned readmission (RR, 1.64; 95% CI, 1.57-1.71; p ≤ 0.001), computer-assisted surgery (RR, 1.031; 95% CI, 1.004-1.059; p ≤ 0.05), initial home discharge with home health component (RR, 1.029; 95% CI, 1.013-1.046; p ≤ 0.001), and very high patient morbidity

  13. Observed Benefits to On-site Medical Services during an Annual 5-day Electronic Dance Music Event with Harm Reduction Services.

    Science.gov (United States)

    Munn, Matthew Brendan; Lund, Adam; Golby, Riley; Turris, Sheila A

    2016-04-01

    With increasing attendance and media attention, large-scale electronic dance music events (EDMEs) are a subset of mass gatherings that have a unique risk profile for attendees and promoters. Shambhala Music Festival (Canada) is a multi-day event in a rural setting with a recognized history of providing harm reduction (HR) services alongside medical care. Study/Objective This manuscript describes the medical response at a multi-day electronic music festival where on-site HR interventions and dedicated medical care are delivered as parallel public health measures. This study was a descriptive case report. Medical encounters and event-related data were documented prospectively using an established event registry database. In 2014, Shambhala Music Festival had 67,120 cumulative attendees over a 7-day period, with a peak daily attendance of 15,380 people. There were 1,393 patient encounters and the patient presentation rate (PPR) was 20.8 per one thousand. The majority of these (90.9%) were for non-urgent complaints. The ambulance transfer rate (ATR) was 0.194 per one thousand and 0.93% of patient encounters were transferred by ambulance. No patients required intubation and there were no fatalities. Harm reduction services included mobile outreach teams, distribution of educational materials, pill checking facilities, a dedicated women's space, and a "Sanctuary" area that provided non-medical peer support for overwhelmed guests. More than 10,000 encounters were recorded by mobile and booth-based preventive and educational services, and 2,786 pills were checked on-site with a seven percent discard rate. Dedicated medical and HR services represent two complementary public health strategies to minimize risk at a multi-day electronic music festival. The specific extent to which HR strategies reduce the need for medical care is not well understood. Incorporation of HR practices when planning on-site medical care has the potential to inform patient management, reduce

  14. Practices of traditional birth attendants in Sierra Leone and perceptions by mothers and health professionals familiar with their care.

    Science.gov (United States)

    Dorwie, Florence M; Pacquiao, Dula F

    2014-01-01

    Describe practices of traditional birth attendants (TBAs) in assisting women in childbirth and the perceptions of TBAs by mothers and health professionals familiar with their work. Qualitative design using focus groups conducted in urban and rural settings in Sierra Leone. Separate audiotaped focus groups conducted for each group of participants lasting between 45 and 90 minutes. Purposive sample of 20 TBAs, 20 mothers, and 10 health professionals who met the following criteria: (a) at least 18 years of age, (b) TBAs currently practicing, (c) mothers who delivered at least one child assisted by a TBA, and (d) health professionals currently practicing in the hospital and familiar with TBA practices. TBAs are valued by mothers, health professionals, and the community because they provide accessible and affordable care to mothers who may otherwise have no access to health services. TBAs need training, supervision, and resources for effective referral of mothers. Systemic problems in the health care system create enormous barriers to effective care for mothers and children independent of TBA practices that contribute to high maternal and infant mortality rates. The study findings have implications on broad public policy in improving maternal and child health in the country.

  15. [Reasons for attending emergency departments. People speak out].

    Science.gov (United States)

    Pasarín, M Isabel; Fernández de Sanmamed, M José; Calafell, Joana; Borrell, Carme; Rodríguez, Dolors; Campasol, Salvador; Torné, Elvira; Torras, M Glòria; Guarga, Alex; Plasència, Antoni

    2006-01-01

    To ascertain why people attend hospital emergency departments (ED) for low complexity health problems. A phenomenological, interactionist, qualitative study was performed. A theoretical sample that selected one urban and one rural area from Catalonia (Spain) was designed. In each setting, persons (n = 36) who had used the ED or a primary care emergency service 1 month before the beginning of the study were chosen. Data were obtained through 8 focus groups. An interpretative content analysis was performed, and emergent categories were constructed through research triangulation. Five categories emerged: symptoms, whether or not self-diagnosis was involved, perception of needs, awareness of the health services available, and the overall context of the person. Symptoms generated feelings of failing health and thus initiated care seeking. Self-diagnosis determined perceived need and the type of care sought. People contrasted their self-perception of need with their own opinion about the health services available. The decision to go to one or other service was made as a result of this contrast, but the individual's family, work, and social situations also played a part. Informants were more familiar with the service provided by the ED than with that provided by primary care. Time consumption also figured heavily in decision making. The presence or absence of self-diagnosis is a determining factor in attendance at EDs. Other factors that influence demand are the level of awareness of the health services available, previous experiences, and the life situation of the individual.

