WorldWideScience

Sample records for center day care

  1. Day Care Centers

    Data.gov (United States)

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

  2. Patterns of fecal coliform contamination in day-care centers.

    Science.gov (United States)

    Holaday, B; Pantell, R; Lewis, C; Gilliss, C L

    1990-12-01

    During a six-month period, on four separate occasions, six licensed day-care centers had cultures taken from environmental surfaces as well as the hands of children and teachers. Fecal coliforms were recovered from 64 (9.5%) of the 675 surfaces sampled. Recovery rate was not influenced by a center's socioeconomic status, time of year, or presence of children who were not toilet trained. Recovery rates did differ significantly in different areas, with the kitchen showing a relatively high recovery rate (19%), and toys and toilets showing remarkably low rates (2% and 4%). Centers with formal hand-washing procedures had lower recovery rates than those without such practices. We also demonstrated a high recovery rate from hands of staff (16%); 6% of children had positive cultures. Contamination of hands and classroom objects is a potential source for the transmission of enteric diseases for children in day-care centers. A program directed at reducing contamination would be important in preventing the spread of diarrheal illness. PMID:2270220

  3. 7 CFR 226.19a - Adult day care center provisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Adult day care center provisions. 226.19a Section 226..., DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the...

  4. Child Day Care Centers, Day Care Centers in Thomas County, GA, Published in 2010, 1:4800 (1in=400ft) scale, Thomas County BOC.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:4800 (1in=400ft) scale, was produced all or in part from Other information as of 2010. It is described as 'Day...

  5. Shared care: negotiations between families and professionals in a child day care center

    Directory of Open Access Journals (Sweden)

    Damaris Gomes Maranhão

    2007-01-01

    Full Text Available Based on a case study of a qualitative nature, this text analyzes the relationship between families and professionals in a child day care center in the process of sharing care during early childhood, using the techniques of observation, interviews and document analysis. The research studied the families and the professionals of a government-run day care center in the city of São Paulo. The conflicts between these social actors became evident, mainly, with regard to care related to feeding and hygiene. The task of sharing care demands from these professionals not only technical preparation, but training in listening to children and their families while taking their uniqueness into account, a requirement that can lead to reflections on the type of care that is most appropriate for the specificity of the group in question, considering the characteristics of locality in its historical and social context.

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

    Science.gov (United States)

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

  7. Child Day Care Centers, Day Care Center point layer, combined with pre-school points., Published in 2005, 1:4800 (1in=400ft) scale, Reno County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:4800 (1in=400ft) scale, was produced all or in part from Published Reports/Deeds information as of 2005. It is...

  8. Child Day Care Centers, Day Care Centers, Published in 2007, 1:2400 (1in=200ft) scale, Iredell County GIS.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:2400 (1in=200ft) scale, was produced all or in part from Orthoimagery information as of 2007. It is described as...

  9. Child Day Care Centers, Point layer showing day care center locations., Published in 1990, 1:600 (1in=50ft) scale, Pitt County GIS.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:600 (1in=50ft) scale, was produced all or in part from Field Survey/GPS information as of 1990. It is described...

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

    Science.gov (United States)

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

  11. The provision of staff development programs in Virginia adult day care centers

    OpenAIRE

    Hensley, A. Dawn

    1994-01-01

    This study examined a neglected area in long term care and adult day care research: staff development. The specific purposes of this study were to describe the provision of a comprehensive staff development program in adult day care centers in Virginia in order to (a) differentiate those centers providing only the minimum required inservice training from those centers providing more comprehensive staff development programs and (b) define what meaning is placed upon sta...

  12. Child Day Care Centers, Statewide Day Cares in the LDSS database., Published in 2006, 1:24000 (1in=2000ft) scale, Louisiana State University.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:24000 (1in=2000ft) scale as of 2006. It is described as 'Statewide Day Cares in the LDSS database.'. The extent...

  13. Intake of protein, calcium and sodium in public child day care centers

    OpenAIRE

    Giovana Longo-Silva; Toloni, Maysa Helena de A.; de Menezes, Risia Cristina E.; Tatiane Leocádio Temteo; Oliveira, Maria Alice A.; Leiko Asakura; Emília Chagas Costa; Taddei, José Augusto de A. C.

    2014-01-01

    OBJECTIVE: To assess calcium, protein and sodium intake, of children that attend public day-care centers and to compare it with the recommended one. METHODS: Cross-sectional descriptive study in seven public day care centers of São Paulo city, Southeast Brazil, which enrolled 366 children between 12 and 36 months of age. The data collection occurred between September and December 2010. Each day care center was evaluated for three non-consecutive days, totaling 42 days and 210 meals. Dietary i...

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

    Directory of Open Access Journals (Sweden)

    Mariana M. Santos

    2013-12-01

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

  15. 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...

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

    Directory of Open Access Journals (Sweden)

    Hosein Rohani

    2014-02-01

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

  17. Transmission of Giardia lamblia from a day care center to the community.

    Science.gov (United States)

    Polis, M A; Tuazon, C U; Alling, D W; Talmanis, E

    1986-01-01

    An outbreak of giardiasis was investigated in one urban day care center; another day care center was selected as a control. In the study day care center, 35 per cent of the children were infected. Infection was spread to at least one household contact of 47 per cent of the infected children. The data suggest person-to-person transmission of giardiasis and the need for measures to prevent its dissemination. Early recognition and treatment of Giardia lamblia infections in children may be indicated. PMID:3740341

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

    OpenAIRE

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

    2014-01-01

    Objective: To identify the age of introduction of petit suisse cheese and instant noodles in the diet of infants attending nurseries of public day care centers and to compare the nutritional composition of these foods with the healthy recommended diet (breast milk and salt meal) for this age, in order to estimate nutritional errors. Methods: Cross-sectional study of 366 children (from nine to 36 months old) who attended day care centers, whose mothers were interviewed about the age of in...

