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.…

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

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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.

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

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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.

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)

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

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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.

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

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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.

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

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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…

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

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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.

Assessment of indoor environment in Paris child day care centers.

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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.

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

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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.

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

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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

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...

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

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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.

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

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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.

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

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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

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.

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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.

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

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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.

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

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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.

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

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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…

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....

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

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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...

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

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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...

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

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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...

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

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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

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

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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.

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

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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.

Fecal coliforms on environmental surfaces in two day care centers.

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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

[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.

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...

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…

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…

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

Science.gov (United States)

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.

[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.

MULTIMEDIA CONCENTRATIONS OF PAH IN SEVERAL DAY CARE CENTERS

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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...

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

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

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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.

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 ...

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

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

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

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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.

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

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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.

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

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...

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

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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.

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...

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

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

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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

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...

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.

[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.

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 ...

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.

How To Pick a Special Day Care Center.

Science.gov (United States)

Colbert, Ronald P.

This paper outlines seven specific areas that parents should examine when visiting a prospective child care center for their child. Parents should examine: (1) the center's staff; (2) the center's parent relations; (3) the physical and teaching environment; (4) the curriculum; (5) staff-child interaction; (6) the administration; and (7) their…

Intestinal Parasites Prevalence in Children from Day Care Centers in Sinop City-MT

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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.

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.

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,…

Testing for lead in toys at day care centers.

Science.gov (United States)

Sanders, Martha; Stolz, Julie; Chacon-Baker, Ashley

2013-01-01

Exposure to lead-based paint or material has been found to impact children's cognitive and behavioral development at blood lead levels far below current standards. The purpose of the project was to screen for lead in toy items in daycare centers in order to raise awareness of inside environmental lead exposures and minimize lead-based exposures for children. Occupational therapy students in a service learning class tested for lead in ten daycare or public centers using the XRF Thermo Scientific Niton XL3t, a method accepted by the Consumer Product Safety Commission (CPSC). A total of 460 items were tested over a two-month period for an average of 66 toys per setting. Fifty six (56) items tested > 100 ppm, which represented 12% of the entire sample. Items with high lead levels included selected toys constructed with lead-based paint, lead metals, plastics using lead as a color enhancer, and decorative objects. While the actual number of lead-based products is small, the cumulative exposure or habitual use may pose an unnecessary risk to children. Indoor exposures occurred for all day care centers regardless of socio-economic levels. Recommendations to minimize exposures are provided.

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.

Snoring habits among healthy persons attending a tertiary care center in Chittagong, Bangladesh: A questionnaire-based study

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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.

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.

EURISWEB – Web-based epidemiological surveillance of antibiotic-resistant pneumococci in Day Care Centers

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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.

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.

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

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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.

Moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a day care center.

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Bocchi, Silvia Cristina Mangini; Cano, Karen Cristina Urtado; Baltieri, Lilian; Godoy, Daniele Cristina; Spiri, Wilza Carla; Juliani, Carmen Maria Casquel Monti

2010-09-01

This study aimed at understanding the interactional experience between family caregivers and disabled elderly persons supported in a Day Care Center according to the caregiver's perspective. It also aimed at developing a representative theoretical model for the events experienced by such caregiver. The Grounded Theory was used as methodological framework whereas Interactional Symbolism served as the theoretical framework. Observation and interviews were used for data collection. The following phenomenon arose from the results: feeling of support by the Day Care Center, by the strength of the bond with the elderly and by spirituality in order to continue playing the challenging role of a family caregiver for a disabled elderly person. The study made possible to understand that, among these three supporting cornerstones for coping with the burden generated by the family caregiver role, the care model promoted by the Day Care Center was the intervenient variable in the process of improving the quality of life of the family caregiver-disabled elderly person binomial. This allowed the identification of the main category--moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a Day Care Center.

Supervisors' Performance Ratings Correlated with Selected Personal Characteristics of Attendants in a Mental Retardation Developmental Center.

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Frederick, Joseph; And Others

A research study investigated the relationship between personal characteristics and selected demographic data of 75 attendants in a mental retardation developmental center and the assessment by 24 administrators of the attendants' job performance. Instruments used included a 20-item Direct Care Performance Scale and the Demographic Data Scale,…

The Nutritional Contribution of Foods and Beverages Provided by Government-Sponsored Day Care Centers in Guatemala.

Science.gov (United States)

Vossenaar, Marieke; Hernández, Liza; Montenegro-Bethancourt, Gabriela; Soto-Méndez, María José; Bermudez, Odilia I; Solomons, Noel W

2015-09-01

Meals served at government-run day care centers must be nutritionally adequate to ensure good health and proper development of preschool-aged children. They can provide a controlled opportunity to complement the daily diet of children in vulnerable populations. To determine the nutrient adequacy and leading food sources of nutrients provided by the diet served in government-sponsored day care centers. Estimated daily energy and nutrient intakes of a theoretical 40-day day care center menu were calculated, and the nutrient adequacy was assessed. Nutrient densities and critical nutrient densities of the menu were computed to identify nutrient inadequacies. Furthermore, main sources of nutrients were identified, and energy and nutrient distributions were examined by meal time. The menu provides approximately 90% of daily energy requirement and more than 100% of Recommended Nutrient Intakes (RNIs), with the exception of vitamin D and calcium. Sugar was the first leading source of energy, whereas milk was the first leading contributor of vitamin D. Within an environment of budgetary constraints, the Guatemalan government developed and advocated an exemplary menu offering for children in the vulnerable preschool period. We have demonstrated that, if prepared and served as planned, the items from the official, standard menu would supply most of the nutrients needed. High vitamin A intake related to the mandated national fortification program is a potential problem. From the analysis, it was found that vitamin D emerges as the most prominent candidate for a problem nutrient of deficient intake. © The Author(s) 2015.

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...

Occurrence of child obesity in preschool children in a São Paulo day-care center

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Marcia Carla Morete Pinto

2009-03-01

Full Text Available Objective: To identify the occurrence of overweight and obesity in preschool children (two to five years in a day-care center in the city of São Paulo, using the weight/height ratio. Methods: This is a descriptive study, with exploratory quantitative approach, conducted in a day-care center in São Paulo. The sample consisted of 29 children, aged from two to five years and the data were collected through questionnaires. Rresults: As for the nutritional assessment of children according to the Waterlow criteria, 12 (41% were normal, 7 (24% obese, 5 (17% overweight, 3 (10% had grade 1 malnutrition, 1 (4%, morbid obesity and 1 (4%, grade 3 malnutrition. Cconclusions: It is concluded that a significant proportion of the children assessed is above the appropriate weight range, requiring the implementation of preventive actions aimed to guide habits of good nutrition, encouraging physical activity, thereby decreasing the rates of child obesity and impacting their health at adulthood.

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...

An Assesment of Emergency Contraception Knowledge of Women Attending the Primary Health Care Center in Umraniye

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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

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

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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.

An evaluation of lead contamination in plastic toys collected from day care centers in the Las Vegas Valley, Nevada, USA.

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Greenway, Joseph A; Gerstenberger, Shawn

2010-10-01

Childhood exposure to environmental lead continues to be a major health concern. This study examined lead content within the plastic of children's toys collected from licensed day care centers in the Las Vegas valley, Nevada. It was hypothesized that the use of lead as a plastics stabilizer would result in elevated lead (≥600 ppm) in polyvinyl chloride plastics (PVC) compared to non-PVC plastics. It was also hypothesized that, due to the use of lead chromate as a coloring agent, yellow toys would contain higher concentrations of lead (≥600 ppm) than toys of other colors. Toy samples were limited to those found in day care centers in Las Vegas, Nevada. 10 day care centers were visited and approximately 50 toy samples were taken from each center. Of the 535 toys tested, 29 contained lead in excess of 600 parts per million (ppm). Of those 29 toys, 20 were PVC and 17 were yellow. Both of the two hypotheses were strongly supported by the data.

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

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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

Functional capacity, independence and home affordances of premature children attending daycare centers

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Marcela Tamiasso Vieira

Full Text Available Abstract Introduction: Child development is the result of the interaction between biological and environmental factors. Objective: The aim of this study is to evaluate and compare the Functional Capacity, Independence and Home Affordances Level of Stimulation of premature children between 18 and 42 months, attending or not daycare centers. Methods: Cross-sectional study with a convenience sample of 26 premature children between 18 and 42 months, paired and divided into two groups: attending (study group and not attending daycare centers (control group. Data was collected from the questionnaires AHEMD-SR, PEDI and an identification questionnaire. Data analysis was performed by descriptive statistics, and Chi-square, Fisher, Mann-Whitney and Univariate Analysis tests, considering the level of significance of α = 0.05 and tendency of differentiation when α < 010. Results: There was a significant difference in the AHEMD-SR`s Variety of Stimulation (p = 0.036, higher in the control group, and tendency in the Gross Motor Toys (p = 0.086, more available in the study group. In PEDI, there was significant difference in Self-care (p = 0.045 and tendency of differentiation in Mobility (0.068, both of the Caregiver Assistance part (greater to the study. The sample showed low stimulation opportunities regarding Fine and Gross Motor Toys and high percentages of delay in Functional Skills (Mobility and Independence (Self Care and Mobility, especially in the control group. Conclusion: Daycare centers seem to positively affect the Functional Capacity and Independence in premature children between 18 and 42 months.

Media-Educational Habitus of Future Educators in the Context of Education in Day-Care Centers

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Friedrichs-Liesenkötter, Henrike

2015-01-01

This research explores these questions: (1) How are the forms of media-educational habitus of future educators shaped? (2) What conditions influence whether or not media education is done in day-care centers? The qualitative study consists of six semi-structured interviews with media education teachers in educator training, four focus group…

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

Integrated Pest Management Intervention in Child Care Centers Improves Knowledge, Pest Control, and Practices.

Science.gov (United States)

Alkon, Abbey; Nouredini, Sahar; Swartz, Alicia; Sutherland, Andrew Mason; Stephens, Michelle; Davidson, Nita A; Rose, Roberta

To reduce young children's exposure to pests and pesticides, an integrated pest management (IPM) intervention was provided for child care center staff. The 7-month IPM education and consultation intervention was conducted by trained nurse child care health consultants in 44 child care centers in California. IPM knowledge surveys were completed by child care staff, objective IPM assessments were completed by research assistants pre- and postintervention, and activity logs were completed by the nurses. There were significant increases in IPM knowledge for the child care staff who attended workshops. There were reductions in the prevalence of pests and increases in IPM practices at the postintervention compared with the preintervention time point. The nurses consulted an average of 5.4 hours per center. A nurse-led IPM intervention in child care centers can reduce exposure to harmful substances for young children attending child care centers. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Frequency and risk factors associated with dry eye in patients attending a tertiary care ophthalmology center in Mexico City

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Martinez JD

2016-07-01

Full Text Available Jaime D Martinez,1 Anat Galor,2,3 Nallely Ramos-Betancourt,1 Andrés Lisker-Cervantes,1 Francisco Beltrán,1 Jorge Ozorno-Zárate,1 Valeria Sánchez-Huerta,1 Marco-Antonio Torres-Vera,1 Everardo Hernández-Quintela1 1Cornea and External Diseases Service, Asociación Para Evitar la Ceguera en Mexico (Association to prevent blindness in Mexico, Universidad Nacional Autónoma de México, Mexico City, Mexico; 2Department of Ophthalmology, Miami Veterans Affairs Medical Center, 3Cornea and External Diseases Division, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA Purpose: The purpose of this study was to ascertain the frequency and risk factors of dry eye (DE among patients attending a tertiary care ophthalmology center in Mexico.Methods: Approximately 338 consecutive new patients attending a tertiary care ophthalmology center in Mexico City underwent an ocular surface examination, which included tear film break-up time, fluorescein corneal staining, Schirmer’s test, and evaluation of meibum quality. Symptoms of DE were evaluated by the Ocular Surface Disease Index and Dry Eye Questionnaire-5. Information on demographics, exposures, past medical and ocular history, and medications was also collected.Results: The frequency of severe DE symptoms was found to be 43% based on the Ocular Surface Disease Index and 30% based on Dry Eye Questionnaire-5. Risk factors significantly associated with increased DE symptoms included dry mouth and gastrointestinal ulcer medications. With regard to signs, aqueous tear deficiency was a less-frequent finding (22% in our population than evaporative deficiency (94%. Risk factors associated with aqueous tear deficiency were dry mouth and diuretic use. No risk factors were associated with evaporative deficiency. Risk factors associated with meibomian gland dysfunction included old age, male sex, arthritis, and use of an antihypertensive. The only risk factor associated with corneal staining was dry

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...

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

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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.

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

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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.

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

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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

Ultra-processed foods: Consumption among children at day-care centers and their classification according to Traffic Light Labelling system

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Giovana LONGO-SILVA

2015-10-01

Full Text Available Objective: To identify the age at which ultra-processed foods are introduced in the diet of infants enrolled in public daycare centers and analyze these foods' nutritional composition according to the Traffic Light Labelling system adapted to the Brazilian norms and recommendations.Methods: Cross-sectional study including 636 nursery age children attending day care centers. Their mothers were interviewed about the age of introduction of instant noodles, snack chips, encased meat, chocolate, ice cream, and stuffed cookies. The proximate composition of these foods was evaluated according to the Traffic Light Labelling adapted to the Brazilian norms and recommendations, which classifies total fat, saturated fat, trans fat, fiber, and sodium amounts as green, yellow, or red indicators.Results: It was found that before 12 months of age 70.6% of children had consumed instant noodles, 65.9% snack chips, 54.7% encased meat, 67.1% chocolate, 36.9% ice cream, and 68.7% stuffed cookies. In addition, all foods were classified as red for saturated fat and sodium and 50.0% were classified as red for total fat.Conclusion: The introduction of ultra-processed foods in the children's diets occurred early, but it is worth mentioning that such foods have an inadequate nutritional composition, contributing to the excess consumption of total fat, saturated fat, and sodium, as well as low fiber.

[The influence of caregivers' anxiety and the home environment on child abuse. A study of children attending child-care centers].

Science.gov (United States)

Mochizuki, Yukiko; Tanaka, Emiko; Shinohara, Ryoji; Sugisawa, Yuka; Tomisaki, Etsuko; Watanabe, Taeko; Tokutake, Kentaro; Matsumoto, Misako; Sugita, Chihiro; Anme, Tokie

2014-01-01

The prevalence of child abuse is increasing in Japan. Therefore, we need appropriate and practical approaches for implementing feasible prevention, early detection, and support services for abused children. The purpose of this study was to examine child-rearing anxieties and the home environment as factors affecting caregivers of suspected abused children who attend child-care centers . First, we applied the millennium edition of the Japan Child and Family Research Institute (JCFRI) Child Rearing Support Questionnaire, and the Index of Child Care Environment (ICCE), for 1,801 caregivers whose children were enrolled in child-care centers based in City A. The millennium edition of the JCFRI Child Rearing Support Questionnaire measures difficulties in childcare for caregivers in terms of feelings, anxiety, and tendencies toward depression. The ICCE measures the quality and frequency of involvement of caregivers with their children and the child-care environment. Next, we interviewed the directors and child-care professionals in the centers to collect information on child abuse. The children were divided into two groups: abused and non-abused. The "abused group" consisted of the children whom the directors and professionals of the child-care centers suspected of being "possibly abused" and so had been placed under the protection of the center; furthermore, the center exchanged information with the City A Municipality "City A municipal government" about these children. We conducted Fisher's exact test to examine the relationship between the "abused group" and the "non-abused group," in relation to child-rearing anxiety and the children's home environments. Questionnaire scores from the two groups were assessed. We calculated odds ratios to examine the significant factors related to child abuse. Our dependent variable was child abuse, our main independent variables were items related to child-care difficulties and the child-care environment, and the moderating variables

Improving Pain Care with Project ECHO in Community Health Centers.

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Anderson, Daren; Zlateva, Ianita; Davis, Bennet; Bifulco, Lauren; Giannotti, Tierney; Coman, Emil; Spegman, Douglas

2017-10-01

Pain is an extremely common complaint in primary care, and patient outcomes are often suboptimal. This project evaluated the impact of Project ECHO Pain videoconference case-based learning sessions on knowledge and quality of pain care in two Federally Qualified Health Centers. Quasi-experimental, pre-post intervention, with comparison group. Two large, multisite federally qualified health centers in Connecticut and Arizona. Intervention (N = 10) and comparison (N = 10) primary care providers. Primary care providers attended 48 weekly Project ECHO Pain sessions between January and December 2013, led by a multidisciplinary pain specialty team. Surveys and focus groups assessed providers' pain-related knowledge and self-efficacy. Electronic health record data were analyzed to evaluate opioid prescribing and specialty referrals. Compared with control, primary care providers in the intervention had a significantly greater increase in pain-related knowledge and self-efficacy. Providers who attended ECHO were more likely to use formal assessment tools and opioid agreements and refer to behavioral health and physical therapy compared with control providers. Opioid prescribing decreased significantly more among providers in the intervention compared with those in the control group. Pain is an extremely common and challenging problem, particularly among vulnerable patients such as those cared for at the more than 1,200 Federally Qualified Health Centers in the United States. In this study, attendance at weekly Project ECHO Pain sessions not only improved knowledge and self-efficacy, but also altered prescribing and referral patterns, suggesting that knowledge acquired during ECHO sessions translated into practice changes. © 2017 American Academy of Pain Medicine.

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.

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...

Diversity and Adaptation of Human Respiratory Syncytial Virus Genotypes Circulating in Two Distinct Communities: Public Hospital and Day Care Center

Directory of Open Access Journals (Sweden)

Gustavo Rocha Garcia

2012-10-01

Full Text Available HRSV is one of the most important pathogens causing acute respiratory tract diseases as bronchiolitis and pneumonia among infants. HRSV was isolated from two distinct communities, a public day care center and a public hospital in São José do Rio Preto – SP, Brazil. We obtained partial sequences from G gene that were used on phylogenetic and selection pressure analysis. HRSV accounted for 29% of respiratory infections in hospitalized children and 7.7% in day care center children. On phylogenetic analysis of 60 HRSV strains, 48 (80% clustered within or adjacent to the GA1 genotype; GA5, NA1, NA2, BA-IV and SAB1 were also observed. SJRP GA1 strains presented variations among deduced amino acids composition and lost the potential O-glycosilation site at amino acid position 295, nevertheless this resulted in an insertion of two potential O-glycosilation sites at positions 296 and 297. Furthermore, a potential O-glycosilation site insertion, at position 293, was only observed for hospital strains. Using SLAC and MEME methods, only amino acid 274 was identified to be under positive selection. This is the first report on HRSV circulation and genotypes classification derived from a day care center community in Brazil.

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.

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…

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.

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…

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

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.

Myths about diabetes mellitus among non-diabetic individuals attending primary health care centers of karachi suburbs

International Nuclear Information System (INIS)

Nisar, N.; Khan, I.A.; Qadri, M.H.; Sher, A.

2007-01-01

To determine the myths and misconception about diabetes mellitus among non-diabetics attending primary health care centers of Gadap town, Karachi. Data was collected from four primary health care centers, located at Gadap Town, Karachi, and about 198 non-diabetic patients, above 18 years of age, and resident of Gadap Town, coming consecutively during the month of July 2005, were interviewed after taking the informed consent by using a semi-structured pre-tested questionnaire regarding prevailing myths about diabetes mellitus. The data collected was entered and analyzed by using a statistical package SPSS 11.0. Myths are defined as stories shared by a group, as part of the cultural identity. There were 198 participants in the study. Mean age of study participants was 40 years with standard deviation of 13, while approximately two thirds, 62.6%, were females. About 39% had history of type II diabetes mellitus in family. Overall myths related to diabetes mellitus were common among the individuals, males reported myths pre-dominantly contagiousness of diabetes (p= <0.03), diabetics becoming more ill (p=<0.009) and belief in spiritual treatment for permanent cure of diabetes (p=<0.006). People having 5- 16 years of education were less misconceived as compared to illiterates. The variables that showed significant difference were overeating, causing diabetes (p= <0.006), diabetics falling ill more than others (p=<0.04), eating less starch (p=< 0.0006) and alternative treatment like spiritual treatment (p=<0.00001). Family history of diabetes was also found significantly associated with reporting myths. Frequency of reporting myths was significantly high in this study with preponderance of males, family history of diabetes mellitus and educational status. Education serves as protective factor, hence efforts should be made to promote education and health awareness regarding the disease, with more emphasis on addressing myths regarding diabetes mellitus. (author)

Prevalence of Intestinal Parasite Infections among Children in the Day Care Centers of Gonbad-e Kavus County, North-Eastern Iran

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Fatemeh Mesgarian

2017-10-01

Full Text Available Background: Intestinal parasite infection is one of the major health problems in the world especially in the developing countries. Objectives: This study was an attempt to examine the prevalence of intestinal parasite infection in the day care centers in Gonbad-e Kavus. Methods: In this cross sectional study, 932 children were recruited from 45 day care centers in Gonbad-e Kavus in Iran, through a survey and their stool samples were examined using direct wet mount, formalin-ether concentration and Trichrome staining techniques. Also, scotch tape slides were microscopically analyzed. Data were analyzed using percentage, frequency and Chi-square test using SPSS ver.16. Odds Ratio was used show the effect size of socio-demographic variables on the rate of intestinal parasite infection. Results: The prevalence of intestinal parasite infections among the children was 26.6%. This study found a significant relationship between the children age, parent education and the place of residency with the rate of intestinal parasite infection (P < 0.05. The children in rural areas were 1.55 times more likely than the children in urban areas to be infected with intestinal parasites (OR = 1.55. Moreover, the results of this study showed that an increase in parent’s education for one level decreased the risk of infection in their children by 6% (OR = 0.94. Also, with a rise in the age of participants for a year, the risk of infection increased by 44% (OR = 1.44. Conclusions: Due to the high rate of intestinal parasite infections among children, parents and child care workers need to learn about the various means by which parasites can be transmitted in day care centers.