  16. Gestalt therapy approaches with aggressive children in a day care setting

    OpenAIRE

    Maxey, Win

    1987-01-01

    This research study was designed to evaluate whether or not Gestalt therapy approaches could be used effectively when intervening with aggressive acts in a day care setting. Five focus children were observed at timed intervals as to whether or not they were aggressive, how the caretaker intervened, and how the children responded to the caretaker intervention. After a baseline of aggressive acts was established, caretakers were trained to use Gestalt therapy interventio...

  17. Gastric dilation-volvulus in dogs attending UK emergency-care veterinary practices: prevalence, risk factors and survival.

    Science.gov (United States)

    O'Neill, D G; Case, J; Boag, A K; Church, D B; McGreevy, P D; Thomson, P C; Brodbelt, D C

    2017-11-01

    To report prevalence, risk factors and clinical outcomes for presumptive gastric dilation-volvulus diagnosed among an emergency-care population of UK dogs. The study used a cross-sectional design using emergency-care veterinary clinical records from the VetCompass Programme spanning September 1, 2012 to February 28, 2014 and risk factor analysis using multivariable logistic regression modelling. The study population comprised 77,088 dogs attending 50 Vets Now clinics. Overall, 492 dogs had presumptive gastric dilation-volvulus diagnoses, giving a prevalence of 0·64% (95% Confidence interval: 0·58 to 0·70%). Compared with cross-bred dogs, breeds with the highest odds ratios for the diagnosis of presumptive gastric dilation-volvulus were the great Dane (odds ratio: 114·3, 95% Confidence interval 55·1 to 237·1, Pdogs aged up to 12 years and neutered male dogs had 1·3 (95% Confidence interval 1·0 to 1·8, P=0·041) times the odds compared with entire females. Of the cases that were presented alive, 49·7% survived to discharge overall, but 79·3% of surgical cases survived to discharge. Approximately 80% of surgically managed cases survived to discharge. Certain large breeds were highly predisposed. © 2017 British Small Animal Veterinary Association.

  18. An intervention involving traditional birth attendants and perinatal and maternal mortality in Pakistan.

    Science.gov (United States)

    Jokhio, Abdul Hakeem; Winter, Heather R; Cheng, Kar Keung

    2005-05-19

    There are approximately 4 million neonatal deaths and half a million maternal deaths worldwide each year. There is limited evidence from clinical trials to guide the development of effective maternity services in developing countries. We performed a cluster-randomized, controlled trial involving seven subdistricts (talukas) of a rural district in Pakistan. In three talukas randomly assigned to the intervention group, traditional birth attendants were trained and issued disposable delivery kits; Lady Health Workers linked traditional birth attendants with established services and documented processes and outcomes; and obstetrical teams provided outreach clinics for antenatal care. Women in the four control talukas received usual care. The primary outcome measures were perinatal and maternal mortality. Of the estimated number of eligible women in the seven talukas, 10,114 (84.3 percent) were recruited in the three intervention talukas, and 9443 (78.7 percent) in the four control talukas. In the intervention group, 9184 women (90.8 percent) received antenatal care by trained traditional birth attendants, 1634 women (16.2 percent) were seen antenatally at least once by the obstetrical teams, and 8172 safe-delivery kits were used. As compared with the control talukas, the intervention talukas had a cluster-adjusted odds ratio for perinatal death of 0.70 (95 percent confidence interval, 0.59 to 0.82) and for maternal mortality of 0.74 (95 percent confidence interval, 0.45 to 1.23). Training traditional birth attendants and integrating them into an improved health care system were achievable and effective in reducing perinatal mortality. This model could result in large improvements in perinatal and maternal health in developing countries. Copyright 2005 Massachusetts Medical Society.

  19. Women's preference for traditional birth attendants and modern health care practitioners in Akpabuyo community of Cross River State, Nigeria.