  19. Intake of protein, calcium and sodium in public child day care centers

    Directory of Open Access Journals (Sweden)

    Giovana Longo-Silva

    2014-06-01

    Full Text Available OBJECTIVE:To assess calcium, protein and sodium intake, of children that attend public day-care centers and to compare it with the recommended one.METHODS:Cross-sectional descriptive study in seven public day care centers of São Paulo city, Southeast Brazil, which enrolled 366 children between 12 and 36 months of age. The data collection occurred between September and December 2010. Each day care center was evaluated for three non-consecutive days, totaling 42 days and 210 meals. Dietary intake was assessed by a direct food weighing method. For the nutritional calculation, DietWin(r Profissional 2.0 was used, and the adequacy was calculated according to the recommendations of the National School Feeding Program for energy, protein, calcium and sodium. The calcium/protein relation was also calculated, as well as calcium density (mg/1,000kcal.RESULTS: The energy (406.4kcal, protein (18.2g and calcium (207.6mg consumption did not reach the recommended values ​​in all the evaluated day care centers. Sodium intake exceeded up to three times the recommendation. The calcium/protein ratio of 11.7mg/g was less than the adequate one (20mg/g.CONCLUSIONS: There was inadequacy of calcium, protein and sodium dietary intake, in children attending public day-care centers.

  20. An epidemiological study of Haemophilus influenzae at a Brazilian day care center

    Directory of Open Access Journals (Sweden)

    M.E. Bonifácio da Silva

    2001-10-01

    Full Text Available Day care centers are a relatively new phenomenon in Brazil that bring together large numbers of young children susceptible to contagious diseases. Haemophilus influenzae (Hi is an important infection in the age range of those attending day care centers. In the present study, the carriage rate of Haemophilus influenzae was identified in 38 day care attendees age 6 to 37 months, and 23 staff members, at a day care center in Ribeirão Preto-São Paulo, in 1997. To identify the carriers, two nasopharyngeal swabs were collected; one in July and one in December. The rate of H. influenzae carriers among the children was 77%. Only 2 of 23 staff members (9% had Hi. Among the children, there were 58 isolates in the two sampling periods; 6 of the Hi were serotype b, 1 was serotype e, and 48 isolates were non-typeable. Two were identified as H. parainfluenzae. One adult had a non-typeable Hi and 1 had H. paraphrohaemolyticus. Three of the 6 children with type B had received a conjugate vaccine against H. influenzae type b, but they still carried this bacterium in the nasopharynx (50%. Forty ribotype patterns were found among the isolates, showing a high exchange rate of nontypeable H. influenzae carriers. The results indicate that, because of the high and changing biotype of Hi carriage, day care centers should be carefully monitored as potential point source of HI disease in the community.

  1. Abandonment Fears in Persons with Alzheimer's at Adult Day Care Centers

    OpenAIRE

    Judkins, Wayne A

    1999-01-01

    In my research, I examined abandonment fears in persons with Alzheimerâ s disease at the Salem Veterans Affairs adult day care center. I observed fifty hours at the center, and conducted open-ended interviews with two of the participants and their respective caregivers. These two participants (Ellen and Opel) at the center expressed abandonment fears much more frequently than any of the other participants. I found that most of the time, these two women would express their abandonment f...

  2. Child Day Care Centers, Day_care_preschool_providers, Published in 2008, 1:600 (1in=50ft) scale, Buffalo County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:600 (1in=50ft) scale, was produced all or in part from Orthoimagery information as of 2008. It is described as...

  3. The Organization of Group Care Environments: The Infant Day Care Center.

    Science.gov (United States)

    Cataldo, Michael F.; Risley, Todd R.

    In designing group day care for infants, special attention has been given to efficient care practices, so that all the children's health needs can be met and so that the staff will have ample time to interact with the children. One efficient method is to assign each staff member the responsibility of a particular area rather than a particular…

  4. 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

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

    Directory of Open Access Journals (Sweden)

    B. Muchiutti

    2013-03-01

    Full Text Available Abstract: The aim of this study was to investigate the intestinal parasitosis prevalence of children from municipal day care centers in Sinop MT. Respecting ethical principles established by Resolution 196/96 of Health National Council/Ministry of Health of quantitative research, the anonymity of participants, as well accept and signature of parents of the Term of Free and Enlightened Consent were performed. Between Junes to October 2012 were applied coproparasitological methods for investigation. Fecal samples were analyzed by Hoffmans methods. From 103 students examined observed the prevalence rate of 19.42% of intestinal parasites. The intestinal parasites with highest prevalence rate were: Giardia lamblia (9.70% and Endolimax nana (5.82%. The results of this study demonstrate the need for sensitization of the population front of diagnosis importance, treatment and monitoring of positive cases and the necessity of more health professionals attention, especially with children.Key-words: Intestinal parasites, day care centers, children.