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

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.

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

Prevalence of Anemia and Associated Risk Factors among Pregnant Women Attending Antenatal Care in Azezo Health Center Gondar Town, Northwest Ethiopia

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Meseret Alem

2013-06-01

Full Text Available ABSTRACT Background: Anemia is a global public health problem affecting both developing and developed countries; approximately 1.3 billion individuals suffer from it. Pregnant women are the most vulnerable groups to anemia. The aim of this study was to assess the prevalence and risk factors for anemia in pregnant women attending antenatal care in Azezo Health Center, Gondar town, Northwest Ethiopia. Method: A cross-sectional study was conducted at Azezo Health Center from February to May 2011. Red blood cell morphology, Hgb level determination and intestinal parasites were assessed following the standard procedures. Socio-demographic data was collected by using a structured questionnaire. The data entered and analyzed by using the SPSS version 16.0 statistical software. P34, rural residence, history of malaria attack, hookworm infection and absence of iron supplements are significantly associated with increased risk of anemia. The most prevalent intestinal parasite among pregnant women was hookworm 18 (4.7%. Conclusion: In the present study, the prevalence of anemia was low when compared with the previous studies carried out in different countries including Ethiopia. More should be done in respect to the importance of regular visit to maternal care centres and health education promotion programs to succeed more. [J Interdiscipl Histopathol 2013; 1(3.000: 137-144

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

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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.

Day hospital and psychosocial care center: Expanding the discussion of partial hospitalization in mental health

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César Augusto Trinta Weber

Full Text Available Summary Introduction: Since the second half of the twentieth century the discussions about mental patient care reveal ongoing debate between two health care paradigms: the biomedical/biopsychosocial paradigm and the psychosocial paradigm. The struggle for hegemony over the forms of care, on how to deal optimally with the experience of becoming ill is underpinned by an intentionality of reorganizing knowledge about the health/disease dichotomy, which is reflected in the models proposed for the implementation of actions and services for the promotion, prevention, care and rehabilitation of human health. Objective: To discuss the guidelines of care in mental health day hospitals (MHDH in contrast to type III psychosocial care centers (CAPS III. Method: Review of mental health legislation from 1990 to 2014. Results: A definition of therapeutic project could not be found, as well as which activities and techniques should be employed by these health services. Conclusion: The MHDH and PCC III are services that replace psychiatric hospital admission and are characterized by their complementarity in the care to the mentally ill. Due to their varied and distinctive intervention methods, which operate synergistically, the contributions from both models of care are optimized. Discussions on the best mental health care model reveal polarization between the biomedical/biopsychosocial and psychosocial paradigms. This reflects the supremacy of the latter over the former in the political-ideological discourse that circumscribes the reform of psychiatric care, which may hinder a better clinical outcome for patients and their families.

Comparison of optimal cardiovascular risk factor management in patients with Type 2 diabetes who attended urban medical health center with those attended a tertiary care center: Experiences from Tehran, Iran

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Sedighe Moradi

2016-01-01

Conclusions: Both centers have failure in target achievement in some risk factors; however, the inability of the primary care center in controlling hyperlipidemia in comparison with the tertiary center is a serious warning to provide training about managing dyslipidemia in these centers.

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.

Games and playthings in a child day care center: a bioecological approach

Directory of Open Access Journals (Sweden)

Rute Estanislava Tolocka

2010-02-01

Full Text Available Social changes have contributed to decreased opportunities for children to perform physical activities. Children have been introduced in preschools where the opportunities of playing are insufficient, thus being deprived of the benefits of such activity. The aim of this study was to analyze the relationship between ludic physical activities and child development. A descriptive study was conducted on 68 children of both genders, aged 4 to 6 years, from a public child day care center. A physical education program was offered twice per week and an event involving other children was carried out. Activities, social roles, interpersonal relations, emotions, and personal characteristics were analyzed. Improvement was observed in interpersonal relations and social relationships, as well as in emotional control. Basic emotions and different child characteristics were expressed. Thus, the introduction of games and playthings at school may contribute to child development and to the engagement of children in physical activities.

Toward a strategy of patient-centered access to primary care.

Science.gov (United States)

Berry, Leonard L; Beckham, Dan; Dettman, Amy; Mead, Robert

2014-10-01

Patient-centered access (PCA) to primary care services is rapidly becoming an imperative for efficiently delivering high-quality health care to patients. To enhance their PCA-related efforts, some medical practices and health systems have begun to use various tactics, including team-based care, satellite clinics, same-day and group appointments, greater use of physician assistants and nurse practitioners, and remote access to health services. However, few organizations are addressing the PCA imperative comprehensively by integrating these various tactics to develop an overall PCA management strategy. Successful integration means taking into account the changing competitive and reimbursement landscape in primary care, conducting an evidence-based assessment of the barriers and benefits of PCA implementation, and attending to the particular needs of the institution engaged in this important effort. This article provides a blueprint for creating a multifaceted but coordinated PCA strategy-one aimed squarely at making patient access a centerpiece of how health care is delivered. The case of a Wisconsin-based health system is used as an illustrative example of how other institutions might begin to conceive their fledgling PCA strategies without proposing it as a one-size-fits-all model. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Outbreaks of human-herpes virus 6 (HHV-6 infection in day-care centers in Belém, Pará, Brazil

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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.

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...

Glycemic control, compliance, and satisfaction for diabetic gravidas in centering group care.

Science.gov (United States)

Parikh, Laura I; Jelin, Angie C; Iqbal, Sara N; Belna, Sarah L; Fries, Melissa H; Patel, Misbah; Desale, Sameer; Ramsey, Patrick S

2017-05-01

To determine if diabetic gravidas enrolled in Centering® group care have improved glycemic control compared to those attending standard prenatal care. To compare compliance and patient satisfaction between the groups. We conducted a prospective cohort study of diabetics enrolled in centering group care from October 2013 to December 2015. Glycemic control, compliance and patient satisfaction (five-point Likert scale) were evaluated. Student's t-test, Chi-Square and mixed effects model were used to compare outcomes. We compared 20 patients in centering to 28 standard prenatal care controls. Mean fasting blood sugar was lower with centering group care (91.0 versus 105.5 mg/dL, p =0.017). There was no difference in change in fasting blood sugar over time between the two groups (p = 0.458). The percentage of time patients brought their blood glucose logs did not differ between the centering group and standard prenatal care (70.7 versus 73.9%, p = 0.973). Women in centering group care had better patient satisfaction scores for "ability to be seen by a physician" (5 versus 4, p = 0.041) and "time in waiting room" (5 versus 4, p =0.001). Fasting blood sugar was lower for patients in centering group care. Change in blood sugar over time did not differ between groups. Diabetic gravidas enrolled in centering group care report improved patient satisfaction.

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...

Spanish courses for older adults at the University of the third age and Adult day care centers

Directory of Open Access Journals (Sweden)

Klara Zavrl

2016-04-01

Full Text Available The article presents theoretical starting points regarding older adults and learning Spanish language in late adulthood. The starting points are based on the assumption that in order to effectively learn a foreign language in late adulthood; the definitions of the cognitive characteristics of the elderly and the characteristics of learning in this period have to be defined first. I continuation the paper explains various characteristics of learning with older adults. The main emphasis is on analyzing the ability of older people to learn a foreign language and their motivation to learn. The empirical part of the paper presents the results of the survey conducted among participants in the initial and intermediate Spanish courses at the University of the Third Age and day center activities for the elderly in Ljubljana; during the academic year 2013/14. The results showed that the most important reason for attending the course were the love of language and the chance to attend trips to Spanish-speaking countries. As the most important activities in the course the participants highlighted listening to the instructor and making notes; exercises in pronunciation and learning new words. The participants valued relaxed atmosphere of mutual understanding as well as cooperation within the learning group. The most important features of a good instructor; according to the participants; are coherent explanation; positive attitude towards the participants; and learning support.

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....

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.

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.

A longitudinal study of enterobiasis in three day care centers of Havana City Estudo longitudinal de enterobíase em três creches da cidade de Havana, Cuba

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Fidel Angel Núñez

1996-04-01

Full Text Available Pinworm infection was prospectively studied during one year in 469 children attending three day care centers. Each child was examined at six months intervals using up to three perianal swabs with adhesive tape. Those found infected were treated with mebendazole. At the beginning of the study we found a prevalence of 28% that dropped to 13% and 12% in the following study periods. The reinfection rate was twice the incidence rate in both study periods. We also found a small percentage (10% of the children reinfected in most or all study periods. There was a high correlation between reinfection and perianal itching. Our results add further knowledge to the epidemiology of intestinal parasites in day care centers.Infecção por oxiuros foi estudada prospectivamente durante um ano em 469 crianças de três creches. Cada criança foi examinada com intervalos de 6 meses usando até 3 esfregaços perianais com fita adesiva. As que estavam infectadas foram tratadas com mebendazole. No início do estudo foi encontrada prevalência de 28% que caiu para 13% e 12% nos períodos de estudo posteriores. A freqüência de reinfecção foi 2 vezes a incidência em ambos os períodos de estudo. Foi encontrada, também, pequena porcentagem (10% de crianças reinfectadas na maioria ou em todos os períodos de estudo. Existiu elevada correlação entre reinfecção e coceira perianal. Nossos resultados adicionam outros conhecimentos à epidemiología dos parásitos intestinais em creches.

Physical Activity Opportunities Within the Schedule of Early Care and Education Centers.

Science.gov (United States)

Mazzucca, Stephanie; Hales, Derek; Evenson, Kelly R; Ammerman, Alice; Tate, Deborah F; Berry, Diane C; Ward, Dianne S

2018-02-01

Physical activity has many benefits for young children's health and overall development, but few studies have investigated how early care and education centers allot time for physical activity, along with measured individual physical activity levels for indoor/outdoor activities during a typical day. Fifty early care and education centers in central North Carolina participated in 4 full-day observations, and 559 children aged 3-5 years within centers wore accelerometers assessing physical activity during observation days. Observation and physical activity data were linked and analyzed for associations between child activity and type of classroom activity. Children averaged 51 (13) minutes per day of moderate to vigorous physical activity and 99 (18) minutes per day of light physical activity while in child care. Children averaged 6 (10) and 10 (13) minutes per day of observed outdoor and indoor daily teacher-led physical activity, respectively. Outdoor time averaged 67 (49) minutes per day, and physical activity levels were higher during outdoor time than during common indoor activities (center time, circle time, and TV time). Physical activity levels varied between indoor and outdoor class activities. Policy and program-related efforts to increase physical activity in preschoolers should consider these patterns to leverage opportunities to optimize physical activity within early care and education centers.

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…

Personality traits affect teaching performance of attending physicians: results of a multi-center observational study.

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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 effects of personality traits on job performance and academic performance in medicine. However, up till date, research in clinical teaching practice did not use quantitative methods and did not account for specialty differences. We empirically studied the relationship of attending physicians' personality traits with their teaching performance across surgical and non-surgical specialties. We conducted a survey across surgical and non-surgical specialties in eighteen medical centers in the Netherlands. Residents evaluated attending physicians' overall teaching performance, as well as the specific domains learning climate, professional attitude, communication, evaluation, and feedback, using the validated 21-item System for Evaluation of Teaching Qualities (SETQ). Attending physicians self-evaluated their personality traits on a 5-point scale using the validated 10-item Big Five Inventory (BFI), yielding the Five Factor model: extraversion, conscientiousness, neuroticism, agreeableness and openness. Overall, 622 (77%) attending physicians and 549 (68%) residents participated. Extraversion positively related to overall teaching performance (regression coefficient, B: 0.05, 95% CI: 0.01 to 0.10, P = 0.02). Openness was negatively associated with scores on feedback for surgical specialties only (B: -0.10, 95% CI: -0.15 to -0.05, Pwork on development paths of attending physicians in medical education.

Green Care Farms

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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.

Wound care centers

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Pressure ulcer - wound care center; Decubitus ulcer - wound care center; Diabetic ulcer - wound care center; Surgical wound - wound ... Common types of non-healing wounds include: Pressure sores Surgical ... flow, or swollen legs Certain wounds may not heal well due to: ...

Automobile Accidents Attended by Mobile Emergency Care Service

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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.

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 ...

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...

Prevalence of intimate partner violence and its associated risk factors among Saudi female patients attending the primary healthcare centers in Western Saudi Arabia

OpenAIRE

Alzahrani, Turki A.; Abaalkhail, Bahaa A.; Ramadan, Iman K.

2016-01-01

Objectives: To estimate the prevalence of intimate partner violence (IPV) among female patients, age 18-60 years, attending primary health care centers (PHCCs) and to measure its determinants, and reporting behavior. Methods: A cross-sectional study design using validated, translated, and self-administered questionnaire among 497 Saudi female patients attending PHCCs in Taif, Kingdom of Saudi Arabia (KSA) from January to February 2015 was employed. A 2-stage probability sampling was ad...

Care Coordination with Schools: The Role of Family-Centered Care for Children with Special Health Care Needs.

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Barnard-Brak, Lucy; Stevens, Tara; Carpenter, Julianna

2017-05-01

Objectives Family-centered care has been associated with positive outcomes for children with special health care needs. The purpose of the current study was to examine the relationship of family-centered care as associated with care coordination with schools and school absences (e.g., missed days) as reported by parents of children with special health care needs. Methods The current study utilized data from the National Survey of Children with Special Health Care Needs 2009-201 (N = 40,242) to achieve this purpose. The National Survey of Children with Special Health Care Needs may be considered a nationally-representative and community-based sample of parent responses for children with special health care needs across the United States. Results Results from the current study indicate that family-centered care is associated with fewer absences and improved care coordination with schools when applicable. The variables of functional difficulties, poverty level, and the number of conditions were statistically controlled. Conclusions We suggest that the positive influence of family-centered care when practiced extends beyond the family and interacts with educational outcomes. We also suggest that the role of schools appears to be under-studied given the role that schools can play in family-centered care.

Relationship between child care centers' compliance with physical activity regulations and children's physical activity, New York City, 2010.

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Stephens, Robert L; Xu, Ye; Lesesne, Catherine A; Dunn, Lillian; Kakietek, Jakub; Jernigan, Jan; Khan, Laura Kettel

2014-10-16

Physical activity may protect against overweight and obesity among preschoolers, and the policies and characteristics of group child care centers influence the physical activity levels of children who attend them. We examined whether children in New York City group child care centers that are compliant with the city's regulations on child physical activity engage in more activity than children in centers who do not comply. A sample of 1,352 children (mean age, 3.39 years) served by 110 group child care centers in low-income neighborhoods participated. Children's anthropometric data were collected and accelerometers were used to measure duration and intensity of physical activity. Multilevel generalized linear regression modeling techniques were used to assess the effect of center- and child-level factors on child-level physical activity. Centers' compliance with the regulation of obtaining at least 60 minutes of total physical activity per day was positively associated with children's levels of moderate to vigorous physical activity (MVPA); compliance with the regulation of obtaining at least 30 minutes of structured activity was not associated with increased levels of MVPA. Children in centers with a dedicated outdoor play space available also spent more time in MVPA. Boys spent more time in MVPA than girls, and non-Hispanic black children spent more time in MVPA than Hispanic children. To increase children's level of MVPA in child care, both time and type of activity should be considered. Further examination of the role of play space availability and its effect on opportunities for engaging in physical activity is needed.

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…

An Analysis of the Child and Adult Care Food Programs in Child Care Centers

National Research Council Canada - National Science Library

Kapur, Kanika

1999-01-01

...) that provides healthy meals and snacks in child and adult day care facilities. This report uses the Cost, Quality and Child Outcomes study to analyze the characteristics of three types of child care centers: (1...

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

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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

Anticoagulation Control in Patients With Nonvalvular Atrial Fibrillation Attended at Primary Care Centers in Spain: The PAULA Study.

Science.gov (United States)

Barrios, Vivencio; Escobar, Carlos; Prieto, Luis; Osorio, Genoveva; Polo, José; Lobos, José María; Vargas, Diego; García, Nicolás

2015-09-01

To determine the current status of anticoagulation control in patients with nonvalvular atrial fibrillation treated with vitamin K antagonists in the primary care setting in Spain. The PAULA study was a multicenter cross-sectional/retrospective observational study conducted throughout Spain. The study included patients with nonvalvular atrial fibrillation who had been receiving vitamin K antagonist therapy during the past year and were attended at primary care centers. International normalized ratio (INR) values over the past 12 months were recorded. The degree of anticoagulation control was defined as the time the patient had remained within the therapeutic range and was determined by both the direct method (poor control < 60%) and by the Rosendaal method (poor control < 65%). The study assessed 1524 patients (mean age, 77.4 ± 8.7 years; 48.6% women; 64.2% in permanent atrial fibrillation; CHADS2 mean, 2.3 ± 1.2; CHA2DS2-VASc, 3.9 ± 1.5, and HAS-BLED, 1.6 ± 0.9). The mean number of INR readings recorded per patient was 14.4 ± 3.8. A total of 56.9% of patients had adequate INR control according to the direct method and 60.6% according to the Rosendaal method. The multivariate analysis identified the following predictors for poor INR control: female sex, dietary habits potentially affecting anticoagulation with vitamin K antagonists, multidrug therapy, and a history of labile INR. Approximately 40% of patients (43.1% by the direct method and 39.4% by the Rosendaal method) with nonvalvular atrial fibrillation who were receiving anticoagulation therapy with vitamin K antagonists in primary care in Spain had poor anticoagulation control during the previous 12 months. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

[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.

Person-centered care and engagement via technology of residents with dementia in aged care facilities.

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Goh, Anita M Y; Loi, Samantha M; Westphal, Alissa; Lautenschlager, Nicola T

2017-12-01

Touchscreen technology (TT) is a resource that can improve the quality of life of residents with dementia, and care staff, in residential aged care facilities (RACF) through a person-centered care approach. To enable the use of TTs to engage and benefit people with dementia in RACFs, education is needed to explore how these devices may be used, what facilitates use, and how to address barriers. We sought to provide education and explore RACF staff views and barriers on using TT to engage their residents with dementia. An educational session on using TT with residents with dementia was given to staff from three long-term RACFs in Melbourne, Australia. A cross-sectional convenience sample of 17 staff members (personal care attendants, registered nurses, enrolled nurses, allied health clinicians, and domestic staff) who attended were administered questionnaires pre- and post-sessions. As a result of the education seminar, they were significantly more confident in their ability to use TT devices with residents. TT, and education to staff about its use with residents with dementia, is a useful strategy to enhance RACF staff knowledge and confidence, thereby enhancing the use of technology in RACFs in order to improve care standards in people with dementia.

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.

Estado nutricional e consumo de energia e nutrientes de pré-escolares que frequentam creches no município de Manaus, Amazonas: existem diferenças entre creches públicas e privadas? Estado nutricional y consumo de energía y nutrientes de pre-escolares que frecuentan guarderías en el municipio de Manaus, Amazonas (Brasil: ¿existen diferencias entre guarderías públicas y privadas? Nutritional status and energy and nutrients intake of children attending day-care centers in the city of Manaus, Amazonas, Brazil: are there differences between public and private day-care centers?

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Bruno Mendes Tavares

2012-01-01

consumo alimentar en la guardería fue evaluado por el método de pesaje directo individual de los alimentos y, en el domicilio, por el registro alimentar de un día aplicado a los responsables. Se estimó la frecuencia de niños con ingestión de nutrientes por encima o por debajo de los puntos de corte de Estimated Average Intake (EAR o Adequate Intake (AI. RESULTADOS: Se verificó mayor frecuencia de niños con exceso de peso en las guarderías privadas, por los índices de peso para estatura e IMC para edad. Los niños de las instituciones públicas, cuando comparados a aquellos de las privadas, consumieron más grasas poliinsaturadas, trans, ácido graso omega-6, vitamina C y sodio, y menos zinc. En ambos tipos de guarderías, se observaron consumo elevado de energía y proporción elevada de niños con consumo de vitaminas A y C, zinc y sodio por encima del límite superior tolerable de ingestión. La proporción de niños con inadecuación de consumo de calcio fue mayor en las guarderías públicas que en las privadas (27,6 versus 7,9%; pOBJECTIVES: To assess the nutritional status and dietary intakes of children attending public and private day care centers in Manaus, Brazil. METHODS: The study assessed children aged 24 to 72 months, enrolled at two public (n=217 and two private (n=91 day care centers in Manaus. Nutritional status was classified according to Z scores for weight-for-age, weight-for-height, height-for-age and BMI-for-age. Dietary intakes were measured using the direct food-weighing method for 1 day. A 1-day dietary recall was administered to parents to assess dietary intakes outside the day care centers. The frequencies of children with nutrient intakes above and below the Estimated Average Requirements (EAR or Adequate Intake (AI cutoffs were calculated. RESULTS: There proportion of overweight children was higher at the private day care centers, according to both weight-for-height and BMI-for-age indexes. Children from the public day care centers

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

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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.