    Science.gov (United States)

    Akpabio, Idongesit I; Edet, Olaide B; Etifit, Rita E; Robinson-Bassey, Grace C

    2014-01-01

    The proportion of women who patronized traditional birth attendants (TBAs) or modern health care practitioners (MHCPs) was compared, including reasons for their choices. A comparative design was adopted to study 300 respondents selected through a multistage systematic random sampling technique. The instrument for data collection was a validated 21-item structured questionnaire. We observed that 75 (25%) patronized and 80 (27%) preferred TBAs, and 206 (69%) patronized and 220 (75%) preferred MHCPs, while 19 (6%) patronized both. The view that TBAs prayed before conducting deliveries was supported by a majority 75 (94%) of the respondents who preferred them. Factors associated with preference for TBAs should be addressed.

  20. Provision of Child Care: Cost Functions for Profit-Making and Not-for-Profit Day Care Centers

    OpenAIRE

    Swati Mukerjee; Ann Dryden Witte; Sheila Hollowell

    1990-01-01

    This paper estimates cost functions for day care centers in Massachusetts. The production technology assumed is the generalized homothetic Cobb-Douglas production function. The cost function dual to this production function is estimated separately for profit-making (P1Os) and not-for-profit (NPOs) organizations. The results are discussed in the context of current NPO literature. NPOs are found to be operating at higher average coats than PMOs for most output levels as predicted by the literat...

  1. Outbreaks of human-herpes virus 6 (HHV-6 infection in day-care centers in Belém, Pará, Brazil

    Directory of Open Access Journals (Sweden)

    FREITAS Ronaldo B.

    2000-01-01

    Full Text Available A total of 730 children aged less than 7 years, attending 8 day-care centers (DCCs in Belém, Brazil were followed-up from January to December 1997 to investigate the occurrence of human-herpes virus 6 (HHV-6 infection in these institutional settings. Between October and December 1997 there have been outbreaks of a febrile- and -exanthematous disease, affecting at least 15-20% of children in each of the DCCs. Both serum- and- plasma samples were obtained from 401 (55% of the 730 participating children for the detection of HHV-6 antibodies by enzyme-linked immunosorbent assay (ELISA, and viral DNA amplification through the nested-PCR. Recent HHV-6 infection was diagnosed in 63.8% (256/401 of them, as defined by the presence of both IgM and IgG-specific antibodies (IgM+/IgG+; of these, 114 (44.5% were symptomatic and 142 (55.5% had no symptoms (p = 0.03. A subgroup of 123 (30.7% children were found to be IgM-/IgG+, whereas the remaining 22 (5.5% children had neither IgM nor IgG HHV-6- antibodies (IgM-/IgG-. Of the 118 children reacting strongly IgM-positive ( > or = 30 PANBIO units, 26 (22.0% were found to harbour the HHV-6 DNA, as demonstrated by nested-PCR. Taken the ELISA-IgM- and- nested PCR-positive results together, HHV-6 infection was shown to have occurred in 5 of the 8 DCCs under follow-up. Serological evidence of recent infections by Epstein-Barr virus (EBV and parvovirus B19 were identified in 2.0% (8/401 and 1.5% (6/401 of the children, respectively. Our data provide strong evidence that HHV-6 is a common cause of outbreaks of febrile/exanthematous diseases among children attending DCCs in the Belém area.

  2. Association between Breastfeeding Duration and Type of Birth Attendant

    Directory of Open Access Journals (Sweden)

    Jordyn T. Wallenborn

    2018-01-01

    Full Text Available Introduction. Healthcare providers play an integral role in breastfeeding education and subsequent practices; however, the education and support provided to patients may differ by type of provider. The current study aims to evaluate the association between type of birth attendant and breastfeeding duration. Methods. Data from the prospective longitudinal study, Infant Feeding Practices Survey II, was analyzed. Breastfeeding duration and exclusive breastfeeding duration were defined using the American Academy of Pediatrics’ national recommendations. Type of birth attendant was categorized into obstetricians, other physicians, and midwife or nurse midwife. If mothers received prenatal care from a different type of provider than the birth attendant, they were excluded from the analysis. Multinomial logistic regression was conducted to obtain crude and adjusted odds ratios and 95% confidence intervals. Results. Compared to mothers whose births were attended by an obstetrician, mothers with a family doctor or midwife were twice as likely to breastfeed at least six months. Similarly, mothers with a midwife birth attendant were three times as likely to exclusively breastfeed less than six months and six times more likely to exclusively breastfeed at least six months compared to those who had an obstetrician birth attendant. Conclusions. Findings from the current study highlight the importance of birth attendants in breastfeeding decisions. Interventions are needed to overcome barriers physicians encounter while providing breastfeeding support and education. However, this study is limited by several confounding factors that have not been controlled for as well as by the self-selection of the population.