  6. Goodness-of-Fit in Center Day Care: Relations of Temperament, Stability, and Quality of Care with the Child's Adjustment

    Science.gov (United States)

    De Schipper, J. Clasien; Tavecchio, Louis W. C.; Van IJzendoorn, Marinus H.; Van Zeijl, Jantien

    2004-01-01

    In this study, the concept of "goodness-of-fit" between the child's temperament and the environment, introduced by Thomas and Chess [Temperament and Development, Brunner/Mazel, New York, 1977], is applied within the setting of center day care. Mothers and primary professional caregivers of 186 children, aged 6-30 months, participated in this…

  7. Tackling 30-Day, All-Cause Readmissions with a Patient-Centered Transitional Care Bundle.

    Science.gov (United States)

    Rice, Yvonne B; Barnes, Carol Ann; Rastogi, Rahul; Hillstrom, Tami J; Steinkeler, Cara N

    2016-02-01

    In 2008, Kaiser Permanente Northwest identified the transition from hospital to home as a pivotal quality improvement opportunity and used multiple patient-centered data collection methods to identify unmet needs contributing to preventable readmissions. A transitional care bundle that crosses care settings and organizational functions was developed to meet needs expressed by patients. It comprises 5 elements: risk stratification, a specialized phone number for discharged patients, timely postdischarge follow-up, standardized patient discharge instructions and same-day discharge summaries, and pharmacist-supported medication reconciliation. The transitional care bundle has been in place for 6 years. Readmission rates decreased from 12.1% to 10.6%, Hospital Consumer Assessment of Healthcare Providers and Systems scores for the discharge instruction composite moved from below the 50(th) to above the 90(th) national percentile, average time to the first postdischarge appointment decreased from 9.7 days to 5.3 days, and error rates on the discharge medication list decreased from 57% to 21% (P<.0001 for all). The program, which continues to evolve to address sustainability challenges and organizational initiatives, suggests the potential of a multicomponent, patient-centered care bundle to address the complex, interrelated drivers of preventable readmissions. PMID:25919315

  8. 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...

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

    Directory of Open Access Journals (Sweden)

    Maysa Helena de A. Toloni

    2014-03-01

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

  10. Home-Type Activities at the Day Care Center. (Tipos De Actividades Del Hogar En El Centro De Cuidado Diario.)

    Science.gov (United States)

    Aaronson, May; Moberg, Patricia E.

    This paper argues that home activities comprise a valuable unplanned curriculum and that many of these activities can be transferred to the day care center. It is suggested that these activities foster a closer relationship between child and caregiver and bridge the gap between familiar home environment and novel day care setting. Home activities…

  11. Child Day Care Centers, Published in 2008, 1:1200 (1in=100ft) scale, Brown County, WI.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:1200 (1in=100ft) scale, was produced all or in part from Published Reports/Deeds information as of 2008. Data by...

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

    Directory of Open Access Journals (Sweden)

    Enserink Remko

    2012-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Semíramis Guimarães

    2002-02-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Guimarães Semíramis

    2002-01-01

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

  15. "Prevalence of Intestinal Parasites among Children in Day-care Centers in Damghan - Iran"

    Directory of Open Access Journals (Sweden)

    A Heidari

    2003-07-01

    Full Text Available In order to identify the prevalence of parasitic intestinal infections and to determine the impact of some factors, such as age, health houses, education, environmental health etc, on infection, this survey was carried out on 461 stool specimens and scotch tapes obtained from children resident in day-care centers in Damghan city, Semnan province, Iran. The samples were tested using formalin-ether concentration and Graham methods. The analysis of the results showed that at least 68.1 percent of the individuals tested, were infected with one species of pathogen or non-pathogen parasites. The rate of infection for Enterobius vermicularis, Giardia lamblia, Entamoeba histolytica, Ascaris lumbricoides, Hymenolepis nana, Entamoeba coli, Blastocystis hominis, Iodamoeba butschlii and Chilomastix mesnili was 33.8%, 26.2%, 2.4%, 3%, 4.8%, 5.8%, 4.8%, 2.7% and 4% respectively. A significant difference was seen between the rate of infection and parents’ education (P<0.005 but was negative regarding age, sex, and health houses. It is concluded that sanitary measurements should be conducted in such centers to decrease the rate of parasitic infection.

  16. Soil pollution in day-care centers and playgrounds in Norway: national action plan for mapping and remediation.

    Science.gov (United States)

    Ottesen, Rolf Tore; Alexander, Jan; Langedal, Marianne; Haugland, Toril; Høygaard, Erik

    2008-12-01

    Systematic geochemical mapping based on sampling and analysis of surface soils (0-2 cm) has been carried out in several Norwegian cities. The soils in the oldest parts of the cities are contaminated with metals (especially Pb) and polycyclic aromatic hydrocarbons (PAH). Due to the fact that children are often in contact with surface soil, it was realized that special focus had to be directed towards soils in day-care centers and playgrounds. The first mapping and remedy program was initiated in Trondheim in 1996. Here, the importance of copper-chromium-arsenic (CCA)-pressure-impregnated wood in playing equipment as a pollution source for soils was documented, and a process was started with the aim to ban this product. Soils from day-care centers in the inner city of Bergen were polluted to a degree that required remediation in 45% out of 87 centers, mainly due to high concentrations of Pb and benzo(a)pyrene. In Oslo, 38% of 700 day-care centers needed remediation due to soil pollution by Pb, BaP, Cd, Hg, Ni and PCB. Removal of CCA-impregnated wood was necessary in more than half of the day-care centers The Norwegian parliament has decided to investigate all outdoor playing areas in day-care centers, playgrounds and schoolyards in Norway, starting in 2007 with day-care centers in the ten largest cities and five most important industrial areas. The Norwegian Institute of Public Health has developed quality criteria for soils in day-care centers and playgrounds for As, Cd, Cr(6+), Hg, Ni, Pb, zinc, PAH(sum16), benzo(a)pyrene, and PCB(sum7). The Geological Survey of Norway has developed guidance for mapping of soil pollution (sampling, chemical analysis and reporting) in day-care centers. Especially the sampling strategy has been developed in the period 1996-2007, and the preferred sampling strategy is to collect at least 10 samples of surface soil (0-2 cm) from (1) "original soil" on the site, (2) artificial man-made "hills", and (3) soils used for growing vegetables