Family Care Map: Sustaining family-centered care in Polytrauma Rehabilitation Centers

Science.gov (United States)

Ford, James H.; Wise, Meg; Krahn, Dean; Oliver, Karen Anderson; Hall, Carmen; Sayer, Nina

2015-01-01

The study assessed sustainability of the Family Care Map, a family-centered approach to providing care for Veterans with polytrauma-related injuries, in four Department of Veterans Affairs Polytrauma Rehabilitation Centers. We applied a mixed-methods approach. Staff surveys used standardized measures of sustainability, commitment to change, information, and participation during implementation. Qualitative inquiry assessed Family Care Map implementation and facilitators and barriers to sustainability. Staff sustainability perceptions had a significant positive correlation with affective commitment to change, participation, and information received about the change process. Family Care Map integration into standard practices and use of its concepts with patients and families related to staff perceptions about sustainability. The degree of use and integration of the Family Care Map in traumatic brain injury/polytrauma care varied among the Polytrauma Rehabilitation Centers. Some successful sustainability strategies included integration into daily workflow and organizational culture. Examples of sustainability barriers included staff awareness and use and outdated information. Some practices, such as measuring and documenting the use of the Family Care Map in treatment plans, may not routinely occur. The focus on family-centered care will require further evaluation of organization-, staff-, and innovation-level attributes that influence sustainability of changes designed to improve family-centered care. PMID:25671632

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…

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.

Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India

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Muthappan Sendhilkumar

2017-01-01

Full Text Available Objective: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. Methods: A mixed-methods (triangulation design study with quantitative methodology (survey and qualitative methodology (interviews was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. Results: The prevalence of high/very high stress was 35% among DM patients. Age 30–40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. Conclusions: This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity.

Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India.

Science.gov (United States)

Sendhilkumar, Muthappan; Tripathy, Jaya Prasad; Harries, Anthony D; Dongre, Amol R; Deepa, Mohan; Vidyulatha, Ashok; Poongothai, Subramanian; Venkatesan, Ulaganathan; Anjana, Ranjit Mohan; Mohan, Viswanathan

2017-01-01

We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. The prevalence of high/very high stress was 35% among DM patients. Age 30-40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity.

Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India

Science.gov (United States)

Sendhilkumar, Muthappan; Tripathy, Jaya Prasad; Harries, Anthony D.; Dongre, Amol R.; Deepa, Mohan; Vidyulatha, Ashok; Poongothai, Subramanian; Venkatesan, Ulaganathan; Anjana, Ranjit Mohan; Mohan, Viswanathan

2017-01-01

Objective: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. Methods: A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. Results: The prevalence of high/very high stress was 35% among DM patients. Age 30–40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. Conclusions: This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity. PMID:28217499

Personality traits affect teaching performance of attending physicians: results of a multi-center observational study.

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Renée A Scheepers

Full Text Available BACKGROUND: 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 effects of personality traits on job performance and academic performance in medicine. However, up till date, research in clinical teaching practice did not use quantitative methods and did not account for specialty differences. We empirically studied the relationship of attending physicians' personality traits with their teaching performance across surgical and non-surgical specialties. METHOD: We conducted a survey across surgical and non-surgical specialties in eighteen medical centers in the Netherlands. Residents evaluated attending physicians' overall teaching performance, as well as the specific domains learning climate, professional attitude, communication, evaluation, and feedback, using the validated 21-item System for Evaluation of Teaching Qualities (SETQ. Attending physicians self-evaluated their personality traits on a 5-point scale using the validated 10-item Big Five Inventory (BFI, yielding the Five Factor model: extraversion, conscientiousness, neuroticism, agreeableness and openness. RESULTS: Overall, 622 (77% attending physicians and 549 (68% residents participated. Extraversion positively related to overall teaching performance (regression coefficient, B: 0.05, 95% CI: 0.01 to 0.10, P = 0.02. Openness was negatively associated with scores on feedback for surgical specialties only (B: -0.10, 95% CI: -0.15 to -0.05, P<0.001 and conscientiousness was positively related to evaluation of residents for non-surgical specialties only (B: 0.13, 95% CI: 0.03 to 0.22, p = 0.01. CONCLUSIONS: Extraverted attending physicians were consistently evaluated as better supervisors. Surgical attending physicians who display high levels of

Diet as a risk factor for pneumococcal carriage and otitis media: a cross-sectional study among children in day care centers.

Science.gov (United States)

Tapiainen, Terhi; Paalanne, Niko; Arkkola, Tuula; Renko, Marjo; Pokka, Tytti; Kaijalainen, Tarja; Uhari, Matti

2014-01-01

Pharyngeal bacteria are exposed to different sugar conditions depending on the diet of the child. We hypothesized that dietary factors such as daily intake of carbohydrates could be associated with pneumococcal carriage and the occurrence of otitis media in children. Our study design was a cross-sectional study among 1006 children attending child day care centers. Parents filled in a food frequency questionnaire. Oropharyngeal swabs were collected from each child. The primary outcome was the occurrence of pneumococcal carriage and the secondary outcome the number of acute otitis media episodes during life. Principal component analysis was used to group dietary intake into nine factors. The models were adjusted for age, gender of the child and educational level of the mother. The dietary factor which included high consumption of sweet pastries and jam was associated with an increased risk of pneumococcal carriage (OR 1.17, 95% CI 1.01 to 1.36, P-value 0.04). The factor including frequent consumption of fruit and berries was associated with a decreased risk of acute otitis (regression coefficient -0.51, 95% CI -0.98 to -0.03, P=0.04). A high intake of consumption of sweets and snacks (OR 1.36, 95% CI 1.03 to 1.80, P=0.03) was associated with an increased risk of caries. Diet was associated with a risk of pneumococcal carriage and the occurrence of otitis media. Diet may thus be a modifiable risk factor for the occurrence of acute otitis media.

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 ...

Prevalence of psychological disorders among patients attending community health centers, Perak, Malaysia

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Asma Perveen

2017-09-01

Full Text Available Objective: The purpose of this study was to explore the prevalence of psychological disorders among community health centers in Batang Padang district Perak. Material & Methods: To conduct this study survey research method was used, seven community health centers in Batang Padang District, Perak were contacted to collect data from (N=216 respondents, who attended health facilities in Batang Padang District. There is no age limit, no education difference and no other requirement needed. Instrument and Materials: Depression, Anxiety and Stress Scale (DASS-21 PRIME Screen and PRIME MD Patient Health Questionnaire (PHQ. Results: Data collected from seven health community centers revealed that prevalence of Stress 86%, anxiety 124%, depression 67, psychotic symptoms 16%, somatoform symptoms 52%, panic symptoms 28%, and substance abuse 21%. the higher prevalence was stress and depression among people attending health centers. Conclusion: Results findings indicated that there is significant prevalence of psychological disorder among community health centers. Analysis of the results help us to determine that there is strong need to provide psychological services, awareness and education plan, management and prevention for psychological disorders

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

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

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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.

Prevalence of childhood and early adolescence mental disorders among children attending primary health care centers in Mosul, Iraq: a cross-sectional study

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Al-Jawadi Asma A

2007-10-01

Full Text Available Abstract Background Children and adolescents are more vulnerable to the affects of war and violence than adults. At the time of initiation of this study, nothing was known about the prevalence of childhood and early adolescence mental disorders. The aim of the present study is to measure the point prevalence of mental disorders among children of 1–15 years age in the city of Mosul, Iraq. Methods A cross-sectional study design was adopted. Four primary health care centers were chosen consecutively as a study setting. The subjects of the present study were mothers who came to the primary health care center for vaccination of their children. The chosen mothers were included by systematic sampling randomization. All children (aged 1–15 that each mother had were considered in the interview and examination. Results Out of 3079 children assessed, 1152 have childhood mental disorders, giving a point prevalence of 37.4%, with a male to female ratio of to 1.22:1. The top 10 disorders among the examined children are post-traumatic stress disorder (10.5%, enuresis (6%, separation anxiety disorder (4.3%, specific phobia (3.3% stuttering and refusal to attend school (3.2% each, learning and conduct disorders (2.5% each, stereotypic movement (2.3% and feeding disorder in infancy or early childhood (2.0%. Overall, the highest prevalence of mental disorders was among children 10–15 years old (49.2% while the lowest was among 1–5 year olds (29.1%. Boys are more affected than girls (40.2% and 33.2%, respectively. Conclusion Childhood mental disorders are a common condition highly prevalent amongst the children and early adolescents in Mosul. Data from the present study mirrors the size of the problem in local community. Several points deserve attention, the most important of which include giving care at the community level, educating the public on mental health, involving communities and families, monitoring community mental health indicators, and

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...

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....

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 ...

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 ...

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

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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,…

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

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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.

Utilization of Dental Services in Public Health Center: Dental Attendance, Awareness and Felt Needs.

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Pewa, Preksha; Garla, Bharath K; Dagli, Rushabh; Bhateja, Geetika Arora; Solanki, Jitendra

2015-10-01

In rural India, dental diseases occur due to many factors, which includes inadequate or improper use of fluoride and a lack of knowledge regarding oral health and oral hygiene, which prevent proper screening and dental care of oral diseases. The objective of the study was to evaluate the dental attendance, awareness and utilization of dental services in public health center. A cross-sectional study was conducted among 251 study subjects who were visiting dental outpatient department (OPD) of public health centre (PHC), Guda Bishnoi, and Jodhpur using a pretested proforma from month of July 2014 to October 2014. A pretested questionnaire was used to collect the data regarding socioeconomic status and demographic factors affecting the utilization of dental services. Pearson's Chi-square test and step-wise logistic regression were applied for the analysis. Statistically significant results were found in relation to age, educational status, socioeconomic status and gender with dental attendance, dental awareness and felt needs. p-value dental services, thereby increasing the oral health status of the population.

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.

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.

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

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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

Prevalence of psychological disorders among patients attending community health centers, Perak, Malaysia

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Asma Perveen

2017-09-01

Full Text Available Objective: The purpose of this study was to explore the prevalence of psychological disorders among community health centers in Batang Padang district Perak. Material & Methods: To conduct this study survey research method was used, seven community health centers in Batang Padang District, Perak were contacted to collect data from (N=216 respondents, who attended health facilities in Batang Padang District. There is no age limit, no education difference and no other requirement needed. Instrument and Materials: Depression, Anxiety and Stress Scale (DASS-21 PRIME Screen and PRIME MD Patient Health Questionnaire (PHQ. Results: Data collected from seven health community centers revealed that prevalence of Stress 86%, anxiety 124%, depression 67, psychotic symptoms 16%, somatoform symptoms 52%, panic symptoms 28%, and substance abuse 21%. the higher prevalence was stress and depression among people attending health centers. Conclusion: Results findings indicated that there is significant prevalence of psychological disorder among community health centers. Analysis of the results help us to determine that there is strong need to provide psychological services, awareness and education plan, management and prevention for psychological disorders

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

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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

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.

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.

Antibiotics use among Palestine refugees attending UNRWA primary health care centers in Jordan - A cross-sectional study.

Science.gov (United States)

Al Baz, Maysun; Law, Michael R; Saadeh, Rawan

The irrational use of antibiotics is increasing in Jordanian refugee camps and consequently so too is bacterial resistance. About one-third of health expenditures at UNRWA health centers in Jordan are attributed to antibiotics. We studied knowledge, attitude and behaviour of Palestine refugees attending UNRWA health centers in Jordan regarding antibiotic use in order to plan public health interventions accordingly. A cross-sectional, interviewer-administered survey among 250 adult Palestine refugees at four different health centers was conducted. Irrational antibiotic use was widespread: 63% of patients share antibiotics at home, 38% use left-over antibiotics and 60% purchase antibiotics directly from the pharmacy without prescription (OTC) . 1 At the same time, knowledge about antibiotics side effects, resistance, and target agent was low. 90% of patients trust their doctor, however long waiting hours prevent them from seeking medical advice, which significantly increased self-medication. Our findings suggest a strong need for public education about antibiotics. In addition, health institutional level improvements such as shorter waiting hours and strict regulations prohibiting dispensing without prescription are necessary to combat growing bacterial resistance. Copyright © 2018 Elsevier Ltd. All rights reserved.

Improved Outcomes for Hispanic Women with Gestational Diabetes Using the Centering Pregnancy© Group Prenatal Care Model.

Science.gov (United States)

Schellinger, Megan M; Abernathy, Mary Pell; Amerman, Barbara; May, Carissa; Foxlow, Leslie A; Carter, Amy L; Barbour, Kelli; Luebbehusen, Erin; Ayo, Katherine; Bastawros, Dina; Rose, Rebecca S; Haas, David M

2017-02-01

Objective To determine the impact of Centering Pregnancy © -based group prenatal care for Hispanic gravid diabetics on pregnancy outcomes and postpartum follow-up care compared to those receiving traditional prenatal care. Methods A cohort study was performed including 460 women diagnosed with gestational diabetes mellitus (GDM) who received traditional or Centering Pregnancy © prenatal care. The primary outcome measured was completion of postpartum glucose tolerance testing. Secondary outcomes included postpartum visit attendance, birth outcomes, breastfeeding, and initiation of a family planning method. Results 203 women received Centering Pregnancy © group prenatal care and 257 received traditional individual prenatal care. Women receiving Centering Pregnancy © prenatal care were more likely to complete postpartum glucose tolerance testing than those receiving traditional prenatal care, (83.6 vs. 60.7 %, respectively; p prenatal care (30.2 vs. 42.1 %; p = 0.009), and were less likely to undergo inductions of labor (34.5 vs. 46.2 %; p = 0.014). When only Hispanic women were compared, women in the Centering group continued to have higher rates of breastfeeding and completion of postpartum diabetes screening. Conclusion for Practice Hispanic women with GDM who participate in Centering Pregnancy © group prenatal care may have improved outcomes.

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…

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...

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…

The efficacy of incentives to motivate continued fitness-center attendance in college first-year students: a randomized controlled trial.

Science.gov (United States)

Pope, Lizzy; Harvey, Jean

2014-01-01

To determine whether fitness-center attendance established with the provision of weekly monetary incentives persisted after the discontinuation, or decreased frequency, of incentives. One hundred seventeen first-year college students participated during the 2011-2012 academic year. A randomized controlled trial with control, discontinued-incentive, and continued-incentive conditions was conducted. During fall semester, students in incentive conditions received weekly monetary payments for meeting fitness-center attendance goals. During spring semester, discontinued-incentive condition participants no longer received incentives, whereas continued-incentive condition participants received payments on a variable-interval schedule. ID-card attendance records tracked fitness-center attendance. Goal completion decreased from 63% in the incentive groups during the fall semester to 3% in the discontinued-incentive condition, and 39% in the continued-incentive condition during the spring semester. There was not a significant interaction between condition and body mass index change, F(6, 332) = 0.67, p = .68. Incentive discontinuation resulted in students no longer meeting fitness-center attendance goals. A variable-interval reward schedule better maintained attendance.

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.

Avaliação do desempenho motor global e em habilidades motoras axiais e apendiculares de lactentes frequentadores de creche Assessment of global motor performance and gross and fine motor skills of infants attending day care centers

Directory of Open Access Journals (Sweden)

Carolina T Souza

2010-08-01

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. RESULTS: 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". CONCLUSIONS: 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.

Mortalidade de crianças usuárias de creches no Município de São Paulo Mortality among children enrolled in public day care centers in Brazil

Directory of Open Access Journals (Sweden)

Eneida S Ramos Vico

2004-02-01

Full Text Available OBJETIVO: Descrever o comportamento da mortalidade em crianças usuárias de creches. MÉTODOS: Trata-se de estudo descritivo da mortalidade de crianças da faixa etária de zero a seis anos e 11 meses, matriculadas em toda a Rede Pública Municipal de Creches de São Paulo (Br, no período de 1995 a 1999. As variáveis de interesse foram sexo, idade, causa básica de morte, tempo de permanência na creche e sazonalidade. RESULTADOS: O coeficiente médio de mortalidade observado para o período foi de 36,4 por cem mil crianças. Do total das mortes, 32,7% ocorreram em menores de um ano e 78,4% em crianças com até três anos. Quanto ao tempo de permanência, 54,2% não chegaram a completar seis meses, destacando os três meses iniciais que concentraram 36,3% das mortes. A maioria dos óbitos ocorreu nos meses de inverno e outono, respectivamente, 31,8% e 29,6%. As causas de morte mais freqüentes foram de origem infecciosa: pneumonias (29,6%, infecção meningocócica (13,0%, meningites não meningocócicas (8,5%, gastroenterites (7,6%, varicela (5,4%. As causas externas representaram 13,5% devido a quedas, atropelamentos, afogamentos, queimaduras e agressões. CONCLUSÕES: A maior parte das mortes ocorreu em menores de três anos e decorreu de causas evitáveis, algumas delas preveníveis por vacinas.OBJECTIVE: To describe the mortality pattern among children enrolled in public day care centers. METHODS: This was a descriptive study of the mortality pattern among children aged from 0 to 6 years and 11 months who were enrolled in all the public day care centers in the city of São Paulo, Brazil, from 1995 to 1999. The variables of interest were sex, age, underlying cause of death, duration of day care attendance and seasonality. RESULTS: The average mortality rate for the period was 36.4 per 100,000 children. Of the total number of deaths, 32.7% were among children under 1 year old and 78.4% under 3 years old. The deaths of 54.2% of these

Audit of a diabetic health education program at a large Primary Health Care Center in Asir region.

Science.gov (United States)

Al-Khaldi, Y M; Khan, M Y

2000-09-01

To evaluate the health education program in a large Primary Health Care Center, to find out the problems faced by the staff and to suggest the practical and relevant solutions. This study was carried out at Wasat Abha Primary Health Care Center, Asir region during 1997. The files of diabetics who attended the center were evaluated for health education topics by using a checklist. The essential structure of diabetic health education program was assessed by using another check list designed by the investigators. Data entry and analysis was carried out through SPSS package. Chi-square test was applied wherever necessary. The total number of diabetics who attended Wasat Abha Primary Health Care Center was 198. The duration of diabetes mellitus was 7.7+5.8 years. Ninety percent of these were married, 50.5% were educated and 79% were employed. Compliance to appointment was good in 60% and poor in 30% of diabetics. About 73% of the diabetics received at least one health education topic while 27% did not receive any health education at all. Only 33% of diabetic patients had adequate health education. Ninety one percent were provided with diabetic identification cards, 80% were explained about diabetes and 77% were educated about the role of diet. Essential structure for diabetes education program was found to be unsatisfactory. Effective diabetic health education program needs the availability of all essential structures, community participation and integration of the government and private sectors. The deficiencies in the structures and the process of health education programs in our practice are almost universal to other Primary Health Care Centers in the Asir region. Providing the Primary Health Care Centers with all essential structures and annual auditing are complimentary to a successful diabetic health education program.

Mental health status of women in Jordan: a comparative study between attendees of governmental and UN relief and works agency's health care centers.

Science.gov (United States)

Al-Modallal, Hanan; Hamaideh, Shaher; Mudallal, Rula

2014-05-01

This study aimed at investigating differences in mental health problems between attendees of governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan. Further, predictors of mental health problems based on women's demographic profile were investigated. A convenience sample of 620 women attending governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan was recruited for this purpose. Independent samples t-tests were used to identify differences in mental health, and multiple linear regression was implemented to identify significant predictors of women's mental health problems. Results indicated an absence of significant differences in mental health problems between attendees of the two types of health care centers. Further, among the demographic indicators that were tested, income, spousal violence, and general health were the predictors of at least three different mental health problems in women. This study highlights opportunities for health professionals to decrease women's propensity for mental health problems by addressing these factors when treating women attending primary care centers in different Jordanian towns, villages, and refugee camps.

Impact of type 1 diabetes mellitus on the family is reduced with the medical home, care coordination, and family-centered care.

Science.gov (United States)

Katz, Michelle L; Laffel, Lori M; Perrin, James M; Kuhlthau, Karen

2012-05-01

To examine whether the medical home, care coordination, or family-centered care was associated with less impact of type 1 diabetes mellitus (T1D) on families' work, finances, time, and school attendance. With the 2005 to 2006 National Survey of Children with Special Health Care Needs, we compared impact in children with T1D (n = 583) with that in children with other special health care needs (n = 39 944) and children without special health care needs (n = 4945). We modeled the associations of the medical home, care coordination, and family-centered care with family impact in T1D. Seventy-five percent of families of children with T1D reported a major impact compared with 45% of families of children with special health care needs (P families of children without special health care needs (P families of children with T1D, 35% reported restricting work, 38% reported financial impact, 41% reported medical expenses >$1000/year, 24% reported spending ≥11 hours/week caring or coordination care, and 20% reported ≥11 school absences/year. The medical home, care coordination, and family-centered care were associated with less work and financial impact. In childhood T1D, most families experience major impact. Better systems of health care delivery may help families reduce some of this impact. Copyright © 2012 Mosby, Inc. All rights reserved.