  3. [Prenatal care in Latin America].

    Science.gov (United States)

    Buekens, P; Hernández, P; Infante, C

    1990-01-01

    Available data on the coverage of prenatal care in Latin America were reviewed. In recent years, only Bolivia had a coverage of prenatal care of less than 50 per cent. More than 90 per cent of pregnant women received prenatal care in Chile, Cuba, the Dominican Republic, and Puerto Rico. Prenatal care increased between the 1970 and 1980 in the Dominican Republic, Ecuador, Guatemala, Honduras, Mexico, and Peru. The coverage of prenatal care decreased in Bolivia and Colombia. The mean number of visits increased in Cuba and Puerto Rico. The increase of prenatal care in Guatemala and Honduras is due to increased care by traditional birth attendants, compared to the role of health care institutions. We compared the more recent data on tetanus immunization of pregnant women to the more recent data on prenatal care. The rates of tetanus immunization are always lower than the rates of prenatal care attendance, except in Costa Rica. The rates of tetanus immunization was less than half as compared to the rates of prenatal care in Bolivia, Guatemala, and Peru. To improve the content of prenatal care should be an objective complementary to the increase of the number of attending women.

  4. Intestinal Parasites Prevalence in Children from Day Care Centers in Sinop City-MT

    Directory of Open Access Journals (Sweden)

    B. Muchiutti

    2013-03-01

    Full Text Available Abstract: The aim of this study was to investigate the intestinal parasitosis prevalence of children from municipal day care centers in Sinop MT. Respecting ethical principles established by Resolution 196/96 of Health National Council/Ministry of Health of quantitative research, the anonymity of participants, as well accept and signature of parents of the Term of Free and Enlightened Consent were performed. Between Junes to October 2012 were applied coproparasitological methods for investigation. Fecal samples were analyzed by Hoffmans methods. From 103 students examined observed the prevalence rate of 19.42% of intestinal parasites. The intestinal parasites with highest prevalence rate were: Giardia lamblia (9.70% and Endolimax nana (5.82%. The results of this study demonstrate the need for sensitization of the population front of diagnosis importance, treatment and monitoring of positive cases and the necessity of more health professionals attention, especially with children.Key-words: Intestinal parasites, day care centers, children.

  5. The experience of being a traditional midwife: relationships with skilled birth attendants.

    Science.gov (United States)

    Dietsch, Elaine

    2010-01-01

    This article focuses on an unexpected finding of a research project which explored the experience of being a traditional midwife. The unexpected finding was that traditional midwives often perceive skilled (professional) birth attendants to be abusive of both them and the women who are transferred to hospital for emergency obstetric care. Eighty-four traditional midwives in the Western Province of Kenya were interviewed individually or in groups with a Bukusu/Kiswahili/English-speaking interpreter. Interviews were audiotaped and the English components were transcribed verbatim. Interview transcripts and observations were thematically analysed. A minority of relationships between traditional midwives and skilled birth attendants were based on mutual respect and collaborative practice. However, the majority of encounters with skilled birth attendants were perceived by the traditional midwives to be abusive for them and the women requiring emergency obstetric care. In the interests of improving health outcomes for women and their newborns, interpersonal skills, including maintaining respectful communication and relationships must be a core competency for all caregivers. Providing opportunities for reciprocal learning and strategies to enhance relationships between traditional midwives and skilled birth attendants are recommended. Current global strategies to reduce maternal and newborn mortality by increasing the number of women birthing with a skilled (professional) birth attendant in an enabling environment may be limited while the reasons for traditional midwives being the caregiver of choice for the majority of women living in areas such as Western Kenya remain unaddressed.