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

    Directory of Open Access Journals (Sweden)

    Sanches Ilda Santos

    2003-07-01

    Full Text Available Abstract Background EURIS (European Resistance Intervention Study was launched as a multinational study in September of 2000 to identify the multitude of complex risk factors that contribute to the high carriage rate of drug resistant Streptococcus pneumoniae strains in children attending Day Care Centers in several European countries. Access to the very large number of data required the development of a web-based infrastructure – EURISWEB – that includes a relational online database, coupled with a query system for data retrieval, and allows integrative storage of demographic, clinical and molecular biology data generated in EURIS. Methods All components of the system were developed using open source programming tools: data storage management was supported by PostgreSQL, and the hypertext preprocessor to generate the web pages was implemented using PHP. The query system is based on a software agent running in the background specifically developed for EURIS. Results The website currently contains data related to 13,500 nasopharyngeal samples and over one million measures taken from 5,250 individual children, as well as over one thousand pre-made and user-made queries aggregated into several reports, approximately. It is presently in use by participating researchers from three countries (Iceland, Portugal and Sweden. Conclusion An operational model centered on a PHP engine builds the interface between the user and the database automatically, allowing an easy maintenance of the system. The query system is also sufficiently adaptable to allow the integration of several advanced data analysis procedures far more demanding than simple queries, eventually including artificial intelligence predictive models.

  18. Practice versus politics in Danish day-care centers: how to bridge the gap?

    DEFF Research Database (Denmark)

    Clasen, Line; Jensen de López, Kristine M.

    2016-01-01

    or the programme users’ perspectives. This study sheds light on the practices of Danish pedagogues when engaging in shared book reading with children with the aim of: (1) foreseeing the success of the implementation of the first Danish ELP; and (2) comparing day-care centres’ practices to Danish ‘New Nordic School......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...

  19. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center

    OpenAIRE

    Leppert, Wojciech; Majkowicz, Mikolaj; Forycka, Maria; Mess, Eleonora; Zdun-Ryzewska, Agata

    2014-01-01

    Aim of the study To assess quality of life (QoL) in cancer patients treated at home, at an in-patient palliative care unit (PCU), and at a day care center (DCC). Patients and methods QoL was assessed in advanced cancer patients at baseline and after 7 days of symptomatic treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL), the Edmonton Symptom Assessment System (ESAS), and the Karnofsky Perfor...

  20. Malaysia's First Day Care Center for Children with Disabilities: Future Needs in Research in Early Intervention.

    Science.gov (United States)

    Bhagwanji, Yash

    This paper describes the development and implementation of the first private nonprofit day care program serving children with disabilities in Malaysia. Preliminary information describes Malaysia's economic, ethnic, and cultural situation. The naturalistic inquiry approach used to prepare this report, involving interviews and observations, is then…

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

    Science.gov (United States)

    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…

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  3. Sociocognitive determinants of observed and self-reported compliance to hand hygiene guidelines in child day care centers

    NARCIS (Netherlands)

    Zomer, T.P.; Erasmus, V.; Empelen, P. van; Looman, C.; Beeck, E.F. van; Tjon-A-Tsien, A.; Richardus, J.H.; Voeten, H.A.C.M.

    2013-01-01

    Background: Although hand hygiene (HH) has proven to be an effective measure to prevent infections, HH compliance is generally low. We assessed sociocognitive determinants of caregivers' HH behavior in child day care centers (DCCs) to develop an effective HH intervention. Methods: Caregivers' compli

  4. Bacillus cereus food poisoning associated with fried rice at two child day care centers--Virginia, 1993.

    Science.gov (United States)

    1994-03-18

    Bacillus cereus, an infectious cause of foodborne illness, accounted for 2% of outbreaks with confirmed etiology that were reported to CDC during 1973-1987 (1). On July 21, 1993, the Lord Fairfax (Virginia) Health District received reports of acute gastrointestinal illness that occurred among children and staff at two jointly owned child day care centers following a catered lunch. This report summarizes the investigation of this outbreak. PMID:8121375

  5. 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.

  6. Quality of post arrest care does not differ by time of day at a specialized resuscitation center.

    Science.gov (United States)

    Uray, Thomas; Sterz, Fritz; Weiser, Christoph; Schreiber, Wolfgang; Spiel, Alexander; Schober, Andreas; Stratil, Peter; Mayr, Florian B