Fatores de risco de anemia em lactentes matriculados em creches públicas ou filantrópicas de São Paulo Risk factors for anemia in infants enrolled in public or philanthropic day-care centers in São Paulo city, Brazil

Directory of Open Access Journals (Sweden)

Tulio Konstantyner

2007-08-01

and without anemia was adjusted. RESULTS: The prevalence of anemia was 51.9%. The final logistic model comprised 4 variables: presence of one or more siblings under 5 years of age (Odds Ratio=2.57; p=0.005, attending day care centers that are managed exclusively by the government (Odds Ratio=2.12; p=0.020, less than 2 months of exclusive breastfeeding (Odds Ratio=1.88; p=0.044, age under 15 months (Odds Ratio=2.32; p=0.006. CONCLUSION: The high prevalence of anemia evidences the inefficiency of the studied day care centers in controlling and preventing this nutritional deficiency; therefore, it is up to the health planner to consider the identified and quantified risks for anemia when elaborating control and prevention programs.

Outcomes of the patients in the respiratory care center are not associated with the seniority of the caring resident

Directory of Open Access Journals (Sweden)

Ming-Ju Tsai

2013-01-01

Full Text Available Although many studies show that the experience level of physicians is significantly associated with the outcomes of their patients, little evidence exists to show whether junior residents provide worse care than senior residents. This study was conducted to analyze whether the experience level of residents may affect the outcomes of patients cared for in a well-organized setting. We conducted a 7-year retrospective study utilizing statistical data from a respiratory care center (RCC in a medical center between October 2004 and September 2011. In addition to the two medical residents who had been trained in the intensive care unit (ICU, the RCC team also included attending physicians in charge, a nurse practitioner, a case manager, a dietitian, a pharmacist, a social worker, registered respiratory therapists, and nursing staff. Weaning from mechanical ventilation was done according to an established weaning protocol. The 84 months analyzed were classified into five groups according to the levels of the two residents working in the RCC: R2 + R1, R2 + R2, R3 + R1, R3 + R2, and R3 + R3. The monthly weaning rate and mortality rate were the major outcomes, while the mean ventilator days, rate of return to the ICU, and nosocomial infection incidence rate were the minor outcomes. The groups did not differ significantly in the monthly weaning rate, mortality rate, mean ventilator days, rate of return to the ICU, or nosocomial infection incidence rate (p > 0.1. Further analysis showed no significant difference in the monthly weaning rate and mortality rate between months with a first-year resident (R1 and those with two senior residents (p > 0.2. Although the weaning rate in the RCC gradually improved over time (p  0.7. Thus, we concluded that in a well-organized setting, the levels (experiences of residents did not significantly affect patient outcomes. This result may be attributed to the well-developed weaning protocol and teamwork

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.

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

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 ...

Anemia ferropriva e estado nutricional de crianças de creches de Guaxupé Anemia and nutritional status of children in day-care centers in Guaxupé

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Carlos César Camillo

2008-04-01

Full Text Available OBJETIVO: Avaliar o estado nutricional e a prevalência de anemia ferropriva de crianças que freqüentam creches no município de Guaxupé, MG. MÉTODOS: Foram incluídas no estudo crianças de ambos os sexos, de 6 a 72 meses de idade, matriculadas em creches do município de Guaxupé. O estado nutricional foi aferido por meio do escore Z das relações estatura para idade e peso para a estatura. Para o diagnóstico de anemia utilizou-se a dosagem de hemoglobina, ferro sérico, capacidade total de ligação de ferro e o índice de saturação de transferrina. RESULTADOS: Escore Z OBJECTIVE: To evaluate the nutritional status and the prevalence of iron deficiency anemia in children attending public day care centers in the city of Guaxupé (MG, Brazil. METHODS: Children of both genders, from 6 to 72 months, registered in public day-care centers in the city of Guaxupé, were studied. Nutritional evaluation was conducted using the Z-score for height-to-age and weight-to-height relationships. Hemoglobin dosage, serum iron, total iron binding capacity and the transferrin saturation index were used for diagnosis of anemia. RESULTS: Z score < - 2 was observed in 3.3% of the children for the height-to-age relationship and of 0.4% for the weight-to-height relationship. Prevalence of total iron deficiency anemia was of 16.1%. In the age span from 6 to 36 months it was of 44.6%. The entire sample showed 45% with low serum iron, 37.9% with high total iron binding capacity and 43.1% with a low transferrin saturation index. CONCLUSION: Malnutrition was not considered to be a problem due to its low prevalence; however, an important prevalence of iron deficiency was observed. Iron deficiency anemia is more prevalent in children between 6 and 36 months confirming that this age span is more vulnerable. No association between iron deficiency anemia and the Z score of the studied anthropometry relationships was found.

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

Alleged sexual abuse at a day care center: impact on parents.

Science.gov (United States)

Dyb, Grete; Holen, Are; Steinberg, Alan M; Rodriguez, Ned; Pynoos, Robert S

2003-08-01

This report describes the cascade of stressful events and secondary life changes experienced by parents in a case of alleged sexual abuse at a day care program. The study evaluated parents' Posttraumatic Stress Disorder (PTSD) symptoms and general psychological responses to the stressful events 4 years after the alleged abuse, and explored predictive factors of parental distress. A total of 39 parents were interviewed about stressful events, life changes, and social support. Current distress reactions, psychological wellbeing, and locus of control were assessed with a battery of standardized measures. Hearing about the sexual abuse, testifying in court, hearing the verdict, and being exposed in media reports were all rated by the parents as distressing events. The majority of the parents experienced secondary life changes after the alleged sexual abuse. Four years after the alleged sexual abuse, one-third of the parents reported a high level of PTSD Intrusive symptoms and one-fourth reported a high level of PTSD Avoidance symptoms. There was a significant positive correlation between a measure of psychological wellbeing and PTSD. Secondary life changes and locus of control significantly predicted PTSD. This study demonstrates that the alleged sexual abuse of children in day care and the resulting events in the legal system and the media constitute significant and chronic stressors in the lives of the children's parents. These findings underscore the need to expand the focus of trauma-related sequelae from the child victim to their parents and family.

Dietary intake at child-care centers and away: are parents and care providers working as partners or at cross-purposes?

Science.gov (United States)

Briley, M E; Jastrow, S; Vickers, J; Roberts-Gray, C

1999-08-01

To examine how meals and snacks children consume before and after their time at a child-care facility complement the menu at the facility. Dietary intake of children at and away from the child-care center was compared with recommended standards for child nutrition. Registered dietitians observed foods consumed at the center during 3 consecutive days. Parents reported foods consumed away from the center during the same 3 days. Six nonprofit child-care centers with strong menus (i.e., menus that come close to meeting dietary recommendations) and 6 with menus supplying less than 50% of the Recommended Dietary Allowance were selected for study. Five families at each center were invited to participate. Complete data sets were obtained for 51 children aged 3 to 6 years. Descriptive and inferential statistics were calculated to compare the children's dietary intake during center time and family time and over a full day with recommended standards. Energy and nutrient profiles and food frequencies were included in the analysis. Children consumed plenty of foods at the center and away from the following groups: meat, poultry, fish, dry beans, eggs, nuts; milk, yogurt, cheese; and fruit, fruit juice. Most children failed to consume enough vegetables. Nearly all the children failed to consume enough bread, cereal, pasta, and rice, especially while at the center. The majority ate more than sparing amounts of fats, oils, and sweets, especially during family time. Average percentage of energy from fat was 33 +/- 4. Intakes of concern for the full day were energy, iron, sodium, and zinc. Child-care menus are an appropriate target for increasing iron and zinc by serving more cereal and whole grains. Families are an appropriate target for reducing young children's consumption of fats, oils, and sweets. Nutrition education and advocacy are needed to strengthen the partnership between parents and caregivers.

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...

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…

Stroke Mortality in Intensive Care Unit from Tertiary Care Neurological Center

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Lekhjung Thapa

2013-06-01

Full Text Available Introduction: Stroke is the second most common cause of death and major cause of disability worldwide. About a quarter of stroke patients are dead within a month, about a third by 6 months, and a half by 1 year. Although the most substantial advance in stroke has been the routine management of patients in stroke care units, intensive care unit has remained the choice for stroke patients’ care in developing countries. This study explores the mortality of stroke patients in intensive care unit setting in tertiary care neurological centre in a developing country. Methods: We collected data of stroke patients admitted in our ICU from August 2009 to Aug 2010 and analyzed. Results: Total 44 (10.25% patients were admitted for acute stroke. Age ranged from 17-93 years. Low GCS (Glasgow Coma Scale, uncontrolled hypertension and aspiration pneumonia were common indications for admission in ICU. Total 23 (52.3% patients had hemorrhagic stroke and 21(47.7% patients had ischemic stroke. 13 (29.54% patients of stroke died within 7 days, 9 (69.23% patients of hemorrhagic stroke died within 6 days, and 4 patients (30.76% of ischemic stroke died within 7 days. 6 (13.63% patients left hospital against medical advice. All of these patients had ischemic stroke. Conclusions: Stroke mortality in intensive care unit remains high despite of care in tertiary neurological center in resource poor settings. Stroke care unit, which would also help dissemination of knowledge of stroke management, is an option for improved outcome in developing countries Keywords: intensive care unit; mortality; stroke; stroke care unit.

Health care employee perceptions of patient-centered care.

Science.gov (United States)

Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

2015-03-01

Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.

Understanding Cortisol Reactivity across the Day at Child Care: The Potential Buffering Role of Secure Attachments to Caregivers

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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,…

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

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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.

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.

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…

A social work study on the effect of family life education on marital satisfaction of women attending in Isfahan Counseling Centers

OpenAIRE

Ali Asghar Rahimi Rezaee; Karim Afshari Neia; Mokhtar Ariri

2013-01-01

This paper studies the effective of family life education (FLE) on marital status among women attending in Isfahan counseling centers. The methodology of this research was quasi experimental with pre-test and post-test design and control group. Statistical populations were women attending in Isfahan city counseling centers. For selecting statistical sample, 30 women from women attending in counseling centers were selected as volunteers and randomly distributed between experimental and control...

Awareness and pattern of utilizing family planning services among women attending urban health care center Azizabad Sukkur

International Nuclear Information System (INIS)

Shah, N.A.; Nisar, N.

2008-01-01

To assess level of awareness and pattern of utilizing family planning services among women (15-49 years) of reproductive age at Urban Health Center, Azizabad Sukkur, Sindh. A cross-sectional study was conducted from April to June 2005 at Urban Health Care Center Azizabad Sukkur. Two hundred women of reproductive age group were interviewed by using a pre tested semi structured questionnaire visiting the health care center during the study period. Information was obtained after taking informed consent regarding socio demographic characteristics, knowledge, attitude and pattern of utilizing family planning services. The data was entered and analyzed by using statistical package SPSS version 13. About 75% of women and 42.5% husbands were found illiterate, 85% women were housewives, 69.5% were married before 18 years of age and 54% had nuclear family. Regarding desired number of children women responded one child (3%), 2-3 children (11%), 4-5 (37.5%), more than five children (36%), 5.5% said that children are God gifted and 7% did not answer. About 60% of women reported use of at least one contraceptive method and 40% had never used any contraceptive method. The women who received counseling from the health care provider were 48.5% and only 6% received information through media. Religious prohibition, shortage of female staff and cost of family planning contraceptive methods were the main reasons identified for not utilizing contraceptive methods. The unsatisfactory variables were long waiting hours at the center, non-availability of contraceptive, shortage of the female staff and cost. Limited number of women was aware and practice contraception in the area and utilization of family planning services were low. The efforts should be made for providing information to couple and improving quality of family planning services in the area. (author)

Child Day Care Centers, This dataset contains the licensed daycare center locations in MD. Addresses were provided by the Department of Labor Licensing and Regulation (DLLR), and geocoded using Maryland Statewide Addressing Initiative Centerline., Published in 2012, 1:2400 (1in=200ft) scale, Towson University.

Data.gov (United States)

NSGIC Education | GIS Inventory — Child Day Care Centers dataset current as of 2012. This dataset contains the licensed daycare center locations in MD. Addresses were provided by the Department of...

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.

[Spread of genetically related methicillin-susceptible Staphylococcus aureus belonging to CC45, in healthy nasal carriers in Child Day Care Centers of Medellin, Colombia].

Science.gov (United States)

Rodríguez-Tamayo, Erika Andrea; Ruiz-Cadavid, Alejandra; Sánchez-González, Leidy Maritza; García-Valencia, Natalia; Jiménez-Quiceno, Judy Natalia

2016-03-01

Colonization plays a major role in the epidemiology and pathogenesis of Staphylococcus aureus infections. The child population is one of the most susceptible to colonization; however, community and children studies are limited in Colombia. To assess the clonal relationship of S.aureus strains isolated from colonized children in eight day care centers (DCCs) from Medellin and to determine the presence of epidemiological characteristics in these populations. An observational cross-sectional study was conducted on a sample of 200 children aged from 6 months to 5 years attending eight DCCs in Medellin, Colombia, during 2011. Nasal samples were collected from each nostril. The isolates species and methicillin resistance were molecularly confirmed using nuc and mec genes. Genotypic analysis included SCCmec typing, spa typing, PFGE and MLST. Epidemiological information was obtained from the parents and analyzed using the statistics program SPSS 21.0 RESULTS: The colonization frequency in DCCs ranged from 16.7% (n=3) to 53.6% (n=15). Genetically related isolates were identified inside four DCCs. Half (50%) of the isolates were grouped in 3 clusters, which belonged to the clonal complexes CC45, CC30, and CC121. Molecular typing of isolates from colonized children and comparison among DCCs showed the spread of colonizing strains inside DCCs in Medellin; predominantly the CC45 clone, a successful child colonizer. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Evaluation design of New York City's regulations on nutrition, physical activity, and screen time in early child care centers.

Science.gov (United States)

Breck, Andrew; Goodman, Ken; Dunn, Lillian; Stephens, Robert L; Dawkins, Nicola; Dixon, Beth; Jernigan, Jan; Kakietek, Jakub; Lesesne, Catherine; Lessard, Laura; Nonas, Cathy; O'Dell, Sarah Abood; Osuji, Thearis A; Bronson, Bernice; Xu, Ye; Kettel Khan, Laura

2014-10-16

This article describes the multi-method cross-sectional design used to evaluate New York City Department of Health and Mental Hygiene's regulations of nutrition, physical activity, and screen time for children aged 3 years or older in licensed group child care centers. The Center Evaluation Component collected data from a stratified random sample of 176 licensed group child care centers in New York City. Compliance with the regulations was measured through a review of center records, a facility inventory, and interviews of center directors, lead teachers, and food service staff. The Classroom Evaluation Component included an observational and biometric study of a sample of approximately 1,400 children aged 3 or 4 years attending 110 child care centers and was designed to complement the center component at the classroom and child level. The study methodology detailed in this paper may aid researchers in designing policy evaluation studies that can inform other jurisdictions considering similar policies.

Establishing a national research center on day care

DEFF Research Database (Denmark)

Ellegaard, Tomas

The paper presents and discusses the current formation of a national research center on ECEC. The center is currently being established. It is partly funded by the Danish union of early childhood and youth educators. It is based on cooperation between a number of Danish universities and this nati...... current new public management policies. However there is also more conflicting issues that emerge in this enterprise – especially on interests, practice relevance and knowledge paradigms....

Prevalence and Risk Factors of Domestic Violence Against Women Attending a Primary Care Center in Riyadh, Saudi Arabia.

Science.gov (United States)

Barnawi, Fatima Hamza

2015-05-27

Domestic violence (DV) against women can negatively affect the physical, mental, sexual, and reproductive health of the women as well as the well-being of their children. The objective was to estimate among Saudi women the prevalence of different types of DV, to identify its associated risk factors, and to determine the immediate victims' reactions to such violence. A cross-sectional study was carried between March and July, 2011. Self-administrated questionnaire was administered to ever-married Saudi women attending Al-Wazarat primary health care center, in Riyadh, Saudi Arabia. Out of the 720 women studied, 144 (20%) reported exposure to DV over the last year. The most common DV types were emotional (69%), social (34%), economic (26%), physical (20%), and sexual violence (10%). In multivariate logistic regression analysis, the following characteristics were independently associated with DV: younger women age, longer duration of marriage, higher women education, lower husband education, working husbands, military occupation, fewer children, husbands with multiple wives, smoking husbands, aggressive husbands, presence of chronic disease in women or husbands, and non-sufficient family income. The most common impacts of DV on women were medical or behavioral problems (72%) and psychiatric problems (58%). The most common reactions to DV were seeking separation (56%) and doing nothing (41%). More than 90% of children of abused women suffered psychological or behavioral problems. In conclusion, DV against Saudi women is considerable and the response is generally passive. Promoting a culture non-tolerant to DV and providing accessible, effective, and trustful social services to abused women are critically needed. © The Author(s) 2015.

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.

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…

Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents.

Science.gov (United States)

Weizman, Zvi; Asli, Ghaleb; Alsheikh, Ahmed

2005-01-01

To investigate the effect of 2 different species of probiotics in preventing infections in infants attending child care centers. A double-blind, placebo-controlled, randomized trial was conducted from December 1, 2000, to September 30, 2002, at 14 child care centers in the Beer-Sheva area of Israel in healthy term infants 4 to 10 months old. Infants were assigned randomly to formula supplemented with Bifidobacterium lactis (BB-12), Lactobacillus reuteri (American Type Culture Collection 55730), or no probiotics. Duration of feeding, including follow-up, for each participant was 12 weeks. All infants were fed only the assigned formula and were not breastfed due to parental decision before recruitment to the study. Probiotic or prebiotic food products or supplements were not allowed. Main outcome measures were number of days and number of episodes with fever (>38 degrees C) and number of days and number of episodes with diarrhea or respiratory illness. Participants (n = 201) were similar regarding gestational age, birth weight, gender, and previous breastfeeding. The controls (n = 60), compared with those fed B lactis (n = 73) or L reuteri (n = 68), had significantly more febrile episodes (mean [95% confidence interval]: 0.41 [0.28-0.54] vs 0.27 [0.17-0.37] vs 0.11 [0.04-0.18], respectively). The controls also had more diarrhea episodes (0.31 [0.22-0.40] vs 0.13 [0.05-0.21] vs 0.02 [0.01-0.05], respectively) and episodes of longer duration (0.59 [0.34-0.84] vs 0.37 [0.08-0.66] vs 0.15 [0.12-0.18] days, respectively). The L reuteri group, compared with BB-12 or controls, had a significant decrease of number of days with fever, clinic visits, child care absences, and antibiotic prescriptions. Rate and duration of respiratory illnesses did not differ significantly between groups. Child care infants fed a formula supplemented with L reuteri or B lactis had fewer and shorter episodes of diarrhea, with no effect on respiratory illnesses. These effects were more prominent

76 FR 50224 - Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center...

Science.gov (United States)

2011-08-12

...] Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center for... (CMS). This two-day training session is the second Accelerated Development Learning Session (ADLS.... Through Accelerated Development Learning Sessions (ADLS), the Innovation Center will test whether...

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...

Palliative care content on cancer center websites.

Science.gov (United States)

Vater, Laura B; Rebesco, Gina; Schenker, Yael; Torke, Alexia M; Gramelspacher, Gregory

2018-03-01

Professional guidelines recommend that palliative care begin early in advanced cancer management, yet integration of palliative and cancer care remains suboptimal. Cancer centers may miss opportunities to provide palliative care information online. In this study, we described the palliative care content on cancer center websites. We conducted a systematic content analysis of 62 National Cancer Institute- (NCI) designated cancer center websites. We assessed the content of center homepages and analyzed search results using the terms palliative care, supportive care, and hospice. For palliative and supportive care webpages, we assessed services offered and language used to describe care. Two researchers analyzed all websites using a standardized coding manual. Kappa values ranged from 0.78 to 1. NCI-designated cancer center homepages presented information about cancer-directed therapy (61%) more frequently than palliative care (5%). Ten percent of cancer centers had no webpage with palliative care information for patients. Among centers with information for patients, the majority (96%) defined palliative or supportive care, but 30% did not discuss delivery of palliative care alongside curative treatment, and 14% did not mention provision of care early in the disease process. Cancer center homepages rarely mention palliative care services. While the majority of centers have webpages with palliative care content, they sometimes omit information about early use of care. Improving accessibility of palliative care information and increasing emphasis on early provision of services may improve integration of palliative and cancer care.

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...

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.

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

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.

76 FR 66931 - Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center...

Science.gov (United States)

2011-10-28

...] Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center for... Services (CMS). This two-day training session is the third and final Accelerated Development Learning... the quality of care for beneficiaries. Through Accelerated Development Learning Sessions (ADLS), the...

Patient-centered care, nurse work environment and implicit rationing of nursing care in Swiss acute care hospitals: A cross-sectional multi-center study.