  6. Best practices: increased attendance in inpatient group psychotherapy improves patient outcomes.

    Science.gov (United States)

    Page, Andrew C; Hooke, Geoffrey R

    2009-04-01

    This column describes an initiative that promoted increased attendance in group psychotherapy and its effect on patient outcomes. Information on patient- and staff-rated outcomes, readmission rates, and patient satisfaction was gathered for 2,782 inpatients in a private psychiatric facility in Australia. On average, after the initiative was implemented, patients went from attending one session per day to two sessions. Inpatients admitted after implementation had better patient- and staff-rated outcomes and lower rates of readmission within one month of discharge. However, patients' treatment satisfaction ratings declined. These findings indicate that increasing attendance in group psychotherapy can be a useful adjunct to hospital treatment.

  7. Decentralizing Maternity Services to Increase Skilled Attendance at Birth and Antenatal Care Utilization in Rural Rwanda: A Prospective Cohort Study

    Science.gov (United States)

    Nathan, Lisa M.; Shi, Quihu; Plewniak, Kari; Zhang, Charles; Nsabimana, Damien; Sklar, Marc; Mutimura, Eugene; Merkatz, Irwin R.; Einstein, Mark H.; Anastos, Kathryn

    2015-01-01

    To evaluate the effectiveness of decentralizing ambulatory reproductive and intrapartum services to increase rates of antenatal care (ANC) utilization and skilled attendance at birth (SAB) in Rwanda. A prospective cohort study was implemented with one control and two intervention sites: decentralized ambulatory reproductive healthcare and decentralized intrapartum care. Multivariate logistic regression analysis was performed with primary outcome of lack of SAB and secondary outcome of ≥3 ANC visits. 536 women were entered in the study. Distance lived from delivery site significantly predicted SAB (p = 0.007), however distance lived to ANC site did not predict ≥3 ANC visits (p = 0.81). Neither decentralization of ambulatory reproductive healthcare (p = 0.10) nor intrapartum care (p = 0.40) was significantly associated with SAB. The control site had the greatest percentage of women receive ≥3 ANC visits (p < 0.001). Receiving <3 ANC visits was associated with a 3.98 times greater odds of not having SAB (p = 0.001). No increase in adverse outcomes was found with decentralization of ambulatory reproductive health care or intrapartum care. The factors that predict utilization of physically accessible services in rural Africa are complex. Decentralization of services may be one strategy to increase rates of SAB and ANC utilization, but selection biases may have precluded accurate analysis. Efforts to increase ANC utilization may be a worthwhile investment to increase SAB. PMID:25652061

  8. Did the strategy of skilled attendance at birth reach the poor in Indonesia?

    Science.gov (United States)

    Hatt, Laurel; Stanton, Cynthia; Makowiecka, Krystyna; Adisasmita, Asri; Achadi, Endang; Ronsmans, Carine

    2007-10-01

    To assess whether the strategy of "a midwife in every village" in Indonesia achieved its aim of increasing professional delivery care for the poorest women. Using pooled Demographic and Health Surveys (DHS) data from 1986-2002, we examined trends in the percentage of births attended by a health professional and deliveries via caesarean section. We tested for effects of the economic crisis of 1997, which had a negative impact on Indonesias health system. We used logistic regression, allowing for time-trend interactions with wealth quintile and urban/rural residence. There was no change in rates of professional attendance or caesarean section before the programmes full implementation (1986-1991). After 1991, the greatest increases in professional attendance occurred among the poorest two quintiles -- 11% per year compared with 6% per year for women in the middle quintile (P = 0.02). These patterns persisted after the economic crisis had ended. In contrast, most of the increase in rates of caesarean section occurred among women in the wealthiest quintile. Rates of caesarean deliveries remained at less than 1% for the poorest two-fifths of the population, but rose to 10% for the wealthiest fifth. The Indonesian village midwife programme dramatically reduced socioeconomic inequalities in professional attendance at birth, but the gap in access to potentially life-saving emergency obstetric care widened. This underscores the importance of understanding the barriers to accessing emergency obstetric care and of the ways to overcome them, especially among the poor.

  9. Impact of Inpatient Versus Outpatient Total Joint Arthroplasty on 30-Day Hospital Readmission Rates and Unplanned Episodes of Care.