    2015-04-01

    Previous studies suggest worse outcomes after out-of-hospital cardiac arrest (OHCA) at night. We analyzed whether patients admitted after nontraumatic OHCA to a resuscitation center received the same quality post arrest care at day and night and whether quality of care affected clinical outcomes. We analyzed data of OHCA patients with return of spontaneous circulation admitted to the Vienna general hospital emergency department between January 2006 and May 2013. Data reported include admission time (day defined from 8 AM to 4 PM based on staffing), time to initiation of hypothermia, and door-to-balloon time in patients with ST-elevation myocardial infarction. Survival and cognitive performance at 12 months were assessed. In this retrospective observational study, 1059 patients (74% males, n = 784) with a mean age of 58 ± 16 years were analyzed. The vast majority was treated with induced hypothermia (77% of day vs. 79% of night admissions, P = 0.32) within 1 hour of admission (median time admission to cooling 27 (confidence interval [CI]: 10-60) vs. 23 (CI: 11-59) minutes day vs. night, P = 0.99). In 298 patients with ST-elevation myocardial infarction, median door-to-balloon time did not differ between day and night admissions (82 minutes, CI: 60 to 142 for day vs. 86 minutes, CI: 50 to 135 for night, P = 0.36). At 12 months, survival was recorded in 238 of 490 day and 275 of 569 night admissions (49% vs. 48%, P = 0.94%), and a good neurologic outcome was recorded in 210 of 490 day and 231 of 569 night admissions (43% vs. 41%, P = 0.46). Patients admitted to our department after OHCA were equally likely to receive timely high-quality postresuscitation care irrespective of time of day. Survival and good neurologic outcome at 12 months did not differ between day and night admissions. Our results may support the concept of specialized post arrest care centers.

  7. How do Danish high quality day care centers sustain children’s learning outcome and how can this be measured?

    DEFF Research Database (Denmark)

    Næsby, Torben; Miller, Tanja

    2016-01-01

    in Denmark.In a formal study the new items and the rating scales are being tested in several communities and municipalities. Data consist of scored scales from approximately 80 day care centers and observations made by our staff. Based on the concepts of the bio-ecological systems theory (e.g. Bronfenbrenner...... further into this and how it is applied across contexts. We include a database (www.legetek.dk) consisting of scores of children´s learning measured in subscales developed upon the theory of proximal processes (Bronfenbrenner 1979; Vygotsky 1978) and practice in Danish early childhood provisions...

  8. Prevalence of Pharyngeal Pneumococcal Carriers and Succeptibility Patterns among Children of Day Care Centers in Yazd District,Iran

    Directory of Open Access Journals (Sweden)

    M Mohammad - Zadeh

    2004-04-01

    Full Text Available Introduction: Streptococcus pneumoniae is one of the most important causes of pneumonia, meningitis and septicemia. Decades after successful treatment of this infection with penicillin, frequency of penicillin resistance is reportedly on the rise throughout the world. This cross sectional study was designed in Yazd to determine the prevalence of pneumococcal pharyngeal carriers and its succeptibility pattern in children of day care centers. Method & materials : Two hundred children were selected randomly from 10 day care centers and pharyngeal swabs were collected and cultured in February, 2002. Results :51% of our study sample were boys and 49% were girls. Their age range was between 7 and 65 months. Prevalence of pharyngeal carriers was 37.5%. The rate of resistance detected was as follows: 50% to penicillin, 62.5% to erythromycin and TMP,SMX, 30.6% to tetracycline, 15.3 % to cephalothin, 5.6% to ceftizoxime and 4.2% to ciprofloxacin. Conclusion: We conclude that penicillin is not the drug of choice in invasive pneumococcal infections in Yazd and a third gereration cephalosporin should be used instead as the first line of treatment while awaiting the culture and sensitivity results.

  9. Relationships of oral habits, oral status and lisping among children in day-care centers of Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Soudabeh Noori

    2012-12-01

    Full Text Available Background and Aim: Oral habits have hazardous effects on children's speech which are sometimes irreversible and permanent. This study was planned to assess these oral habits among children in day-care centers of Tehran, Iran.Methods: In this descriptive, cross-sectional study, 400 children were selected through multistage sampling from 16 day-care centers in Tehran, Iran, They were 24 to 72-month old. Bottle feeding, pacifier usage and digit sucking were determined. After interviewing parents, oral examination [using Paediatric oral skills package (POSO] and doing standard Phonetic test, a questionnaire was completed for each child.Results: Sixty eight had one oral habit. The most prevalent habit was digit sucking (52.9%. The prevalence of bottle feeding, both digit sucking with bottle feeding, and pacifier habit were 38.2%, 7.3% and 1.4%, respectively. There were significant relationship between digit sucking and malocclusion (p<0.001, r=0.4 and hard palate malformationand (p<0.001, r=0.39. Besides, a significant relationship between bottle feeding and  malocclusion (p<0.001, r=0.25 was conduted. Digit sucking had significant relationship with lisping, too (p<0.001, r=0.37. There was no gender priority in oral habits.Conclusion: Oral habits cause permanent structural conversion in speech producing and oral status.

  10. Attendance at day care centers increases the risk of childhood pneumonia among the urban poor in Fortaleza, Brazil

    Directory of Open Access Journals (Sweden)

    Walter Fonseca

    1996-06-01

    Full Text Available We carried out a case-control study to investigate risk factors for childhood pneumonia in two groups of 650 children aged under two years in the city of Fortaleza, Ceará, Brazil. The cases were children recruited at the main pediatric hospital with a radiological diagnosis of pneumonia, and controls were children of the same age group recruited from the neighbourhood of the cases. In this paper we focus on variables related to childcare practices. Working mothers, proportion of time the mother had worked since the child was born, and use of day care centers emerged as important risk factors with estimated relative risks of 1.58, 1.76 and 5.22, respectively. Also important were the number of children living in the house and presence of grandparents. However, the presence of siblings under two years and the birth order were not associated with pneumonia. All analysis included adjustment for confounding by income, parents' education, and other risk factors as appropriate. This is the first study from a developing country to identify attendance at day care centers as a risk factor for increased childhood morbidity, in this case pneumonia. This finding is of significant public health importance for countries such as Brazil with growing urban populations and an increasing need by mothers to find work outside the home.