Science.gov (United States)

Bachnick, Stefanie; Ausserhofer, Dietmar; Baernholdt, Marianne; Simon, Michael

2018-05-01

Patient-centered care is a key element of high-quality healthcare and determined by individual, structural and process factors. Patient-centered care is associated with improved patient-reported, clinical and economic outcomes. However, while hospital-level characteristics influence patient-centered care, little evidence is available on the association of patient-centered care with characteristic such as the nurse work environment or implicit rationing of nursing care. The aim of this study was to describe patient-centered care in Swiss acute care hospitals and to explore the associations with nurse work environment factors and implicit rationing of nursing care. This is a sub-study of the cross-sectional multi-center "Matching Registered Nurse Services with Changing Care Demands" study. We included 123 units in 23 acute care hospitals from all three of Switzerland's language regions. The sample consisted of 2073 patients, hospitalized for at least 24 h and ≥18 years of age. From the same hospital units, 1810 registered nurses working in direct patient care were also included. Patients' perceptions of patient-centered care were assessed using four items from the Generic Short Patient Experiences Questionnaire. Nurses completed questionnaires assessing perceived staffing and resource adequacy, adjusted staffing, leadership ability and level of implicit rationing of nursing care. We applied a Generalized Linear Mixed Models for analysis including individual-level patient and nurse data aggregated to the unit level. Patients reported high levels of patient-centered care: 90% easily understood nurses, 91% felt the treatment and care were adapted for their situation, 82% received sufficient information, and 70% felt involved in treatment and care decisions. Higher staffing and resource adequacy was associated with higher levels of patient-centered care, e.g., sufficient information (β 0.638 [95%-CI: 0.30-0.98]). Higher leadership ratings were associated with

Stennis Space Center celebrates Diversity Day

Science.gov (United States)

2009-01-01

Kendall Mitchell of the Naval Oceanographic Office (right) learns about the culture of Bolivia from Narda Inchausty, president of the Foreign Born Wives Association in Slidell, La., during 2009 Diversity Day events at NASA's John Stennis Space Center. Stennis hosted Diversity Day activities for employees on Oct. 7. The day's events included cultural and agency exhibits, diversity-related performances, a trivia contest and a classic car and motorcycle show. It also featured the first-ever sitewide Stennis Employee Showcase.

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.

PESTICIDE MEASUREMENT RESULTS FROM THE FIRST NATIONAL ENVIRONMENTAL SURVEY OF CHILD CARE CENTERS

Science.gov (United States)

Approximately 13 million children are placed in non-parental child care during the work day; however, children's exposures to chemicals in child care centers have not been characterized. To address this data gap, three federal agencies teamed to characterize contaminants in child...

PESTICIDE RESULTS FROM AN INTERAGENCY EFFORT TO CHARACTERIZE CONTAMINANTS IN CHILD CARE CENTERS

Science.gov (United States)

Approximately 13 million children are placed in non-parental child care during the work day; but, children's exposures to chemicals in child care centers have not been characterized. To address this data gap, three federal agencies teamed to characterize contaminants in child ...

Fear of deportation is not associated with medical or dental care use among Mexican-origin farmworkers served by a federally-qualified health center--faith-based partnership: an exploratory study.

Science.gov (United States)

López-Cevallos, Daniel F; Lee, Junghee; Donlan, William

2014-08-01

Migrant and seasonal farmworkers face many health risks with limited access to health care and promotion services. This study explored whether fear of deportation (as a barrier), and church attendance (as an enabling factor), were associated with medical and dental care use among Mexican-origin farmworkers. Interviews were conducted with 179 farmworkers who attended mobile services provided by a local federally-qualified health center (FQHC) in partnership with area churches, during the 2007 agricultural season. The majority of respondents (87 %) were afraid of being deported, and many (74 %) attended church. Although about half of participants reported poor/fair physical (49 %) and dental (58 %) health, only 37 % of farmworkers used medical care and 20 % used dental care during the previous year. Fear of deportation was not associated with use of medical or dental care; while church attendance was associated with use of dental care. Findings suggest that despite high prevalence of fear of deportation, support by FQHCs and churches may enable farmworkers to access health care services.

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…

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

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.

Relationship-Focused Child Care Practices: Quality of Care and Child Outcomes for Children in Poverty

Science.gov (United States)

Owen, Margaret Tresch; Klausli, Julia F.; Mata-Otero, Ana-Maria; Caughy, Margaret O'Brien

2008-01-01

Research Findings: Child care delivery practices promoting continuous, primary caregiver-child relationships (relationship-focused child care) were evaluated for 223 preschool-age children (45% African American, 55% Latino) attending child care centers serving low-income children. Both relationship-focused and non-relationship-focused centers were…

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.

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...

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.

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.

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.

Decision-Making in Audiology: Balancing Evidence-Based Practice and Patient-Centered Care

Science.gov (United States)

Clemesha, Jennifer; Lundmark, Erik; Crome, Erica; Barr, Caitlin; McMahon, Catherine M.

2017-01-01

Health-care service delivery models have evolved from a practitioner-centered approach toward a patient-centered ideal. Concurrently, increasing emphasis has been placed on the use of empirical evidence in decision-making to increase clinical accountability. The way in which clinicians use empirical evidence and client preferences to inform decision-making provides an insight into health-care delivery models utilized in clinical practice. The present study aimed to investigate the sources of information audiologists use when discussing rehabilitation choices with clients, and discuss the findings within the context of evidence-based practice and patient-centered care. To assess the changes that may have occurred over time, this study uses a questionnaire based on one of the few studies of decision-making behavior in audiologists, published in 1989. The present questionnaire was completed by 96 audiologists who attended the World Congress of Audiology in 2014. The responses were analyzed using qualitative and quantitative approaches. Results suggest that audiologists rank clinical test results and client preferences as the most important factors for decision-making. Discussion with colleagues or experts was also frequently reported as an important source influencing decision-making. Approximately 20% of audiologists mentioned utilizing research evidence to inform decision-making when no clear solution was available. Information shared at conferences was ranked low in terms of importance and reliability. This study highlights an increase in awareness of concepts associated with evidence-based practice and patient-centered care within audiology settings, consistent with current research-to-practice dissemination pathways. It also highlights that these pathways may not be sufficient for an effective clinical implementation of these practices. PMID:28752808

Physician organization-practice team integration for the advancement of patient-centered care.

Science.gov (United States)

Wise, Christopher G; Alexander, Jeffrey A; Green, Lee A; Cohen, Genna R

2012-01-01

The patient-centered medical home is being promoted as a cornerstone for transforming primary care. Physician organizations (POs) are playing a more prominent role by facilitating practices' transformation to the patient-centered medical home. Using a framework of organizational integration, we investigated the changing relationship between POs and practices through qualitative interviews. Through increased integration, POs can support both the big picture and day-to-day activities of practice transformation. Most PO-practice unit connections we identified reflected new areas of engagement-competencies that POs were not developing in the past-that are proving integral to the broad-scale practice change of patient-centered medical home implementation.

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…

The Schwartz Center Rounds: evaluation of an interdisciplinary approach to enhancing patient-centered communication, teamwork, and provider support.

Science.gov (United States)

Lown, Beth A; Manning, Colleen F

2010-06-01

To assess the impact of Schwartz Center Rounds, an interdisciplinary forum where attendees discuss psychosocial and emotional aspects of patient care. The authors investigated changes in attendees' self-reported behaviors and beliefs about patient care, sense of teamwork, stress, and personal support. In 2006-2007, researchers conducted retrospective surveys of attendees at six sites offering Schwartz Center Rounds ("the Rounds") for > or =3 years and prospective surveys of attendees at 10 new Rounds sites that have held > or =7 Rounds. Most of the retrospective survey respondents indicated that attending Rounds enhanced their likelihood of attending to psychosocial and emotional aspects of care and enhanced their beliefs about the importance of empathy. Respondents reported better teamwork, including heightened appreciation of the roles and contributions of colleagues. There were significant decreases in perceived stress (P teamwork (both: P communication, teamwork, and provider support. The impact on measured outcomes increased with the number of Rounds attended. The Rounds represent an effective strategy for providing support to health care professionals and for enhancing relationships among them and with their patients.

WITHDRAWN: Day care for pre-school children.

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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

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

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

[Frequent attendance in a Primary Health Care District].

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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.

Prevalence of intestinal parasitic infections and associated risk factors among pregnant women attending antenatal care center at Felege Hiwot Referral Hospital, northwest Ethiopia.

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Derso, Adane; Nibret, Endalkachew; Munshea, Abaineh

2016-09-30

Parasitic infections affect tens of millions of pregnant women worldwide, and directly or indirectly lead to a spectrum of adverse maternal and fetal/placental effects. The objective of this study was to assess the prevalence of intestinal parasite infections and associated risk factors among pregnant women attending antenatal care center in Felege Hiwot Referral Hospital, Bahir Dar city, northwest Ethiopia. A cross-sectional hospital based study was conducted from November 2013 to January 2014 among 384 pregnant women. Stool samples were examined for the presence of trophozoites, cysts, oocysts, and ova using direct, formal-ether sedimentation, and modified Ziehl-Neelsen techniques. An overall prevalence of 31.5 % intestinal parasite infections was recorded. Eight different species of intestinal parasites were found: two protozoan and six helminth species. The highest prevalence was due to Giardia lamblia (13.3 %) followed by Entamoeba histolytica/dispar (7.8 %), hookworm (5.5 %), Ascaris lumbricoides (2.9 %), Schistosoma mansoni (2.9 %), Strongyloides stercoralis (1.6 %), Taenia spp. (0.8 %), and Hymenolepis nana (0.3 %). A relatively high prevalence of intestinal parasite infections was observed among pregnant women. Routine stool examination and provision of health education are required for early medical intervention that would affect the pregnant mothers and their foetuses.

How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation.

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Bokhour, Barbara G; Fix, Gemmae M; Mueller, Nora M; Barker, Anna M; Lavela, Sherri L; Hill, Jennifer N; Solomon, Jeffrey L; Lukas, Carol VanDeusen

2018-03-07

Healthcare organizations increasingly are focused on providing care which is patient-centered rather than disease-focused. Yet little is known about how best to transform the culture of care in these organizations. We sought to understand key organizational factors for implementing patient-centered care cultural transformation through an examination of efforts in the US Department of Veterans Affairs. We conducted multi-day site visits at four US Department of Veterans Affairs medical centers designated as leaders in providing patient-centered care. We conducted qualitative semi-structured interviews with 108 employees (22 senior leaders, 42 middle managers, 37 front-line providers and 7 staff). Transcripts of audio recordings were analyzed using a priori codes based on the Consolidated Framework for Implementation Research. We used constant comparison analysis to synthesize codes into meaningful domains. Sites described actions taken to foster patient-centered care in seven domains: 1) leadership; 2) patient and family engagement; 3) staff engagement; 4) focus on innovations; 5) alignment of staff roles and priorities; 6) organizational structures and processes; 7) environment of care. Within each domain, we identified multi-faceted strategies for implementing change. These included efforts by all levels of organizational leaders who modeled patient-centered care in their interactions and fostered willingness to try novel approaches to care amongst staff. Alignment and integration of patient centered care within the organization, particularly surrounding roles, priorities and bureaucratic rules, remained major challenges. Transforming healthcare systems to focus on patient-centered care and better serve the "whole" patient is a complex endeavor. Efforts to transform healthcare culture require robust, multi-pronged efforts at all levels of the organization; leadership is only the beginning. Challenges remain for incorporating patient-centered approaches in the

Health Care Employee Perceptions of Patient-Centered Care: A Photovoice Project

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Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.

2015-01-01

Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

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

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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.

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

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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.

Seeking Humanizing Care in Patient-Centered Care Process: A Grounded Theory Study.

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Cheraghi, Mohammad Ali; Esmaeili, Maryam; Salsali, Mahvash

Patient-centered care is both a goal in itself and a tool for enhancing health outcomes. The application of patient-centered care in health care services globally however is diverse. This article reports on a study that sought to introduce patient-centered care. The aim of this study is to explore the process of providing patient-centered care in critical care units. The study used a grounded theory method. Data were collected on 5 critical care units in Tehran University of Medical Sciences. Purposive and theoretical sampling directed the collection of data using 29 semistructured interviews with 27 participants (nurses, patients, and physician). Data obtained were analyzed according to the analysis stages of grounded theory and constant comparison to identify the concepts, context, and process of the study. The core category of this grounded theory is "humanizing care," which consisted of 4 interrelated phases, including patient acceptance, purposeful patient assessment and identification, understanding patients, and patient empowerment. A core category of humanizing care integrated the theory. Humanizing care was an outcome and process. Patient-centered care is a dynamic and multifaceted process provided according to the nurses' understanding of the concept. Patient-centered care does not involve repeating routine tasks; rather, it requires an all-embracing understanding of the patients and showing respect for their values, needs, and preferences.

Comparing performance of 30-day readmission risk classifiers among hospitalized primary care patients.

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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.

A Study in Child Care (Case Study from Volume II-A): "Tacos and Tulips." Day Care Programs Reprint Series.

Science.gov (United States)

O'Farrell, Brigid

The Holland Day Care Center in Michigan serves a diverse community of Anglo children of Dutch ancestry and children of former migrant workers of Chicano, Black, Puerto Rican and Cuban origins who have settled in the area. Located in two churches which are about three blocks apart, the program divides children by ability and age into five…

Customer care policy for utilities - demonstrated with the example of a call center; Customer Care fuer EVU - Wirkungszusammenhaenge am Beispiel des Telefon-Service

Energy Technology Data Exchange (ETDEWEB)

Weisse, D. [Consulting und Services, pdv Unternehmensberatung GmbH, Roesrath (Germany)

2000-01-10

Customer care policy, for preventing change to another provider and consolidating customer loyalty, is becoming a strategic (powerful) instrument for a utility in the competitive market. But what does this really imply for the day-to-day process of dealing with client-specific operations and workflows? The article describes the interactions between strategic marketing for ensuring client satisfaction and the resulting requirements to be met by a utility's call center, and also describes the key 'parameters' and requirements for successful day-to-day management of call centers. (orig./CB) [German] Customer Care zur Reduzierung der Wechselbereitschaft bzw. zur Erhoehung der Kundenbindung wird fuer EVU zu einem strategischen Instrument im Kampf um die Kunden. Aber was bedeutet dies fuer die operative Abwicklung der kundenbezogenen Geschaeftsprozesse? Der Verfasser erlaeutert die Zusammenhaenge zwischen dem strategischen Ziel der Kundenzufriedenheit und der operativen Umsetzung des Telefon-Service und beschreibt die 'Stellschrauben', die fuer diesen Zweck bei der Planung aber auch im taeglichen Management eines Call Centers zur Verfuegung stehen. (orig.)

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

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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…

Guidelines for the Development of Comprehensive Care Centers for Congenital Adrenal Hyperplasia: Guidance from the CARES Foundation Initiative

Directory of Open Access Journals (Sweden)

Rink RichardC

2010-11-01

Full Text Available Patients with rare and complex diseases such as congenital adrenal hyperplasia (CAH often receive fragmented and inadequate care unless efforts are coordinated among providers. Translating the concepts of the medical home and comprehensive health care for individuals with CAH offers many benefits for the affected individuals and their families. This manuscript represents the recommendations of a 1.5 day meeting held in September 2009 to discuss the ideal goals for comprehensive care centers for newborns, infants, children, adolescents, and adults with CAH. Participants included pediatric endocrinologists, internal medicine and reproductive endocrinologists, pediatric urologists, pediatric surgeons, psychologists, and pediatric endocrine nurse educators. One unique aspect of this meeting was the active participation of individuals personally affected by CAH as patients or parents of patients. Representatives of Health Research and Services Administration (HRSA, New York-Mid-Atlantic Consortium for Genetics and Newborn Screening Services (NYMAC, and National Newborn Screening and Genetics Resource Center (NNSGRC also participated. Thus, this document should serve as a "roadmap" for the development phases of comprehensive care centers (CCC for individuals and families affected by CAH.

Creche: ambiente expositor ou protetor nas infestações por parasitas intestinais em Aracaju, SE Children day care center: exposition or protection environment to intestinal parasites infestation in Aracaju, SE

Directory of Open Access Journals (Sweden)

Ricardo Queiroz Gurgel

2005-05-01

Full Text Available Para avaliar se creches são ambientes protetores ou propiciadores de infestação intestinal, foi feito exame coproparasitológico de crianças de creche e grupo controle. Creche relacionou-se à maior prevalência de parasitoses (63% x 41,4 % ; pThe work aimed to evaluate whether child daycare centers are an environment that protects against or exposes children to intestinal parasite infestation. Stool samples were analyzed from children attending such centers and a control group. It was concluded that attending daycare centers is related to intestinal parasitosis (630% vs. 41.4 %; p <0.01 and the risk of infestation is 1.5 times higher.

[Initiation and consumption of psychoactive substances among adolescents and young adults in an Anti-Drug Psychosocial Care Center].

Science.gov (United States)

Silva, Carolina Carvalho; Costa, Maria Conceição Oliveira; de Carvalho, Rosely Cabral; Amaral, Magali Teresópolis Reis; Cruz, Nilma Lázara de Almeida; da Silva, Mariana Rocha

2014-03-01

The study seeks to characterize the initiation and consumption pattern of psychoactive substances among adolescents and young adults enrolled in an Alcohol and Drug Psychosocial Care Center (CAPS-AD). This study was conducted with records of attendance and the consumption pattern was classified in accordance with WHO: infrequent use (lifetime use, per year or up to five days per month); frequent use (6 to 19 times in the past 30 days); heavy use (≥ 20 times in the last 30 days). In the age group comparison, the test for proportion and association analysis was used and the prevalence and prevalence ratio was calculated with a significance level of 5% and 95% confidence interval. Of the total of adolescents and young adults treated between 2003 and 2008 (475), most were male, single, poorly educated, live with relations and have psychic symptoms. Statistical significance was found for age at initiation of use: adolescents compared to young adults started earlier (≤ 14 years): tobacco, marijuana, cocaine, crack and other SPA consumption. Among adolescents, significant results were found for the less frequent consumption of tobacco, more frequent use of alcohol, and heavy consumption of marijuana. These findings may contribute to the preventive and therapeutic CAPS-AD programs.

Improving access to care through the patient-centered medical home.

Science.gov (United States)

North, Stephen W; McElligot, James; Douglas, Gaye; Martin, Amanda

2014-02-01

School-based health centers (SBHCs) serve an essential role in providing access to high-quality, comprehensive care to underserved children and adolescents in more than 2,000 schools across the United States. SBHCs are an essential component of the health care safety net, and their role in the patient-centered medical home (PCMH) continues to evolve as both collaborating partners and, when fully functioning, independent PCMHs. The American Academy of Pediatrics (AAP) supports the use of SBHCs, citing the proven benefits and exciting potential as justification, but also offers caution and recommends a focus on communication within the community. Traditional "brick and mortar" SBHCs are more likely to be located in urban communities (54.2% urban versus 18.0% rural) and be in schools with more students, allowing for a greater return on investment. Current SBHCs are located in schools with an average population of 997 students. The need for a large school population to help an SBHC approach financial viability excludes children in rural communities who are more likely to attend a school with fewer than 500 students, be poor, and have difficulty accessing health care.2 The expansion of telehealth technologies allows the creation of solutions to decrease geographic barriers that have limited the growth of SBHCs in rural communities. Telehealth school-based health centers (tSBHCs) that exclusively provide services through telemedicine are operating and developing in communities where geographic barriers and financial challenges have prevented the establishment of brick and mortar SBHCs. TSBHCs are beginning to increase the number and variety of services they provide through the use of telehealth to include behavioral health, nutrition services, and pediatric specialists. Understanding the role of tSBHCs in the growth of the PCMH model is critical for using these tools to continue to improve child and adolescent health. Copyright 2014, SLACK Incorporated.

Examining the Relationship Between Perceived Quality of Care and Actual Quality of Care as Measured by 30-Day Readmission Rates.

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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.

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.

[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.