    Science.gov (United States)

    Springer, Bryan D; Odum, Susan M; Vegari, David N; Mokris, Jeffrey G; Beaver, Walter B

    2017-01-01

    This article describes a study comparing 30-day readmission rates between patients undergoing outpatient versus inpatient total hip (THA) and knee (TKA) arthroplasty. A retrospective review of 137 patients undergoing outpatient total joint arthroplasty (TJA) and 106 patients undergoing inpatient (minimum 2-day hospital stay) TJA was conducted. Unplanned hospital readmissions and unplanned episodes of care were recorded. All patients completed a telephone survey. Seven inpatients and 16 outpatients required hospital readmission or an unplanned episode of care following hospital discharge. Readmission rates were higher for TKA than THA. The authors found no statistical differences in 30-day readmission or unplanned care episodes. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. HIV status disclosure and ARV adherence among patients attending ...

    African Journals Online (AJOL)

    HIV status disclosure and ARV adherence among patients attending Jomo Kenyatta University comprehensive care clinic. ... Failure to daily intake of Anti Retrovirals (ARV) not only prevents treatment failure but may also lead to viral development of resistance to the drugs. The fact that HIV is mainly sexually transmitted ...

  11. Day-care hypospadias surgery: Single surgeon experience

    Directory of Open Access Journals (Sweden)

    Chandrasekharam V.V.S.S

    2007-01-01

    Full Text Available Aim: To report the results of the early discharge of children after hypospadias repair with an indwelling catheter. Materials and Methods: To facilitate early the discharge of children after hypospadias repair, the author adopted the technique of draining the indwelling urinary catheter into diapers in children undergoing this operation. Home catheter care was taught to the mother; the dressings and catheters were subsequently managed in the outpatient clinic. Results: Over a 2-year period, 43 children were managed by this technique and were sent home within 24-48 h after the operation with an indwelling catheter. Minor problems requiring outpatient visits to the surgeon occurred in nine (20% children after discharge from the hospital. All the nine children were successfully managed as outpatients and no child required rehospitalisation. The catheter remained in position for 5 days in all the children. The overall results were satisfactory with an acceptable (7% fistula rate. Conclusions: It is possible to reduce the duration of the hospital stay of children after hypospadias repair without compromising on the final results.

  12. Contribution of the education of the prospective fathers to the success of maternal health care programme.

    OpenAIRE

    Bhalerao V; Galwankar M; Kowli S; Kumar R; Chaturvedi R

    1984-01-01

    The role of involving prospective fathers in the care of pregnant women attending the Mother Craft Clinic of the Malavani Health Center in Bombay, India was evaluated. Beginning in October 1982, pregnant women attending the Clinic were requested to ask their husands to meet the resident medical officer of the center who was available on the premises of the Center on all days and evenings including the holidays. 1 of the medico-social workers explained to the women the reason and the need fo...

  13. Epidemiology of Mental Health Attendances at Emergency Departments: Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Helen Barratt

    Full Text Available The characteristics of Emergency Department (ED attendances due to mental or behavioural health disorders need to be described to enable appropriate development of services. We aimed to describe the epidemiology of mental health-related ED attendances within health care systems free at the point of access, including clinical reason for presentation, previous service use, and patient sociodemographic characteristics.Systematic review and meta-analysis of observational studies describing ED attendances by patients with common mental health conditions.18 studies from seven countries met eligibility criteria. Patients attending due to mental or behavioural health disorders accounted for 4% of ED attendances; a third were due to self-harm or suicidal ideation. 58.1% of attendees had a history of psychiatric illness and up to 58% were admitted. The majority of studies were single site and of low quality so results must be interpreted cautiously.Prevalence studies of mental health-related ED attendances are required to enable the development of services to meet specific needs.

  14. A qualitative study of conceptions and attitudes regarding maternal mortality among traditional birth attendants in rural Guatemala.

    OpenAIRE

    Rööst, Mattias; Johnsdotter, Sara; Liljestrand, Jerker; Essén, Birgitta

    2004-01-01

    OBJECTIVE: To explore conceptions of obstetric emergency care among traditional birth attendants in rural Guatemala, elucidating social and cultural factors. STUDY: design Qualitative in-depth interview study. SETTING: Rural Guatemala. SAMPLE: Thirteen traditional birth attendants from 11 villages around San Miguel Ixtahuacán, Guatemala. METHOD: Interviews with semi-structured, thematic, open-ended questions. Interview topics were: traditional birth attendants' experiences and conceptions...