  11. Attendance at day care centers increases the risk of childhood pneumonia among the urban poor in Fortaleza, Brazil

    Directory of Open Access Journals (Sweden)

    Fonseca Walter

    1996-01-01

    Full Text Available We carried out a case-control study to investigate risk factors for childhood pneumonia in two groups of 650 children aged under two years in the city of Fortaleza, Ceará, Brazil. The cases were children recruited at the main pediatric hospital with a radiological diagnosis of pneumonia, and controls were children of the same age group recruited from the neighbourhood of the cases. In this paper we focus on variables related to childcare practices. Working mothers, proportion of time the mother had worked since the child was born, and use of day care centers emerged as important risk factors with estimated relative risks of 1.58, 1.76 and 5.22, respectively. Also important were the number of children living in the house and presence of grandparents. However, the presence of siblings under two years and the birth order were not associated with pneumonia. All analysis included adjustment for confounding by income, parents' education, and other risk factors as appropriate. This is the first study from a developing country to identify attendance at day care centers as a risk factor for increased childhood morbidity, in this case pneumonia. This finding is of significant public health importance for countries such as Brazil with growing urban populations and an increasing need by mothers to find work outside the home.

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

    Directory of Open Access Journals (Sweden)

    AMV Silva

    2001-11-01

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

  13. Prisoners of the Method: Breaking Open the Child-Centered Pedagogy in Day Care Centres.

    Science.gov (United States)

    Singer, Elly

    1996-01-01

    Examines basic concepts forming the foundation for professional care and education of young children and how these concepts may impede interaction between teachers or caregivers and children. Critiques the concepts of natural development, developmentally appropriate curriculum, and child centeredness. Advocates increased scaffolding, increased…

  14. Ventilation in day care centers and sick leave among nursery children

    DEFF Research Database (Denmark)

    Kolarik, Barbara; Andersen, Z. Jovanovic; Ibfelt, T.;

    2015-01-01

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

  15. Child Day Care Centers, Published in 2007, 1:63360 (1in=1mile) scale, S-RCAA, Inc. Head Start/Early Head Start.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:63360 (1in=1mile) scale, was produced all or in part from Hardcopy Maps information as of 2007. Data by this...

  16. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center

    Directory of Open Access Journals (Sweden)

    Leppert W

    2014-05-01

    Full Text Available Wojciech Leppert,1 Mikolaj Majkowicz,2 Maria Forycka,1 Eleonora Mess,3 Agata Zdun-Ryzewska2 1Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland; 2Department of Quality of Life Research, Gdansk Medical University, Gdansk, Poland; 3Palliative Care Nursing Department, Wroclaw Medical University, Wroclaw, Poland Aim of the study: To assess quality of life (QoL in cancer patients treated at home, at an in-patient palliative care unit (PCU, and at a day care center (DCC. Patients and methods: QoL was assessed in advanced cancer patients at baseline and after 7 days of symptomatic treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL, the Edmonton Symptom Assessment System (ESAS, and the Karnofsky Performance Status (KPS scale. Results: A total of 129 patients completed the study, with 51 patients treated at home, 51 patients treated at the PCU, and 27 patients at DCC. In the EORTC QLQ-C15-PAL, improvement in functional and symptom scales was observed except in physical functioning and fatigue levels; patients at DCC had a better physical functioning, global QoL, appetite, and fatigue levels. In the ESAS, improvement in all items was found except for drowsiness levels, which was stable in patients treated at DCC and deteriorated in home and PCU patients. Higher activity, better appetite and well-being, and less drowsiness were observed in patients treated at DCC. KPS was better in DCC patients compared to those treated at home and at the PCU; the latter group deteriorated. Conclusions: QoL improved in all patient groups, with better results in DCC patients and similar scores in those staying at home and at the PCU. Along with clinical assessment, baseline age, KPS, physical and emotional functioning may be considered when assigning patients to care at a DCC, PCU, or at home. Keywords: oncology, patient care

  17. Do environmental influences alter motor abilities acquisition? A comparison among children from day-care centers and private schools

    Directory of Open Access Journals (Sweden)

    Barros Karla Mônica F. T. de

    2003-01-01

    Full Text Available Development occurs in a proper rhythm as result of genetic inheritance and environment factors. This study had the aim to identify some environmental risk factors for the motor development in two groups of healthy children. 100 pre-school aged (five years children from two day-care centers and a private school were evaluated, in Recife-PE. All the children underwent to a motor skills assessment and their parents answered a questionnaire. The children from the public nursery remained behind in fine motor skills. The results showed that the biologically healthy children development can suffer negative influence of the environmental risk factors. In this research these factors were: the father absence, improper toys use to the correct age, the place were the child was kept in the early childhood, the lack of pedagogical guidance and extra-parental socialization and low familiar socioeconomic status.