Estado nutricional e prevalência de enteroparasitoses em crianças matriculadas em creche Nutritional status and enteroparasitosis prevalence among children enrolled in a day care center

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Terezinha Soares Biscegli

2009-09-01

Full Text Available OBJETIVO: Avaliar o estado nutricional e descrever a prevalência de enteroparasitoses em crianças de uma creche. MÉTODOS: Estudo transversal com 133 crianças (sete a 78 meses de idade matriculadas na Creche "Sinharinha Neto", Catanduva (SP. Avaliou-se o estado nutricional pelas curvas da OMS/2006 e NCHS/2000 (menores e maiores de cinco anos, respectivamente e investigou-se enteroparasitoses por meio de exames parasitológicos de fezes. O escore Z dos índices peso/altura foi aplicado para classificar desnutrição aguda (Z2 e o da altura/idade para desnutrição pregressa e crônica (ZOBJECTIVE: To evaluate the nutritional status and the prevalence of intestinal parasitic diseases among children enrolled in a day care center. METHODS: This cross-sectional study comprised 133 children, aged seven to 78 months, assisted in a nonprofit day care center in Catanduva, SP, Brazil. The nutritional status was classified according to WHO/2006 and NCHS/2000 curves (younger and older than five years, respectively. Faecal samples were collected for parasite examination. Z scores of weight/height were used to classify acute malnutrition (Z2, and height/age to classify past and chronic malnutrition (Z<-2. Statistical analyses were performed by Z test for proportions, beeing significant p<0.05. RESULTS: Among the evaluated children, 0.8% presented acute malnutrition, 1.5% past malnutrition and 6% obesity. Nutritional disorders were more prevalent among boys. The prevalence of intestinal parasites was 29.2%. The parasites identified were Giardia lamblia (73.6%, Entamoeba coli and yeasts (10.5% each and Endolimax nana (7.9%. Children aged 25 to 60 months presented more parasites (60.5%. Entamoeba coli and yeasts were more prevalent among malnourished children in comparison to eutrophic children. CONCLUSIONS: Nutritional transition was observed in this study. Improvement in life conditions contributed to the disappearance of some parasites, but not of

Mother Behavior Prefer Untrained Traditional Birth Attendant As Labor Support Person At Tembilahan Hulu Public Health Center Districts On 2016

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alhidayati yati

2018-03-01

Full Text Available Background: Maternal Mortality Rate (MMR is one indicator of health development in Indonesia. Deliveries by health personnel to be very important in efforts to reduce maternal mortality. Coverage of births attended by skilled health personnel at health centers Tembilahan Hulu has yet to reach the target of 90%. Target Health Center Tembilahan Hulu is 80% but reached only 45%. The number of maternal deaths in health centers Hulu 2016 Tembilahan 1 case and the number of infant mortality as much as 5 case, one cause of death is handled by TBAs. Objective: to know the mother's behavior in selecting birth attendants in health centers working area Tembilahan Hulu. Design: Qualitative research, to obtain in-depth information about how the Mother Behavior in Choosing Auxiliary Power Delivery at Puskesmas Tembilahan Hulu 2016. Methods: This study used a qualitative descriptive method, which is an approach to research that revealed certain social situations to describe reality correctly, formed by words based on the techniques of collecting and analyzing relevant data obtained from the natural situation. Results and Discussion: Research shows that mothers choose birth attendants decision is closely linked to the knowledge, attitudes, social culture, access to health services, family support. Conclusions: The behavior of mothers in selecting birth attendant is still a lot to TBAs compared to the health worker / midwife.

Prevalence of overweight preschool children in public day care centers: a cross-sectional study

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Viviane Gabriela Nascimento

Full Text Available CONTEXT AND OBJECTIVE: Brazil is undergoing a period of epidemiological transition associated with demographic and nutritional changes. The prevalence of obesity is also increasing in children and is causing numerous health problems that are becoming public health issues. The aim here was to evaluate the prevalence of overweight among children of two and three years of age. DESIGN AND SETTING: Cross-sectional study in municipal day care centers in Taubaté, state of São Paulo, Brazil. METHODS: Weight and height measurements were made on 447 preschool children forming a probabilistic randomized sample. Their body mass index (BMI was calculated. Their nutritional status was classified using the World Health Organization reference cutoff points (2006. Their mean weight, height and BMI were compared according to their age and sex. RESULTS: The mean values for the final sample (n = 447 were as follows: mean age: 38.6 months (± 3.5 and Z scores for: weight/height (W/H: 0.50 (± 1.22; height/age: -0.03 (± 1.07; weight/age (W/A: 0.51 (± 1.23; and BMI: 0.51(± 1.23. The prevalence of overweight children (BMI > 1 z was 28.86%, while the prevalence of underweight children (BMI < -2 z was 0.89%. There were no differences in mean BMI among the two and three-year age groups (P = 0.66. CONCLUSION: A high prevalence of overweight was observed in the sample of two and three-year-old children, with practically no malnutrition, thus showing that a significant nutritional transition may already be occurring, even in medium-sized cities of developing countries.

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

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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.

Awareness of the Care Team in Electronic Health Records

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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

Distribution of specialized care centers in the United States.

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Wang, Henry E; Yealy, Donald M

2012-11-01

As a recommended strategy for optimally managing critical illness, regionalization of care involves matching the needs of the target population with available hospital resources. The national supply and characteristics of hospitals providing specialized critical care services is currently unknown. We seek to characterize the current distribution of specialized care centers in the United States. Using public data linked with the American Hospital Association directory and US Census, we identified US general acute hospitals providing specialized care for ST-segment elevation myocardial infarction (STEMI) (≥40 annual primary percutaneous coronary interventions reported in Medicare Hospital Compare), stroke (The Joint Commission certified stroke centers), trauma (American College of Surgeons or state-designated, adult or pediatric, level I or II), and pediatric critical care (presence of a pediatric ICU) services. We determined the characteristics and state-level distribution and density of specialized care centers (centers per state and centers per state population). Among 4,931 acute care hospitals in the United States, 1,325 (26.9%) provided one of the 4 defined specialized care services, including 574 STEMI, 763 stroke, 508 trauma, and 457 pediatric critical care centers. Approximately half of the 1,325 hospitals provided 2 or more specialized services, and one fifth provided 3 or 4 specialized services. There was variation in the number of each type of specialized care center in each state: STEMI median 7 interquartile range (IQR 2 to 14), stroke 8 (IQR 3 to 17), trauma 6 (IQR 3 to 11), pediatric specialized care 6 (IQR 3 to 11). Similarly, there was variation in the number of each type of specialized care center per population: STEMI median 1 center per 585,135 persons (IQR 418,729 to 696,143), stroke 1 center per 412,188 persons (IQR 321,604 to 572,387), trauma 1 center per 610,589 persons (IQR 406,192 to 917,588), and pediatric critical care 1 center per 665

A social work study on the effect of family life education on marital satisfaction of women attending in Isfahan Counseling Centers

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Ali Asghar Rahimi Rezaee

2013-06-01

Full Text Available This paper studies the effective of family life education (FLE on marital status among women attending in Isfahan counseling centers. The methodology of this research was quasi experimental with pre-test and post-test design and control group. Statistical populations were women attending in Isfahan city counseling centers. For selecting statistical sample, 30 women from women attending in counseling centers were selected as volunteers and randomly distributed between experimental and control groups. The main hypothesis of this research states that FLE increases marital satisfaction and their subscales in women. In this study, the dependent variable was marital-satisfaction and the independent variable was family life education conducted to case group in 10 sessions. The results of this survey show that the FLE improved marital satisfaction (p<0.01 and it was effective on the subscales (p<0.01.

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

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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…

Critical thinking in patient centered care.

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Mitchell, Shannon H; Overman, Pamela; Forrest, Jane L

2014-06-01

Health care providers can enhance their critical thinking skills, essential to providing patient centered care, by use of motivational interviewing and evidence-based decision making techniques. The need for critical thinking skills to foster optimal patient centered care is being emphasized in educational curricula for health care professions. The theme of this paper is that evidence-based decision making (EBDM) and motivational interviewing (MI) are tools that when taught in health professions educational programs can aid in the development of critical thinking skills. This paper reviews the MI and EBDM literature for evidence regarding these patient-centered care techniques as they relate to improved oral health outcomes. Comparisons between critical thinking and EBDM skills are presented and the EBDM model and the MI technique are briefly described followed by a discussion of the research to date. The evidence suggests that EBDM and MI are valuable tools; however, further studies are needed regarding the effectiveness of EBDM and MI and the ways that health care providers can best develop critical thinking skills to facilitate improved patient care outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

Value Based Care and Patient-Centered Care: Divergent or Complementary?

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Tseng, Eric K; Hicks, Lisa K

2016-08-01

Two distinct but overlapping care philosophies have emerged in cancer care: patient-centered care (PCC) and value-based care (VBC). Value in healthcare has been defined as the quality of care (measured typically by healthcare outcomes) modified by cost. In this conception of value, patient-centeredness is one important but not necessarily dominant quality measure. In contrast, PCC includes multiple domains of patient-centeredness and places the patient and family central to all decisions and evaluations of quality. The alignment of PCC and VBC is complicated by several tensions, including a relative lack of patient experience and preference measures, and conceptions of cost that are payer-focused instead of patient-focused. Several strategies may help to align these two philosophies, including the use of patient-reported outcomes in clinical trials and value determinations, and the purposeful integration of patient preference in clinical decisions and guidelines. Innovative models of care, including accountable care organizations and oncology patient-centered medical homes, may also facilitate alignment through improved care coordination and quality-based payment incentives. Ultimately, VBC and PCC will only be aligned if patient-centered outcomes, perspectives, and preferences are explicitly incorporated into the definitions and metrics of quality, cost, and value that will increasingly influence the delivery of cancer care.

Cost Effectiveness of On-site versus Off-site Depression Collaborative Care in Rural Federally Qualified Health Centers

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Pyne, Jeffrey M.; Fortney, John C.; Mouden, Sip; Lu, Liya; Hudson, Teresa J; Mittal, Dinesh

2018-01-01

Objective Collaborative care for depression is effective and cost-effective in primary care settings. However, there is minimal evidence to inform the choice of on-site versus off-site models. This study examined the cost-effectiveness of on-site practice-based collaborative care (PBCC) versus off-site telemedicine-based collaborative care (TBCC) for depression in Federally Qualified Health Centers (FQHCs). Methods Multi-site randomized pragmatic comparative cost-effectiveness trial. 19,285 patients were screened for depression, 14.8% (n=2,863) screened positive (PHQ9 ≥10) and 364 were enrolled. Telephone interview data were collected at baseline, 6-, 12-, and 18-months. Base case analysis used Arkansas FQHC healthcare costs and secondary analysis used national cost estimates. Effectiveness measures were depression-free days and quality-adjusted life years (QALYs) derived from depression-free days, Medical Outcomes Study SF-12, and Quality of Well Being scale (QWB). Nonparametric bootstrap with replacement methods were used to generate an empirical joint distribution of incremental costs and QALYs and acceptability curves. Results Mean base case FQHC incremental cost-effectiveness ratio (ICER) using depression-free days was $10.78/depression-free day. Mean base case ICERs using QALYs ranged from $14,754/QALY (depression-free day QALY) to $37,261/QALY (QWB QALY). Mean secondary national ICER using depression-free days was $8.43/depression-free day and using QALYs ranged from $11,532/QALY (depression-free day QALY) to $29,234/QALY (QWB QALY). Conclusions These results support the cost-effectiveness of the TBCC intervention in medically underserved primary care settings. Results can inform the decision about whether to insource (make) or outsource (buy) depression care management in the FQHC setting within the current context of Patient-Centered Medical Home, value-based purchasing, and potential bundled payments for depression care. The www.clinicaltrials.gov # for

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

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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.

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

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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.

Causes of prolonged hospitalization among general internal medicine patients of a tertiary care center.

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Ruangkriengsin, Darat; Phisalprapa, Pochamana

2014-03-01

Unnecessary days of prolonged hospitalization may lead to the increase in hospital-related complications and costs, especially in tertiary care center Currently, there have not been many studies about the causes of prolonged hospitalization. Some identified causes could, however, be prevented and improved. To identify the prevalence, causes, predictive factors, prognosis, and economic burden of prolonged hospitalization in patients who had been in general internal medicine wards of the tertiary care center for 7 days or more. Retrospective chart review study was conducted among all patients who were admitted for 7 days or more in general internal medicine wards of Siriraj Hospital, the largest tertiary care center in Thailand. The period of this study was from 1 August 2012 to 30 September 2012. Demographic data, principle diagnosis, comorbid diseases, complications, discharge status, total costs of admission and percentage of reimbursement were collected. The causes of prolonged hospitalization at day 7, 14, 30, and 90 were assessed. Five hundred and sixty-two charts were reviewed. The average length of stay was 25.9 days. The two most common causes of prolonged admission at day 7 were treatment of main diagnosed disease with stable condition (27.6%) and waiting for completion of intravenous antibiotics administration with stable condition (19.5%). The causes of prolonged hospitalization at day 14 were unstable condition from complications (22.6%) and those waiting for completion of intravenous antibiotics administration with stable condition (15.8%). The causes of prolonged admission at day 30 were unstable conditions from complications (25.6%), difficulty weaning or ventilator dependence (17.6%), and caregiver problems (15.2%). The causes of prolonged hospitalization at day 90 were unstable condition from complications (30.0%), caregiver problems (30.0%), and palliative care (25.0%). Poor outcomes were shown in the patients admitted more than 90 days. Percentage

Patient-centered family meetings in palliative care: a quality improvement project to explore a new model of family meetings with patients and families at the end of life.

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Sanderson, Christine R; Cahill, Philippa J; Phillips, Jane L; Johnson, Anne; Lobb, Elizabeth A

2017-12-01

Family meetings in palliative care can enhance communication with family members and identify unmet needs. However, the patient's voice may not be heard. This pre and post-test quality improvement project was conducted from 2013-2014 and investigated a patient-centered family meeting, which is a different approach to palliative care family meetings, to determine its feasibility and acceptability for patients, family and the palliative care team. Newly admitted patients to an Australian in-patient specialist palliative care unit were invited to ask anyone they wished to join them in a meeting with the palliative care team and to identify issues they wished to discuss. Consenting inpatients were interviewed shortly after admission; participated in a family meeting and re-interviewed 2-3 days after the meeting. Family members provided feedback at the end of the meeting. A focus group was held with staff for feedback on this new approach for family meetings. Meetings were observed, documented and thematically analyzed. Thirty-one newly admitted patients were approached to participate in a family meeting. Eighty-four percent had family meetings and the majority (96%) was attended by the patient. Thematic analysis revealed 69% of patient-centered meetings raised end-of-life concerns and 54% were "family-focused". Patient-centered family meetings in palliative care were shown to be feasible and acceptable for staff, patients and family members. Many patients and families spontaneously shared end-of-life concerns. A patient-centered approach to family meetings that includes active patient involvement may provide additional and valued opportunities for patients and families to: express mutual concerns, deliver messages of comfort and appreciation, and prepare for death. Further investigation of this approach, including families' bereavement outcomes, is warranted.

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...

Community-Based Care

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... our e-newsletter! Aging & Health A to Z Community-Based Care Basic Facts & Information A variety of healthcare options ... day care centers are either in churches or community centers. Adult day care is commonly used to care for people who ...

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...

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

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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.

The ten successful elements of an ambulatory care center.

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Watkins, G

1997-01-01

Experts in healthcare predict that in the future, over 80% of all care will be provided either in the home or ambulatory care centers. How radiology facilities position themselves for this shifting market is critical to their long-term success, even though it appears there are endless opportunities for providing care in this atmosphere. The ten most critical elements that healthcare providers must address to ensure their preparedness are discussed. Location is critical, particularly since patients no longer want to travel to regional medical centers. The most aggressive providers are building local care centers to serve specific populations. Ambulatory care centers should project a high tech, high touch atmosphere. Patient comfort and the appeal of the overall environment must be considered. Centers need to focus on their customers' needs in multiple areas of care. A quick and easy registration process, providing dressing gowns in patient areas, clear billing functions--these are all important areas that centers should develop. Physicians practicing in the ambulatory care center are key to its overall success and can set the tone for all staff members. Staff members must be friendly and professional in their work with patients. The hours offered by the center must meet the needs of its client base, perhaps by offering evening and weekend appointments. Keeping appointments on schedule is critical if a center wants satisfied customers. It's important to identify the target before developing your marketing plan. Where do your referrals come from? Look to such sources as referring physicians, managed care plans and patients themselves. Careful billing is critical for survival in the ambulatory care world. Costs are important and systems that can track cost per exam are useful. Know your bottom line. Service remains the central focus of all successful ambulatory care center functions.

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.

Function of "nontrauma" surgeons in level I trauma centers in the United States.

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Pate, J W

1997-06-01

Although the general "trauma" surgeon is usually the team leader in level I trauma centers, the use of surgical subspecialists and nonsurgeons is frequently ill-defined. This study was done to gain data in regard to actual use of subspecialists in busy centers. First, a survey of the patterns of staffing in 140 trauma centers was elicited by mail questionnaire, supplemented by telephone cells. Second, records of 400 consecutive patients at the Elvis Presley Trauma Center were reviewed to determine the use of subspecialists during the first 24 hours of care of individual patients. There were differences in the use of surgical subspecialists and nonsurgeons at different centers: in receiving, admitting, operating, and critical care areas and in privileges for admission and attending of inpatients. Consultation "guidelines" are used for many specific injuries. At our center, a mean of 1.92 subspecialists, in addition to general surgeons, were involved in the early care of each patient. Problems exist in many centers regarding the use of subspecialists, especially for management of facial and chest injuries. In some centers nonsurgeons function in the intensive care unit, and as admitting and attending physicians of trauma patients.

Daycare Center Attendance Buffers the Effects of Maternal Authoritarian Parenting Style on Physical Aggression in Children.

Science.gov (United States)

Muñoz, José M; Braza, Paloma; Carreras, Rosario; Braza, Francisco; Azurmendi, Aitziber; Pascual-Sagastizábal, Eider; Cardas, Jaione; Sánchez-Martín, José R

2017-01-01

A maternal authoritarian style has been related to the development of physical aggression during childhood and later future social problems; however, not too many studies have detected other than individual or family factors that may buffer this maternal effect. This work examines whether daycare center attendance may moderate the relationships between a mother authoritarian style and physical aggression. The study sample was 72 (40 girls) kindergarten children from Spain. Parents were asked to complete two questionnaires focused on individual family characteristics and parenting styles. At age 5, children physical aggression was assessed by direct observation at playtime; aggression scores at 6 was obtained by a peer-rated questionnaire. A least squared multiple regression was performed after controlling for children's level of physical aggression at 5, child sex and siblings. A positive contribution of maternal authoritarian style on physical aggression was detected. Daycare center attendance appears to attenuate the effect of the mother's authoritarian style on physical aggression, only in boys.

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.

Cost-income analysis of oral health units of health care centers in Yazd city

Directory of Open Access Journals (Sweden)

Hosein Fallahzadeh

2012-01-01

Full Text Available Background and Aims: Increasing demands for health care's services on one hand and limited resources on the other hand brings about pressure over governments to find out a mechanism for fair and appropriate distribution of resources. Economic analysis is one of the appropriate tools for policy making on this priority. The aim of this study was to assess capital and consumption of oral health units of health care centers in Yazd city and comparing it with revenue of these centers and determining of cost effectiveness.Materials and Methods: In this descriptive cross sectional study, all health care centers of Yazd city with active dentistry department were evaluated. The data has been extracted from current documents in health care center of county based issued receipts and daily information registers.Results: Expended cost for providing of oral hygiene services in second half of 2008 in 13 medical health centers of Yazd included active dentistry section was 557.887.500 Rials and revenue to cost ratio was about 34%. The most provided service was related to tooth extraction and the average of tooth restoration in each working day was 0.48.Conclusion: With attention to low tariffs of dentistry services in medical health centers and paying subsidy to target groups, expenses of oral hygiene are always more than its revenue.

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

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

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;…

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...

[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.

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.

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.

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.

Hypertension Control and co-morbidities in primary health care centers in Riyadh

Energy Technology Data Exchange (ETDEWEB)

Al-Tuwijri, Abdulmohsin A [Dept. of Family Medicine, Ministry of Health, Riyadh (Saudi Arabia); Al-Rukban, Mohammed Othman [Dept. of Family and Community Medicine, Coll. of Medicine, King Saud Univ., Riyadh (Saudi Arabia)

2006-07-01

The prevalence of hypertension in Saudi Arabia has been assessed only in preliminary reports. The aim of this study was to determine the degree of control of blood pressure and the prevalence of common hypertension co-morbidities among hypertensive patients attending primary health care (PHC) centers in Riyadh. A cross sectional study was conducted by reviewing medical records of hypertensive patients during May and June 2001. Two hundred fifty-five medical records selected by a stratified randomization process according to the distribution of the 73 PHC centers in the city and the total number of hypertensive patients registered in the mini-clinic of each PHC-center. Trained mini-clinic nurses collected data using a data collection form developed for this purpose. Of 255 patients, 121 (47.5%) were males and 134 (52.5%) were females, the mean age was 57.2+-11.1 years and 8.3% were smokers. The majority 204 (85.7%) had greater than normal body weight. Only 101 (40.4%) had controlled systolic BP. The most common co-morbidity was diabetes mellitus found in 98 (38.4%), followed by dislipidemia in 50 (19.6%), bronchial asthma in 28 (11.0%) and renal diseases in 12 (4.7%). Except for osteoporosis, which was reported by females only (P=0.003), the occurrences of hypertensive co-morbidities did not vary from other demographic characteristics. This study demonstrated poor blood pressure control in the mini-clinics in the PHC-centers. To improve the quality of care for hypertensive patients, we recommend an improvement in PHC physician knowledge of and attitudes toward the importance of achieving targeted blood pressure levels. (author)

Hypertension Control and co-morbidities in primary health care centers in Riyadh

International Nuclear Information System (INIS)

Al-Tuwijri, Abdulmohsin A.; Al-Rukban, Mohammed Othman

2006-01-01

The prevalence of hypertension in Saudi Arabia has been assessed only in preliminary reports. The aim of this study was to determine the degree of control of blood pressure and the prevalence of common hypertension co-morbidities among hypertensive patients attending primary health care (PHC) centers in Riyadh. A cross sectional study was conducted by reviewing medical records of hypertensive patients during May and June 2001. Two hundred fifty-five medical records selected by a stratified randomization process according to the distribution of the 73 PHC centers in the city and the total number of hypertensive patients registered in the mini-clinic of each PHC-center. Trained mini-clinic nurses collected data using a data collection form developed for this purpose. Of 255 patients, 121 (47.5%) were males and 134 (52.5%) were females, the mean age was 57.2+-11.1 years and 8.3% were smokers. The majority 204 (85.7%) had greater than normal body weight. Only 101 (40.4%) had controlled systolic BP. The most common co-morbidity was diabetes mellitus found in 98 (38.4%), followed by dislipidemia in 50 (19.6%), bronchial asthma in 28 (11.0%) and renal diseases in 12 (4.7%). Except for osteoporosis, which was reported by females only (P=0.003), the occurrences of hypertensive co-morbidities did not vary from other demographic characteristics. This study demonstrated poor blood pressure control in the mini-clinics in the PHC-centers. To improve the quality of care for hypertensive patients, we recommend an improvement in PHC physician knowledge of and attitudes toward the importance of achieving targeted blood pressure levels. (author)

Satisfaction of Patients Attending in Primary Healthcare Centers in Riyadh, Saudi Arabia: A Random Cross-Sectional Study.