  15. Birth attendance and magnitude of obstetric complications in Western Kenya: a retrospective case-control study.

    Science.gov (United States)

    Liambila, Wilson N; Kuria, Shiphrah N

    2014-09-08

    Skilled birth attendance is critical in the provision of child birth related services. Yet, literature is scanty on the outcomes of child birth related complications in situations where majority of women deliver under the care of non-skilled birth attendants compared to those who are assisted by skilled providers. The study sought to assess the nature of childbirth related complications among the skilled and the non-skilled birth attendants in Western Kenya. A case-control study was conducted among women aged 15-49 years at the household. Controls were individually matched to cases on the basis of age and socio-economic status. A total of 294 cases and 291 controls were interviewed. Data were collected on various demographic and socio-economic characteristics and women's perception on the quality of care. All independent variables were analysed initially in bivariate models and those that were significantly associated with obstetric complications were included in multiple logistic regression model in order to control for confounding factors. Odds ratios (ORs), with 95% confidence intervals, were computed to show the association between the occurrence, magnitude and the extent to which child birth related complications were managed. Demographic and socio-economic characteristics of the cases and controls were similar. About 52% of the deliveries were assisted by skilled birth attendants while non-skilled providers attended to 48% of them. The odds of the occurrence of obstetric complications were greater among the women who were attended to by skilled providers in health facilities: adjusted odds ratio (AOR): 1.32 (CI 0.95, 1.84) than among those who were assisted by unskilled birth attendants, AOR 0.76 (CI 0.55, 1.06). Undignified care, high delivery and transport costs and fear of hospital procedures such as HIV tests and mishandling of the placenta were cited as some of the barriers to facility deliveries. Skilled birth attendants in facilities were associated

  16. Attendance at antenatal clinics in inner-city Johannesburg, South Africa and its associations with birth outcomes: analysis of data from birth registers at three facilities.

    Science.gov (United States)

    Gumede, Siphamandla; Black, Vivian; Naidoo, Nicolette; Chersich, Matthew F

    2017-07-04

    Antenatal care (ANC) clinics serve as key gateways to screening and treatment interventions that improve pregnancy outcomes, and are especially important for HIV-infected women. By disaggregating data on access to ANC, we aimed to identify variation in ANC attendance by level of care and across vulnerable groups in inner-city Johannesburg, and document the impact of non-attendance on birth outcomes. This record review of routine health service data involved manual extraction of 2 years of data from birth registers at a primary-, secondary- and tertiary-level facility within inner-city Johannesburg. Information was gathered on ANC attendance, HIV testing and status, pregnancy duration, delivery mode and birth outcomes. Women with an unknown attendance status were considered as not having attended clinic, but effects of this assumption were tested in sensitivity analyses. Multiple logistic regression was used to identify associations between ANC attendance and birth outcomes. Of 31,179 women who delivered, 88.7% (27,651) had attended ANC (95% CI = 88.3-89.0). Attendance was only 77% at primary care (5813/7543), compared to 89% at secondary (3661/4113) and 93% at tertiary level (18,177/19,523). Adolescents had lower ANC attendance than adults (85%, 1951/2295 versus 89%, 22,039/24,771). Only 37% of women not attending ANC had an HIV test (1308/3528), compared with 93% of ANC attenders (25,756/27,651). Caesarean section rates were considerably higher in women who had attended ANC (40%, 10,866/27,344) than non-attenders (13%, 422/3360). Compared to those who had attended ANC, non-attenders were 1.6 fold more likely to have a preterm delivery (95% CI adjusted odds ratio [aOR] = 1.4-1.8) and 1.4 fold more likely to have a stillbirth (aOR 95% CI = 1.1-1.9). Similar results were seen in analyses where missing data on ANC attendance was classified in different ways. Inner-city Johannesburg has an almost 5% lower ANC attendance rate than national levels. Attendance is

  17. "To cherish each day as it comes": a qualitative study of spirituality among persons receiving palliative care.