  18. Um estudo sobre creches como ambiente de desenvolvimento A study on day-care centers as development context

    Directory of Open Access Journals (Sweden)

    Ana Beatriz Rocha Lima

    2006-12-01

    Full Text Available Preparar o ambiente de sala para crianças entre quatro e 36 meses tem sido um desafio para a educação infantil - EI. A despeito do fato de crianças pequenas serem tradicionalmente educadas no seio da família, o número de pais que procuram escolas de educação infantil vem crescendo rapidamente. Por isso, estudar as possibilidades da sala e da instituição para estas crianças constitui, hoje, um importante tema de investigação. Diversas áreas de conhecimento discutem o impacto do ambiente no comportamento e no desenvolvimento das crianças pequenas, como também nas interações e ações dos envolvidos no processo educativo. Avaliar a qualidade do ambiente para essas crianças é, portanto, primordial. Na pesquisa, avaliamos todas as creches de um município de Santa Catarina - um total de doze salas - utilizando a escala Iters-R, traduzida e testada para o português. Os itens Atividades e Cuidado Pessoal tiveram os escores médios mais baixos em todas as instituições; Interação e Pais e equipe, os escores médios mais altos. Quanto às turmas, as de três anos foram as que apresentaram os piores resultados. A utilização desse instrumento desencadeia discussões produtivas sobre a qualidade do ambiente para crianças pequenas.Preparing the classroom environment for babies and toddlers has been a current challenge for day care center's professionals all over the world. Despite the fact that young children in Brazil have been traditionally looked after by family members, the number of parents looking for quality day care centers is growing rapidly. Therefore, having groups of babies and toddlers attending such centers from a very early age has proved to be a topic worth studying. Many disciplines have emphasized that context is an important aspect to consider, since it has a great impact on development. Assessing the quality of the environment prepared for young children in Brazil is, consequently, of utmost importance. This

  19. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center

    OpenAIRE

    Leppert, Wojciech

    2014-01-01

    Wojciech Leppert,1 Mikolaj Majkowicz,2 Maria Forycka,1 Eleonora Mess,3 Agata Zdun-Ryzewska2 1Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland; 2Department of Quality of Life Research, Gdansk Medical University, Gdansk, Poland; 3Palliative Care Nursing Department, Wroclaw Medical University, Wroclaw, Poland Aim of the study: To assess quality of life (QoL) in cancer patients treated at home, at an in-patient palliative care unit (PCU), and at a day care...

  20. Reduction of particulates in a child-day-care center; Reductie van de fijn- en ultrafijnstof in een kinderdagverblijf

    Energy Technology Data Exchange (ETDEWEB)

    Broek, R.; Vons, V. [Virus Free Air VFA, Delft (Netherlands); Jacobs, P. [Afdeling Energy and Comfort Systems, TNO, Delft (Netherlands)

    2012-10-15

    During a practical test an innovative low pressure induct filtration system has been tested on the air inlet of a child day care center. Bottom line is that a significant amount of fine and ultrafine particles were captured from the inlet air while generating little pressure loss. 85% reduction in nano-particles with only 25 Pa pressure drop, is one of the results. This promising filtration system makes it possible to effectively clean the air supply before it is spread throughout the building. Due to low pressure drop larger airflows can be let in a very energy efficient way. This provides a good solution for improving existing as well as new ventilation systems. Conventional F- or H-filters can be replaced or complemented [Dutch] Voldoende frisse lucht in gebouwen is belangrijk. Professionals in de gezondheidszorg adviseren ventilatie om bijvoorbeeld luchtwegklachten te verminderen. Tevens is aangetoond dat productiviteit en welbevinden bevorderd worden naarmate er voldoende frisse lucht aanwezig is. Echter, zomaar buitenlucht direct naar binnen blazen om te ventileren kan in veel gevallen ook negatieve gevolgen hebben, aangezien met de ventilatielucht ook fijnstof naa rbinnenkomt. In de VS is aangetoond dat in gebouwen waarin minder geventileerd werd, mensen minder blootgesteld werden aan fijnstof. Bij deze mensen traden ook minder COPD, hartklachten en longontsteking op. Met name het ultrafijnstof (<0,1 micrometer) is schadelijk. In stedelijke omgeving is dit vooral afkomstig van (diesel) verkeer.

  1. QuickStats: Percentages* of Residential Care Communities and Adult Day Services Centers That Provided(†) Selected Services - United States, 2014.

    Science.gov (United States)

    2016-01-01

    In 2014, a greater percentage of residential care communities than adult day service centers provided five of seven selected services. The majority of residential care communities provided pharmacy services (82%); followed by transportation for social activities (79%); physical, occupational, or speech therapy (69%); hospice (62%); skilled nursing (59%); and mental health services (52%). Fewer than half provided social work services (48%). The majority of adult day services centers provided transportation for social activities (69%); skilled nursing (66%); and social work (52%). %). Fewer than half provided physical, occupational, or speech therapy (49%). One third or less provided mental health (33%), pharmacy (27%), and hospice services (12%). PMID:27607333

  2. Maryland Day Care Voucher System.

    Science.gov (United States)

    Hildebrand, Joan M.

    This manual was written to assist States and other governmental units wishing to replicate the Maryland Day Care Voucher Program, a system of providing child care subsidies to eligible families. Chapter I provides brief histories of day care in Maryland and that State's grant to demonstrate the viability of a day care voucher system. Chapter II…

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

    OpenAIRE

    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: 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, i...

  4. How a Young Child Learns How to Take Part in Mealtimes in a Japanese Day-Care Center: A Longitudinal Case Study

    Science.gov (United States)

    Ishiguro, Hiroaki

    2016-01-01

    This research is a longitudinal, ethnographic study that focuses on mealtimes with one boy from 9 to 78 months of age in a day-care center in Japan. It looks at routine interactions between a child, his nursery teachers, and the environment, which is a shared and mutually available communicative space between participants in collaboration. The aim…

  5. Cortisol Patterns at Home and Child Care: Afternoon Differences and Evening Recovery in Children Attending Very High Quality Full-Day Center-Based Child Care

    Science.gov (United States)

    Watamura, Sarah E.; Kryzer, Erin M.; Robertson, Steven S.