Science.gov (United States)

Almutairi, Khalid M

2017-06-01

This study aims to determine the level of satisfaction of patients who visit primary healthcare centers in Riyadh, Saudi Arabia. The investigation was a cross-sectional study conducted in twenty randomly selected primary healthcare centers in Riyadh, Saudi Arabia from October to December 2014. A descriptive data analysis was performed. Eligible participants had visited at least one of the selected primary healthcare centers within the past 12 months. A total of 1741 participants completed the survey, providing a response rate of 87 % (43 % male, 57 % female). The highest satisfaction rates were in the following areas: comprehensiveness and coordination 76.2 % (95 % CI 74.8 ± 77.5), communication 72.7 % (95 % CI 71.3 ± 74) and attitude of staff 73.4 % (95 % CI 72.1 ± 74.8) The areas of greatest concern expressed by the participants were the length of the wait and the quality of the facility 55.4 % (95 % CI 53.3 ± 57.5), 50.5 % (95 % CI 48.3 ± 52.7), respectively. The majority of the patients attending primary healthcare centers in Riyadh showed high levels of satisfaction; however, there are still some factors that need to be considered and improved upon. These include the accessibility of primary healthcare centers as well as waiting time of patients. The results of the current study showed relative improvement in other factors such as comprehensiveness and coordination, communication and attitude of staff. The level of satisfaction of patients and stakeholders shows the progress of the quality of care in healthcare facilities in Riyadh, Saudi Arabia.

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

Gender in relation to work motivation, satisfaction and use of day center services among people with psychiatric disabilities.

Science.gov (United States)

Eklund, Mona; Eklund, Lisa

2017-05-01

Day centres can prepare for open-market employment, and attendees' work motivation is key in this. Adopting a gender perspective, this study investigated (1) motivation for day centre attendance, satisfaction with the day centre services, number of hours spent there, and number and type of occupations performed; and (2) whether those factors were related with motivation for open-market employment. Women (n = 164) and men (n = 160) with psychiatric disabilities completed self-report questionnaires. There were no gender differences regarding satisfaction with the day centre services or number of hours spent there, but women engaged in more occupations. More women than men performed externally-oriented services and textile work, while men were in the majority in workshops. Externally oriented services, working in workshops, and low satisfaction with the day centre services were associated with higher motivation for employment. Women and men were equally motivated for employment. Women scored higher on motivation for attending the day centre, something that may deter transition into open-market employment. For men, less motivation for attending day centres may reduce their possibilities of gaining skills that can facilitate transitioning to open-market employment. Thus, the possibility for transitioning from day centre activities to open-market employment may be gendered.

[Prevalence and factors associated with frequent attendence in family medicine clinic].

Science.gov (United States)

Parejo Maestre, N; Lendínez-de la Cruz, J M; Bermúdez-Torres, F M; Gónzalez-Contero, L; Gutierrez-Espinosa de Los Monteros, M P; Espejo-Almazán María, T

2016-01-01

The use of health services has seen a steep rise. The frequent users are responsible for significant economic, human and social impact. The objective is to analyze the characteristics of frequent attenders in our Health Center, in order to evaluate the possibility of taking corrective measures to improve the quality of care and efficiency in the use of resources. Descriptive observational study of a sample of 379 patients over 18 years old. The dependent variables were attendance (number of visits to their family doctor during the previous year), frequent attendance (10 or more visits to the family doctor in the last year), and persistent frequent attenders (10 or more visits to the family doctor in each of the last two years). Data were collected from medical records and by telephone interview. The mean attendance was 6.83 (95%CI: 6.13-7.53), frequent attendance reached 25.4% (95%CI: 21.4-29.6), and persistent frequent attenders, 1.6% (95%CI: 0.5-2.9). Frequent attendance was associated with sex, age, marital status, educational level, family structure, existence of chronic disease, use of anxiolytic and antidepressants, request for additional tests, and referrals to other specialists, proximity to the health center, and level of satisfaction with their family doctor. The low persistent frequent attenders found suggests that frequent attendance could be largely due to factors related to professional and organization. Studies are required to address the high level of consumption of psychotropic drugs, and improving professional skills in dealing with mental problems. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

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 ...

The epidemiological profile of Pediatric Intensive Care Center at Hospital Israelita Albert Einstein.

Science.gov (United States)

Lanetzki, Camila Sanches; de Oliveira, Carlos Augusto Cardim; Bass, Lital Moro; Abramovici, Sulim; Troster, Eduardo Juan

2012-01-01

This study outlined the epidemiological profiles of patients who were admitted to the Pediatric Intensive Care Center at Albert Einstein Israelite Hospital during 2009. Data were retrospectively collected for all patients admitted to the PICC during 2009. A total of 433 medical charts were reviewed, and these data were extracted using the DATAMARTS System and analyzed using the statistical software package STATA, version 11.0. There were no statistically significant differences in regards to patient gender, and the predominant age group consisted of patients between the ages of 1 to 4 years. The average occupancy rate was 69.3% per year, and there was a greater number of admissions during April, August, and October. The average length of stay at the hospital ranged from 9.7 to 19.1 days. Respiratory diseases were the main cause for admission to the Pediatric Intensive Care Center, and the mortality rate of the patients admitted was 1.85%. Respiratory diseases were the most common ailment among patients admitted to the Pediatric Intensive Care Center, and the highest mortality rates were associated with neoplastic diseases.

Healthcare-seeking preferences of patients with sexually transmitted infection attending a tertiary care center in South Kerala.

Science.gov (United States)

Jayapalan, Sabeena

2016-01-01

Sexually transmitted infections (STIs) are a major public health problem in developing countries. These diseases are associated with increased risk of transmission of human immunodeficiency virus as well as adverse outcomes on pregnancy and reproductive health. Sexual behavior and healthcare-seeking behavior are identified as the true risk factors of STIs. Hospital-based cross-sectional study design was adopted. Eighty-five STI patients were studied regarding the inappropriate treatment-seeking behavior, the nature of the first point of contact with the health care, the appropriateness of treatment and the concerns of the patient regarding the services rendered by government health-care facilities. Among the 85 patients studied, 55.3% were males and 44.7% were females. Inappropriate treatment-seeking behavior was seen in 29.8% of males and 36.8% of females. About 59.6% of males and 81.6% of females sought appropriate treatment from modern medicine practitioners before attending our institution. Only 7.1% of males and 3.2% of females received appropriate treatment. The government sector was the choice of treatment for 46.4% males and 93.5% females and this difference was statistically significant ( P = 0.00081). Lack of free medicines, issues of confidentiality, and privacy were the major service-related issues in the public sector. Appropriate treatment at the first point of contact with the health system is an important measure to prevent further transmission and development of complications. Health providers from both private and public sector should be given frequent periodic training regarding syndromic management of STIs and the training should stress on the need for risk reduction and condom promotion messages along with medical management. Program planners should take necessary steps to ensure adequate and continuous supply of free drugs and tackle issues of confidentiality and privacy.

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

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.

Cancer Survivorship Care: Person Centered Care in a Multidisciplinary Shared Care Model

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Jacqueline Loonen

2018-01-01

Full Text Available Survivors of childhood and adult-onset cancer are at lifelong risk for the development of late effects of treatment that can lead to serious morbidity and premature mortality. Regular long-term follow-up aiming for prevention, early detection and intervention of late effects can preserve or improve health. The heterogeneous and often serious character of late effects emphasizes the need for specialized cancer survivorship care clinics. Multidisciplinary cancer survivorship care requires a coordinated and well integrated health care environment for risk based screening and intervention. In addition survivors engagement and adherence to the recommendations are also important elements. We developed an innovative model for integrated care for cancer survivors, the “Personalized Cancer Survivorship Care Model”, that is being used in our clinic. This model comprises 1. Personalized follow-up care according to the principles of Person Centered Care, aiming to empower survivors and to support self management, and 2. Organization according to a multidisciplinary and risk based approach. The concept of person centered care is based on three components: initiating, integrating and safeguarding the partnership with the patient. This model has been developed as a universal model of care that will work for all cancer survivors in different health care systems. It could be used for studies to improve self efficacy and the cost-effectiveness of cancer survivorship care.

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…

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.

A EDUCAÇÃO INFANTIL NO CONTEXTO DA CRECHE: UM ESTUDO SOBRE A EDUCAÇÃO, O CUIDADO DA CRIANÇA DE ZERO A TRÊS ANOS E A FORMAÇÃO DE PROFESSORES NO MUNICÍPIO DE MARÍLIA – SP

OpenAIRE

Ana Corina Machado Spada

2010-01-01

This research discusses the children.s education developed in public child day care centers. Historically, the attendance developed by child day care had been directed to children from popular class in Brazil and specially in Brazil, this kind of attendance were developed based on philanthropic work, with practices inside the institutions purely based on physical care. Considering on these elements that influenced the practices used inside the child day care space, as well the public policies...

Training social workers to enhance patient-centered care for drug-resistant TB-HIV in South Africa.

Science.gov (United States)

Zelnick, J R; Seepamore, B; Daftary, A; Amico, K R; Bhengu, X; Friedland, G; Padayatchi, N; Naidoo, K; O'Donnell, M R

2018-03-21

KwaZulu-Natal, South Africa, is the epicenter of an epidemic of drug-resistant tuberculosis (DR-TB) and human immunodeficiency virus (HIV) co-infection, characterized by low rates of medication adherence and retention in care. Social workers may have a unique role to play in improving DR-TB-HIV outcomes. We designed, implemented and evaluated a model-based pilot training course on patient-centered care, treatment literacy in DR-TB and HIV coinfection, patient support group facilitation, and self-care. Ten social workers participated in a 1-day training course. Post-training questionnaire scores showed significant overall gains ( P = 0.003). A brief training intervention may be a useful and feasible way to engage social workers in patient-centered care for DR-TB and HIV coinfection.

The impact of incentives on intrinsic and extrinsic motives for fitness-center attendance in college first-year students.

Science.gov (United States)

Pope, Lizzy; Harvey, Jean

2015-01-01

A criticism of incentives for health behaviors is that incentives undermine intrinsic motivation. The objective of this study was to determine the impact of monetary incentive provision on participation motives for exercise in first-year college students at a northeastern public university. Randomized-controlled trial. Public university in the Northeastern United States. One hundred seventeen first-year college students. Participants were randomized to one of three conditions: a control condition receiving no incentives for meeting fitness-center attendance goals; a discontinued-incentive condition receiving weekly incentives during fall semester 2011, and no incentives during spring semester 2012; or a continued-incentive condition receiving weekly incentives during fall semester, and incentives on a variable-interval schedule during spring semester. The Exercise Motivation Inventory 2 measured exercise participation motives at baseline, end of fall semester, and end of spring semester. Fitness-center attendance was monitored by using ID-card check-in/check-out records. Repeated-measures analyses using linear mixed models with first-order autoregressive covariance structures were run to compare motive changes in the three conditions. Participation motives of Enjoyment and Revitalization associated with intrinsic motivation did not decrease significantly over time in any of the conditions, F(4, 218) = 2.25, p = .065 and F(4, 220) = 1.67, p = .16, respectively. Intrinsically associated participation motives for exercise did not decrease with incentive provision. Therefore, incentives may encourage fitness-center attendance without negatively impacting participation motives for exercise.

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.

Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center.

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Manzano, Joanna-Grace M; Gadiraju, Sahitya; Hiremath, Adarsh; Lin, Heather Yan; Farroni, Jeff; Halm, Josiah

2015-09-01

Hospital readmissions are considered by the Centers for Medicare and Medicaid as a metric for quality of health care delivery. Robust data on the readmission profile of patients with cancer are currently insufficient to determine whether this measure is applicable to cancer hospitals as well. To address this knowledge gap, we estimated the unplanned readmission rate and identified factors influencing unplanned readmissions in a hospitalist service at a comprehensive cancer center. We retrospectively analyzed unplanned 30-day readmission of patients discharged from the General Internal Medicine Hospitalist Service at a comprehensive cancer center between April 1, 2012, and September 30, 2012. Multiple independent variables were studied using univariable and multivariable logistic regression models, with generalized estimating equations to identify risk factors associated with readmissions. We observed a readmission rate of 22.6% in our cohort. The median time to unplanned readmission was 10 days. Unplanned readmission was more likely in patients with metastatic cancer and those with three or more comorbidities. Patients discharged to hospice were less likely to be readmitted (all P values quality measures in cancer hospitals. Copyright © 2015 by American Society of Clinical Oncology.

Integrating a Nurse-Midwife-Led Oral Health Intervention Into CenteringPregnancy Prenatal Care: Results of a Pilot Study.

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Adams, Sally H; Gregorich, Steven E; Rising, Sharon S; Hutchison, Margaret; Chung, Lisa H

2017-07-01

National and professional organizations recommend oral health promotion in prenatal care to improve women's oral health. However, few prenatal programs include education about oral health promotion. The objective of this study was to determine if women receiving a brief, low-cost, and sustainable educational intervention entitled CenteringPregnancy Oral Health Promotion had clinically improved oral health compared to women receiving standard CenteringPregnancy care. Women attending CenteringPregnancy, a group prenatal care model, at 4 health centers in the San Francisco Bay Area, participated in this nonrandomized controlled pilot study in 2010 to 2011. The intervention arm received the CenteringPregnancy Oral Health Promotion intervention consisting of two 15-minute skills-based educational modules addressing maternal and infant oral health, each module presented in a separate CenteringPregnancy prenatal care session. The present analysis focused on the maternal module that included facilitated discussions and skills-building activities including proper tooth brushing. The control arm received standard CenteringPregnancy prenatal care. Dental examinations and questionnaires were administered prior to and approximately 9 weeks postintervention. Primary outcomes included the Plaque Index, percent bleeding on probing, and percent of gingival pocket depths 4 mm or greater. Secondary outcomes were self-reported oral health knowledge, attitudes (importance and self-efficacy), and behaviors (tooth brushing and flossing). Regression models tested whether pre to post changes in outcomes differed between the intervention versus the control arms. One hundred and one women participated in the study; 49 were in the intervention arm, and 52 were in the control arm. The control and intervention arms did not vary significantly at baseline. Significant pre to post differences were noted between the arms with significant improvements in the intervention arm for the Plaque Index

Morbidade em creche de Brasília: estudo longitudinal de incidência de enfermidades no ano de 1977 Morbidity in a Brasilia day care center: a longitudinal study of disease incidence in 1977

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Ana Maria Low

1980-12-01

Full Text Available Foi feito estudo longitudinal de morbidade em creche de Brasília (Brasil freqüentada por crianças com bom estado nutricional. Foram admitidas na creche durante o ano de 1977 o total de 67 crianças (34 do sexo masculino e 33 do sexo feminino, com idade entre 3 e 21 meses. Infecções de vias aéreas superiores (25,4%, diarréia (23,6% e febre não esclarecida (18,4% representaram dois terços dos diagnósticos. A seguir, em ordem de freqüência, apareceram conjuntivite (15,5%, viroses da infância (7,9%, doenças de pele (3,8%, pequenos acidentes (2,6%, hepatite (2,6% e meningococcemia (0,3%. Houve um total de 343 episódios agudos, dando uma taxa de incidência de 14 enfermidades por criança por ano, independente de sexo e idade.A longitudinal morbidity study was carried out in a day care center in Brasilia (Brazil on a sample of 67 (34 male and 33 female, 3 to 21 months of age well-fed children from middle-class families. A pediatrician was on duty daily in the center. The incidence of disease was: upper respiratory, 25.4%; diarrhea, 23.6%; and undetermined fever, 18.4%. These represented 2/3 of the diagnoses. The other diseases found (and here listed in order of frequency were: conjunctivitis, 15.5%; childhood infections, 7.9%; skin diseases, 3.8%; accidents, 2.6%; hepatitis, 2.6%; and meningitis, 0.3%. There were a total of 343 acute illnesses, giving a mean incidence rate of 14 illnesses per child per year, independent of sex and age. Perhaps the incidence of illnesses would have been lower if the children had not been attending the center, a natural factor in the dissemination of communicable diseases.

Effects of person-centered care on residents and staff in aged-care facilities: a systematic review

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Brownie S

2013-01-01

Full Text Available Sonya Brownie, Susan NancarrowSchool of Health and Human Sciences, Southern Cross University, Lismore, NSW, AustraliaBackground: Several residential aged-care facilities have replaced the institutional model of care to one that accepts person-centered care as the guiding standard of practice. This culture change is impacting the provision of aged-care services around the world. This systematic review evaluates the evidence for an impact of person-centered interventions on aged-care residents and nursing staff.Methods: We searched Medline, Cinahl, Academic Search Premier, Scopus, Proquest, and Expanded Academic ASAP databases for studies published between January 1995 and October 2012, using subject headings and free-text search terms (in UK and US English spelling including person-centered care, patient-centered care, resident-oriented care, Eden Alternative, Green House model, Wellspring model, long-term care, and nursing homes.Results: The search identified 323 potentially relevant articles. Once duplicates were removed, 146 were screened for inclusion in this review; 21 were assessed for methodological quality, resulting in nine articles (seven studies that met our inclusion criteria. There was only one randomized, controlled trial. The majority of studies were quasi-experimental pre-post test designs, with a control group (n = 4. The studies in this review incorporated a range of different outcome measures (ie, dependent variables to evaluate the impact of person-centered interventions on aged-care residents and staff. One person-centered intervention, ie, the Eden Alternative, was associated with significant improvements in residents' levels of boredom and helplessness. In contrast, facility-specific person-centered interventions were found to impact nurses' sense of job satisfaction and their capacity to meet the individual needs of residents in a positive way. Two studies found that person-centered care was actually associated with an

Using a Birth Center Model of Care to Improve Reproductive Outcomes in Informal Settlements-a Case Study.

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Wallace, Jacqueline

2018-06-04

The world is becoming increasingly urban. For the first time in history, more than 50% of human beings live in cities (United Nations, Department of Economic and Social Affairs, Population Division, ed. (2015)). Rapid urbanization is often chaotic and unstructured, leading to the formation of informal settlements or slums. Informal settlements are frequently located in environmentally hazardous areas and typically lack adequate sanitation and clean water, leading to poor health outcomes for residents. In these difficult circumstances women and children fair the worst, and reproductive outcomes for women living in informal settlements are grim. Insufficient uptake of antenatal care, lack of skilled birth attendants and poor-quality care contribute to maternal mortality rates in informal settlements that far outpace wealthier urban neighborhoods (Chant and McIlwaine (2016)). In response, a birth center model of maternity care is proposed for informal settlements. Birth centers have been shown to provide high quality, respectful, culturally appropriate care in high resource settings (Stapleton et al. J Midwifery Women's Health 58(1):3-14, 2013; Hodnett et al. Cochrane Database Syst Rev CD000012, 2012; Brocklehurst et al. BMJ 343:d7400, 2011). In this paper, three case studies are described that support the use of this model in low resource, urban settings.

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

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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.

Seroprevalence of hepatitis B and C viral co-infections among children infected with human immunodeficiency virus attending the paediatric HIV care and treatment center at Muhimbili National Hospital in Dar-es-Salaam, Tanzania

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Munubhi Emmanuel K

2007-11-01

Full Text Available Abstract Background With increased availability of antibiotics and antifungal agents hepatitis B virus (HBV and hepatitis C virus (HCV infections are becoming a cause for significant concern in HIV infected children. We determined the seroprevalence and risk factors for HBV and HCV among HIV infected children aged 18 months to 17 years, attending the Paediatric HIV Care and Treatment Center (CTC at Muhimbili National Hospital (MNH in Dar-es-Salaam, Tanzania. Methods Investigations included; interviews, physical examination and serology for HBsAg, IgG antibodies to HCV and alanine aminotransferase (ALT levels. HIV serostatus and CD4 counts were obtained from patient records. Results 167 HIV infected children, 88(52.7% males and 79(47.3% females were enrolled. The overall prevalence of hepatitis co-infection was 15%, with the seroprevalence of HBV and HCV being 1.2% and 13.8%, respectively. Hepatitis virus co-infection was not associated with any of the investigated risk factors and there was no association between HBV and HCV. Elevated ALT was associated with hepatitis viral co-infection but not with ART usage or immune status. Conclusion The high seroprevalence (15% of hepatitis co-infection in HIV infected children attending the Paediatrics HIV CTC at the MNH calls for routine screening of hepatitis viral co-infection and modification in the management of HIV infected children.