    Science.gov (United States)

    Asgeirsdottir, Gudlaug Helga; Sigurbjörnsson, Einar; Traustadottir, Rannveig; Sigurdardottir, Valgerdur; Gunnarsdottir, Sigridur; Kelly, Ewan

    2013-05-01

    Spirituality is one of the main aspects of palliative care. The concept is multidimensional and encompasses the existential realm as well as value-based and religious considerations. The aim of this study was to explore spirituality from the perspective of persons receiving palliative care and examine their experience of spirituality and its influence on their lives and well-being. Qualitative interviews were conducted with ten persons receiving palliative care from Palliative Care Services in Iceland. The interviews were tape-recorded, transcribed and analysed. The study is in the field of practical theology and used the theoretical approach of hermeneutical phenomenology. Thematic analysis found that the spiritual dimension was of significance for the participants who understood it as a vital element connected to seeking meaning, purpose and transcendence in life. Religious and non-religious aspects of spirituality were expressed including strong spiritual components of family relationships, the meaning of God/a higher being and spiritual practices which served as a key factor in giving strength, activating inner resources and motivating hope. Nine of the participants expressed their spirituality as faith. Spirituality was experienced broadly as an important dimension of how participants lived with terminal illness. Religious and non-religious characteristics were recognised which reveals the complex nature of the phenomenon. Faith was a significant part of the participants' spirituality indicating the importance of attending to this aspect of palliative care. The study suggests the potential contributions of theological approaches which are relevant for palliative care research and practice.

  18. Factors influencing non-attendance of clinic appointments in ...

    African Journals Online (AJOL)

    without an appointment, with an average of eight patients per day missing their appointment. The low rate of compliance with clinic appointments was of concern for the physicians at both the diabetes clinics. Prior to the current study, the reasons for non-attendance had not been examined. Materials and methods. A sample ...

  19. A qualitative study of conceptions and attitudes regarding maternal mortality among traditional birth attendants in rural Guatemala.

    Science.gov (United States)

    Rööst, Mattias; Johnsdotter, Sara; Liljestrand, Jerker; Essén, Birgitta

    2004-12-01

    To explore conceptions of obstetric emergency care among traditional birth attendants in rural Guatemala, elucidating social and cultural factors. design Qualitative in-depth interview study. Rural Guatemala. Thirteen traditional birth attendants from 11 villages around San Miguel Ixtahuacán, Guatemala. Interviews with semi-structured, thematic, open-ended questions. Interview topics were: traditional birth attendants' experiences and conceptions as to the causes of complications, attitudes towards hospital care and referral of obstetric complications. Conceptions of obstetric complications, hospital referrals and maternal mortality among traditional birth attendants. Pregnant women rather than traditional birth attendants appear to make the decision on how to handle a complication, based on moralistically and fatalistically influenced thoughts about the nature of complications, in combination with a fear of caesarean section, maltreatment and discrimination at a hospital level. There is a discrepancy between what traditional birth attendants consider appropriate in cases of complications, and the actions they implement to handle them. Parameters in the referral system, such as logistics and socio-economic factors, are sometimes subordinated to cultural values by the target group. To have an impact on maternal mortality, bilateral culture-sensitive education should be included in maternal health programs.

  20. An Open Conversation with Traditional Birth Attendants in Rural Uganda: The Potential for Collaborative Care

    Directory of Open Access Journals (Sweden)

    Elizabeth D. Yuan

    2017-06-01

    Full Text Available Background: Imaging the World-Africa (ITWA is a registered non-governmental organization aimed at distributing low-cost ultrasound services at health centres in rural Uganda. Yet, studies demonstrate that the majority of mothers continue to deliver with unregulated traditional birth attendants (TBAs in their local villages. It has been suggested that the unregulated practices of TBAs has contributed to the high rate of maternal and fetal mortality. A greater understanding of the roles of TBAs in the management of pregnancy and delivery is needed. Purpose: The purpose of this report is to provide the international community with a greater understanding of TBA practices as well as an assessment of their willingness for future collaboration. Methods: Three TBAs from different nearby villages attended a meeting with ITWA in Kamuli District, Uganda. The meeting included an interview and an educational session. A test on the management principles of common obstetric complications was administered at the beginning and end of the meeting to assess baseline knowledge and the effect of the interaction. Results: The meeting with the TBAs provided valuable qualitative information about TBA clinical experience, the value of TBAs to the community and TBA understanding of ultrasound. On the pre-educational test, the TBAs had a limited understanding of pregnancy complications and conditions in which it would be safer for a mother to deliver at a hospital. After the educational session, the TBAs performed statistically significantly better on the post-test (p=0.03. Conclusion: The open conversation with the TBAs provided valuable information on the current role of TBAs in rural Uganda. Our experience with the TBAs demonstrates that TBAs are willing to engage with trained healthcare providers. Collaboration between TBAs and health centers in Uganda has the potential to bring to light previously unknown barriers and create solutions to better maternal and fetal