Management of severe childhood pneumonia by day care approach in developing countries

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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.

Improving Patient-Centered Care for Young People in General Practice With a Codesigned Screening App: Mixed Methods Study.

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Webb, Marianne Julie; Wadley, Greg; Sanci, Lena Amanda

2017-08-11

Despite experiencing a high prevalence and co-occurrence of mental health disorders and health-compromising behaviors, young people tend not to seek professional help for these concerns. However, they do regularly attend primary care, making primary care providers ideally situated to identify and discuss mental health and lifestyle issues as part of young people's routine health care. The aim was to investigate whether using a codesigned health and lifestyle-screening app, Check Up GP, in general practice influenced young people's assessment of the quality of their care (measures of patient-centered care and youth friendliness), and their disclosure of sensitive issues. In addition, this study aimed to explore young people's acceptance and experience of using a screening app during regular health care. This was a mixed methods implementation study of Check Up GP with young people aged 14 to 25 years attending a general practice clinic in urban Melbourne, Australia. A 1-month treatment-as-usual group was compared to a 2-month intervention group in which young people and their general practitioners (GPs) used Check Up GP. Young people in both groups completed an exit survey immediately after their consultation about disclosure, patient-centered and youth-friendly care, and judgment. In addition, participants in the intervention group were surveyed about app acceptability and usability and their willingness to use it again. Semistructured interviews with participants in the intervention group expanded on themes covered in the survey. The exit survey was completed by 30 young people in the treatment-as-usual group and 85 young people in the intervention group. Young people using Check Up GP reported greater disclosure of health issues (Ptime to ask questions. In all, 86% (73/85) of young people felt the app was a "good idea" and only 1% (1/85) thought it a "bad idea." Thematic analysis of qualitative interviews with 14 participants found that Check Up GP created scope

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

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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

A inclusão da criança com necessidades especiais na visão de berçaristas The inclusion of special needs children in the vision of day care center professionals

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Fabiana Cristina Frigieri de Vitta

2010-04-01

Full Text Available A inserção das crianças de zero a 18 meses em creches poderá estimular o seu desenvolvimento motor e perceptocognitivo, podendo essa fase ser considerada a primeira da educação inclusiva. Objetivou-se verificar as concepções das profissionais do berçário relativas à inserção da criança com necessidades especiais na rotina de atividades desenvolvidas. Foram entrevistadas sete berçaristas da Secretaria Municipal de Educação de Bauru. Os dados, organizados segundo categorias analíticas: conceitos relativos ao processo de inclusão, benefícios para a criança e diferenças entre as crianças nessa faixa etária, foram submetidos à análise qualitativa. Os resultados mostraram que a inclusão de crianças com necessidades especiais é vista com reservas, explicitando ideias preconcebidas sobre a deficiência. Eles se justificam pela falta de conhecimento do desenvolvimento infantil e dos fatores que o envolvem, bem como pelo fato de os profissionais vincularem suas atividades às experiências pessoais.The inclusion of children from birth to 18 months in day care centers, a phase that can be considered as the first one for inclusive education, may stimulate their motor development and perceptual-cognitive abilities. The goal of this study was to identify how people working in such centers conceive the inclusion of children with special needs in their routine activities. For such, seven women involved in a municipal day care center in the city of Bauru (SP, Brazil were interviewed. The data - organized according to three analytical categories: believes related to the inclusion process; benefits that it can bring for the child; and differences between children in this age group - were subjected to a qualitative analysis. The results indicated that the inclusion of children with special needs in day-care centers is viewed with reservations. This negative bias toward disability can be explained by the lack of knowledge related to

Palliative Care Leadership Centers Are Key To The Diffusion Of Palliative Care Innovation.

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Cassel, J Brian; Bowman, Brynn; Rogers, Maggie; Spragens, Lynn H; Meier, Diane E

2018-02-01

Between 2000 and 2015 the proportion of US hospitals with more than fifty beds that had palliative care programs tripled, from 25 percent to 75 percent. The rapid adoption of this high-value program, which is voluntary and runs counter to the dominant culture in US hospitals, was catalyzed by tens of millions of dollars in philanthropic support for innovation, dissemination, and professionalization in the palliative care field. We describe the dissemination strategies of the Center to Advance Palliative Care in the context of the principles of social entrepreneurship, and we provide an in-depth look at its hallmark training initiative, Palliative Care Leadership Centers. Over 1,240 hospital palliative care teams have trained at the Leadership Centers to date, with 80 percent of them instituting palliative care services within two years. We conclude with lessons learned about the role of purposeful technical assistance in promoting the rapid diffusion of high-value health care innovation.

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

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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

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

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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

South Florida Health Care Centers | NSU

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diagnosed with autism spectrum disorder. Optometric Care Complete range of personalized eye care delays or symptoms on the autism spectrum. Support services are also available for families with a child Segal Center provides programs for early childhood, parenting, and autism. Institutes Distance Education

Adult care transitioning for adolescents with special health care needs: a pivotal role for family centered care.

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Duke, Naomi N; Scal, Peter B

2011-01-01

To examine the relationship between having a usual source of care, family centered care, and transition counseling for adolescents with special health care needs. Data are from 18,198 parents/guardians, of youth aged 12-17 years, who participated in the 2005-2006 National Survey of Children With Special Health Care Needs. Linear and logistic regression models were used to define relationships between parent report of identification of a usual place and provider of medical care for their child and counseling on four transition issues: transfer to adult providers, review of future health needs, maintaining health insurance in adulthood, and youth taking responsibility for care. The direct mediating effect of family centered care was evaluated. Youth having a usual source of care (vs. not) were more likely to receive counseling on future health needs (47.4 vs. 33.6%, P needs (56.3 vs. 39.6%, P needs and 94.9% of the effect of a usual source of care on encouragement to take responsibility for care. Study findings support the development of health care delivery models focusing on family centered care to the same degree as other health care access issues.

"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

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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…

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

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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

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

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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.

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.

Pulmonary Hypertension Care Center Network: Improving Care and Outcomes in Pulmonary Hypertension.

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Sahay, Sandeep; Melendres-Groves, Lana; Pawar, Leena; Cajigas, Hector R

2017-04-01

Pulmonary hypertension (PH) is a chronic, progressive, life-threatening disease that requires expert multidisciplinary care. To facilitate this level of care, the Pulmonary Hypertension Association established across the United States a network of pulmonary hypertension care centers (PHCCs) with special expertise in PH, particularly pulmonary arterial hypertension, to raise the overall quality of care and outcomes for patients with this life-threatening disease. Since the inception of PHCCs in September 2014, to date 35 centers have been accredited in the United States. This model of care brings together physicians and specialists from other disciplines to provide care, facilitate basic and clinical research, and educate the next generation of providers. PHCCs also offer additional opportunities for improvements in PH care. The patient registry offered through the PHCCs is an organized system by which data are collected to evaluate the outcomes of patients with PH. This registry helps in detecting variations in outcomes across centers, thus identifying opportunities for improvement. Multiple tactics were undertaken to implement the strategic plan, training, and tools throughout the PHCC network. In addition, strategies to foster collaboration between care center staff and individuals with PH and their families are the cornerstone of the PHCCs. The Pulmonary Vascular Network of the American College of Chest Physicians believes this to be a positive step that will improve the quality of care delivered in the United States to patients with PH. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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

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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.

Pediculose nos centros de educação infantil: conhecimentos e práticas dos trabalhadores Infestión de piojos en los centros de educación infantil: conocimientos y prácticas de los trabajadores Pediculosis in children attending day care centers: knowledge and practice of workers

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Flávia Lopes Gabani

2010-06-01

ún son limitadas. Persisten muchos mitos y tabúes (que los piojos saltan, el uso de la sal, del vinagre y de la parafina, etc. Las principales dudas se relacionan con el tratamiento y la mayor dificultad que se presenta es la falta de cooperación de los padres. Por último, cabe señalar la necesidad y la importancia de que se implementen acciones intersectoriales, preventivas y sistemáticas en el ambiente escolar.This study aimed to identify and analyze knowledge and practices, about pediculosis, from employees at Child Day Care Centers at two areas of coverage of the Family Health Units, Londrina, Paraná. It's descriptive transversal study. Form was applied with questions about myths, taboos, practices, doubts and difficulties in stopping the infestation of pediculosis in eight Child Day Care Centers. Subsequently, workshop was held with educational materials. 60.4% of employees participated, those who were present on the day determined by the institution. Almost all indicated the ectoparasitic infestation, as well as their families. The problem is faced daily in Child Day Care Centers (72.1%. Practice appropriate care is still limited. Many myths and taboos persist (lice jump, use salt, vinegar and kerosene, etc. The main questions are related to treatment and the greatest difficulty is the lack of cooperation from parents. It emphasizes, finally, the need and the importance of internal actions, preventive and systematic in the school environment.

Patient-centered Fertility Care: From Theory to Practice

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Fatemeh Jafarzadeh-Kenarsari

2016-07-01

Full Text Available Background & aim: Healthcare areas, especially fertility care (commonly accompanied with high emotions, as well as long-term and recurring treatment periods could exclusively benefit from patient-centered care (PCC. Despite evident advantages of PCC, this approach has not been practiced as a routine procedure in current clinical environments yet, even in western developed countries. Therefore, this review aimed to evaluate the significance and different aspects of PCC, while emphasizing on patient-centered fertility care, its challenges, and applicable recommendations in this regard. Methods: This narrative review was conducted on 29 relevant medical and clinical papers (published during 1990-2015 collected using various national and international databases (e.g., SID, Magiran, Medlib, Google scholar, Proquest, Pubmed, Wiley, Science direct, and Scopus. Key words and phrases used in this review were “infertility”, “fertility care”, “childlessness”, “patient-centered care”, “patient-centered fertility care” “shared decision-making”, “infertile patient preferences”, and “patient involvement in fertility care”. Results: According to the literature, implementation challenges of patient-centered fertility care were reported as different individual and organizational factors. These factors include lack of professional motivation to change, underestimating the significance of patient-centeredness by healthcare professionals, difficulty in translation of feedback into concrete measures, lack of time and financial resources, insufficient experience of healthcare professionals with regard to identification of needs and preferences of patients, traditional organizational culture, and common misconceptions. Conclusion: Promotion of patient-centered fertility services requires the identification of infertile needs and priorities of individuals, designation of interventional and supportive programs based on sociocultural

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...

Stennis Space Center observes 2009 Safety and Health Day

Science.gov (United States)

2009-01-01

Sue Smith, a medical clinic employee at NASA's John C. Stennis Space Center, takes the temperature of colleague Karen Badon during 2009 Safety and Health Day activities Oct. 22. Safety Day activities included speakers, informational sessions and a number of displays on safety and health issues. Astronaut Dominic Gorie also visited the south Mississippi rocket engine testing facility during the day to address employees and present several Silver Snoopy awards for outstanding contributions to flight safety and mission success. The activities were part of an ongoing safety and health emphasis at Stennis.

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

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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.

Improving nutrition and physical activity in child care: what parents recommend.

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Benjamin, Sara E; Haines, Jess; Ball, Sarah C; Ward, Dianne S

2008-11-01

A large percentage of children in the United States spend part of their day in out-of-home child care. As rates of obesity continue to rise, especially among young children, child care has become a focus for nutrition and physical activity intervention. Parental involvement is an important component of these efforts. During summer 2006, parents of children in child care were surveyed to better understand their perceived quality of meals, snacks, and physical activity at the child-care center, and their recommendations for improvement. Parents of children who attended 94 licensed child-care centers in North Carolina were invited to complete a brief survey of perceived quality of meals, snacks, and physical activity at their centers using close-ended questions. Open-ended questions were used to identify suggestions for improvement. Five hundred eight parents from 91 child-care centers completed the questionnaire. The majority of parents reported quality of meals and snacks at the center as either excellent (30% meals, 27% snacks) or good (42% meals, 46% snacks). The main recommendations for improving meals and snacks were to increase fruits and vegetables and provide a variety of healthful foods. The majority of parents categorized the quality of physical activity at the center as excellent (36%) or good (46%), and suggested more structured, outdoor activities for children. Findings from this study provide insight into key areas of concern for parents regarding the nutrition and activity environment of child-care centers. This information may be used to create or modify interventions or policies and to help motivate parents to become advocates for change in child care.

De-hospitalization of the pediatric day surgery by means of a freestanding surgery center: pilot study in the lazio region

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Mangia Giovanni

2012-02-01

Full Text Available Abstract Background Day surgery should take place in appropriate organizational settings. In the presence of high volumes, the organizational models of the Lazio Region are represented by either Day Surgery Units within continuous-cycle hospitals or day-cycle Day Surgery Centers. This pilot study presents the regional volumes provided in 2010 and the additional volumes that could be provided based on the best performance criterion with a view to suggesting the setting up of a regional Freestanding Center of Pediatric Day Surgery. Methods This is an observational retrospective study. The activity volumes have been assessed by means of a DRG (Diagnosis Related Group-specific indicator that measures the ratio of outpatients to the total number of treated patients (freestanding indicator, FI. The included DRGs had an FI exceeding the 3rd quartile present in at least a health-care facility and a volume exceeding 0.5% of the total patients of the pediatric surgery and urology facilities of the Lazio Region. The relevant data have been provided by the Public Health Agency and relate to 2010. The best performance FI has been used to calculate the theoretical volume of transferability of the remaining facilities into freestanding surgery centers. Patients under six months of age and DRGs common to other disciplines have been excluded. The Chi Square test has been used to compare the FI of the health-care facilities and the FI of the places of origin of the patients. Results The DRG provided in 2010 amounted to a total of 5768 belonging to 121 types of procedures. The application of the criteria of inclusion have led to the selection of seven final DRG categories of minor surgery amounting to 3522 cases. Out of this total number, there were 2828 outpatients and 694 inpatients. The recourse of the best performance determines a potential transfer of 497 cases. The total outpatient volume is 57%. The Chi Square test has pointed to a statistically significant

Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

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Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

2017-03-01

International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.

Cortisol Levels and Children's Orientation in Day Care

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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…

The Study of Trichomoniasis in Pregnant Women Attending Hamadan City Health Centers in 2015

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Zarifeh Akbari

2017-04-01

Full Text Available Background Trichomoniasis is one of the most non-viral sexually transmitted diseases worldwide that causes some complications such as adverse pregnancy outcomes. Objectives The aim of this study was to determine the frequency of Trichomonas vaginalis infection among pregnant women in Hamadan, west of Iran. Methods This study was conducted on 1200 pregnant women attending the Hamadan city health centers in 2015. After gathering socio-demographic characteristics and clinical signs and symptoms of the women, first-voided morning urine was collected from the all participants and subjected to sediment wet-mount preparations and Dorset culture medium for detection of T. vaginalis. Data analysis was done using descriptive statistics and chi-square test. Results T. vaginalis was diagnosed in 0.6% (7/1200 of the urine samples using two parasitological methods. Dorset culture medium and direct wet-mount examination of the urine sediments were positive in 7 (0.6% and 4 (0.3% samples, respectively. There was no relationship between trichomoniasis and age, education, occupation, place of living, husband's job, and history of contraceptive methods (P > 0.05. Conclusions The results demonstrated the rate of T. vaginalis infection in pregnant women is relatively low in the area but, because of the importance of this issue in pregnant women, it can be substantial during antenatal care.

Thyroid Status in Patients with Type 2 Diabetes Attending a Tertiary Care Hospital in Eastern India.

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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.

Thyroid status in patients with Type 2 diabetes attending a Tertiary Care Hospital in Eastern India

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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.

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...

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...

Evaluation Of The Overload Of Care In Families Of Psychiatric Patients In Psychosocial Care Center

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Mayron Morais Almeida

2017-07-01

Full Text Available Introduction: The burden of care in family refers to the weight caused by the primary caregiver role to psychiatric patients and the difficulties encountered in performing this function in daily life. Objectives: Assessing the objective and subjective overload of family members who live with the reality of psychiatric disorder in a child day-care psychosocial care center. Methods: Cross-sectional study, descriptive-exploratory, of quantitative approach, with non-probabilistic samples of accidental type with 80 families of psychiatric patients held in a Psychosocial Care Center. For overload evaluation, the subscales "B" and "D" of the Family Overload Rating Scale (FBIS-BR were used. Results: The study was conducted with 80 families of psychiatric patients. The average age of female caregivers was 39,6 years old, and 40,7 years old for male caregivers, with female predominance (87,5% compared to men (12,5%, with low education for both genres. Family caregivers presented high objective burden due to excessive demand attention (p<0,001, heteroaggressiveness (p<0,001 and perplexing behavior of psychiatric patients regarding the supervision of problematic behaviors (p<0,001. The items on the impact on the family's daily routine have not helped to generate objective overload for the family members. On subjective overload, it was clear to observe familiar members with high degree of disturbance in all the dimensions assessed (p < 0,001. Conclusion: The high degree of care overload observed in family members indicates the need to develop contacts with the family of the psychiatric patient to answer questions, offer support and assistance to the family caregiver. Keywords: Caregivers. Patients. Mental Health Services.

Views of parents and health-care providers regarding parental presence at bedside rounds in a neonatal intensive care unit.

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Grzyb, M J; Coo, H; Rühland, L; Dow, K

2014-02-01

To examine the views of parents and health-care providers regarding parental presence during neonatal intensive care rounds. Cross-sectional survey of parents whose children were admitted to a tertiary-care neonatal intensive care unit (n=81). Medical trainees (n=67) and nurses (n=28) were also surveyed. The majority of parents reported that attending rounds reduced their anxiety and increased their confidence in the health-care team. Nurses were more likely than medical trainees to support parental presence at rounds (P=0.02). About three-quarters of medical trainees and nurses thought discussion is inhibited and 69% of trainees felt teaching is decreased when parents attend rounds. Most parents who attended rounds found the experience beneficial, but medical trainees' views were mixed. The positive impact on parents, and the learning opportunities created in family-centered care and communication when parents are present on rounds, should be highlighted for trainees and other neonatal intensive care personnel.

Validation of Using Fitness Center Attendance Electronic Records to Assess the Frequency of Moderate/Vigorous Leisure-Time Physical Activity among Adults

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Amireault, Steve; Godin, Gaston

2014-01-01

The purpose of this study was to provide three construct validity evidence for using fitness center attendance electronic records to objectively assess the frequency of leisure-time physical activity among adults. One hundred members of a fitness center (45 women and 55 men; aged 18 to 64 years) completed a self-report leisure-time physical…

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

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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

Financial performance among adult day centers: results of a national demonstration program.

Science.gov (United States)

Reifler, B V; Henry, R S; Rushing, J; Yates, M K; Cox, N J; Bradham, D D; McFarlane, M

1997-02-01

This paper describes the financial performance (defined as percent of total expenses covered by net operating revenue) of 16 adult day centers participating in a national demonstration program on day services for people with dementia, including examination of possible predictors of financial performance. Participating sites submitted quarterly financial and utilization reports to the National Program Office. Descriptive statistics summarize the factors believed to influence financial performance. Sites averaged meeting 35% of expenses from self-pay and 29% from government (mainly Medicaid) revenue, totaling 64% of all (cash plus in-kind) expenses met by operating revenue. Examination of center characteristics suggests that factors related to meeting consumer needs, such as being open a full day (i.e., 7:30 am to 6:00 pm) rather than shorter hours, and providing transportation, may be related to improved utilization and, thus, improved financial performance. Higher fees were not related to lower enrollment, census, or revenue. Adult day centers are able to achieve financial viability through a combination of operating (i.e., fee-for-service) and non-operating revenue. Operating revenue is enhanced by placing emphasis on consumer responsiveness, such as being open a full day. Because higher fees were not related to lower utilization, centers should set fees to reflect actual costs. The figure of 64% of expenses met by operating revenue is conservative inasmuch as sites included in-kind revenue as expenses in their budgeting calculations, and percent of cash expenses met by operating revenue would be higher (approximately 75% for this group of centers).

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.

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

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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.

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

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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.

Customer Quality during Prenatal Care in Health Care Centers in Tabriz City

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Jafar Sadegh Tabrizi

2015-07-01

Full Text Available Background and Objectives :  Customer Quality (CQ refers to customer’s characteristics and is concerned with the knowledge, skills and confidence of health services customers who actively participate with health team in proper decision-making, appropriate activities and changing environment and health related behaviors. The purpose of this study was measuring customer quality of pregnant women during prenatal care. Materials and Methods :  This is a cross- sectional study which was conducted with the participation of 185 pregnant women who received prenatal care from urban health centers in Tabriz city. All participants were selected randomly from 40 health centers. Customer quality was measured based on CQMH-CQ questionnaire.  Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α = 0.714. Spss v.17 was used for data analysis. Results : According to the results, the mean score of customer quality among pregnant women was (11.29± 67.79   and only %14 of the participants reported the highest customer quality score and ability of continuity of care under stressful situations. There was a positive relationship between customer quality score and visiting midwife and a better evaluation of overall quality of care, but there was inverse relationship with early registration at health centers. Conclusion :  The participation of pregnant women in service delivery process and decision-making can promote costumer quality. Furthermore, training health care providers in empowering patients and using their abilities to improve quality of care and paying attention to patient-centered care will be helpful. ​