    2008-01-01

    Previous work has found that many young children show different patterns of production of the hormone cortisol, which is sensitive to stress and challenge, on days when they are at child care compared with days when they are at home. At home, preschool age children typically show a decreasing pattern of cortisol production across the day which is…

  6. Day Care Services: Industry's Involvement. Bulletin 296.

    Science.gov (United States)

    Besner, Arthur

    This bulletin provides an overview of the need for services for the children of working mothers. Topics discussed include historical developments in industry day care programs, alternative roles for industry involvement, costs of operating day care centers, and income tax allowances. Also given are examples of unique programs which suggest various…

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

    Directory of Open Access Journals (Sweden)

    Mani S

    2010-06-01

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

  8. Day Care for America's Children.

    Science.gov (United States)

    LaCrosse, E. Robert

    High quality day care is a pressing social need for the 1970's. Factors responsible for the strong interest in day care include pressures for welfare reform, the growing number of women in the labor force, minority pressures for equal opportunities, and research findings stressing the importance of development during the early years of a child's…

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

    Directory of Open Access Journals (Sweden)

    Marina Vieira da Silva

    1998-06-01

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

  10. Day-Care in Denmark

    DEFF Research Database (Denmark)

    Bundgaard, Helle

    2011-01-01

      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...... 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...... which structure daily socialization practices in a Danish day-care, and by implication in Danish society....

  11. [The role of a day care center for sick children in the convalescent stage to enable female medical practitioners to successfully continue their careers].

    Science.gov (United States)

    Kizuki, Noyuri

    2013-11-01

    From my experience of child rearing difficulties, when I decided to start a private practice, I planned to have a day care center for sick children in the convalescent stage in the same building to help working mothers, especially those employed in the provision of critical medical services to the community. Financial support was obtained from the city where the clinic exists, and the facility was built that satisfied the requirements of this purpose. I believe that the female surgeons are an especially important personnel resource of Japan's medical services, because surgeons are decreasing in number these days. However, sometimes, qualified medical practitioners, such as surgeons, have to give up their careers because of the difficulty of raising children and working at the same time, especially when their children become ill. The number of these types of day care centers should be increasing, along with necessary support systems to be established immediately, so that female professionals, most particularly in medical facilities, can continue successful careers. PMID:24358733

  12. Blastocystis hominis: occurrence in children and staff members of municipal day-care centers from Botucatu, São Paulo State, Brazil

    Directory of Open Access Journals (Sweden)

    Semíramis Guimarães

    1993-09-01

    Full Text Available To study the frequency of Blastocystis hominis among healthy individuals, feces were collected from 153 children and 20 staff members of some municipal day-care centers. Three separate stool specimens of each individual were processed by Lutz and Faust methods. From 173 studied individuals, 60 (34.7% showed B. hominis, frequently in association with other intestinal parasites and/or commensals. B. hominis was found mainly in adults and children between 36 and 72 months old. All positive cases were detected only by Lutz method and the use of three stool specimens increased the positivity of the parasitological diagnostic.

  13. Patient-centered Care.

    Science.gov (United States)

    Reynolds, April

    2009-01-01

    Patient-centered care focuses on the patient and the individual's particular health care needs. The goal of patient-centered health care is to empower patients to become active participants in their care. This requires that physicians, radiologic technologists and other health care providers develop good communication skills and address patient needs effectively. Patient-centered care also requires that the health care provider become a patient advocate and strive to provide care that not only is effective but also safe. For radiologic technologists, patient-centered care encompasses principles such as the as low as reasonably achievable (ALARA) concept and contrast media safety. Patient-centered care is associated with a higher rate of patient satisfaction, adherence to suggested lifestyle changes and prescribed treatment, better outcomes and more cost-effective care. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store. According to one theory, most patients judge the quality of their healthcare much like they rate an airplane flight. They assume that the airplane is technically viable and is being piloted by competent people. Criteria for judging a particular airline are personal and include aspects like comfort, friendly service and on-time schedules. Similarly, patients judge the standard of their healthcare on nontechnical aspects, such as a healthcare practitioner's communication and "soft skills." Most are unable to evaluate a practitioner's level of technical skill or training, so the qualities they can assess become of the utmost importance in satisfying patients and providing patient-centered care.(1). PMID:19901351

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

    Directory of Open Access Journals (Sweden)

    Letícia Baltieri

    2010-09-01

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

  15. Emotional Exhaustion in Day-Care Workers

    Science.gov (United States)

    Løvgren, Mette

    2016-01-01

    Although childcare workers have the second-worst occupation for work-related health problems and the number of professional day-care centers is growing throughout Europe, few studies have examined these workers' emotional well-being. This study investigates the effect of position, competence, work role, role clarity, and work tasks on emotional…

  16. Should day care be subsidized?

    OpenAIRE

    Domeij, David; Klein, Paul

    2010-01-01

    In an economy with distortionary taxes on labor, can subsidies on day care, financed by an increase in taxes, raise welfare by encouraging women with small children to work? We show, within a heterogeneous-agent life-cycle framework, that the Ramsey optimal policy consists in equalizing consumption/leisure wedges over the life cycle and across agents. A simple way to implement this is to make day care expenses tax deductible. Calibrating our model to Germany, we find that tax deductibility fo...

  17. Child Day Care Centers, Located during MicroData field address collection 2004-2006. Kept in Spillman database for retrieval., Published in 2004, Vilas County Land Information/Mapping.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, was produced all or in part from Field Observation information as of 2004. It is described as 'Located during MicroData field...

  18. Child Day Care Centers, Part of our City of Hutchinson polygon building footprint layer and the list was/is derived from the fire department, Published in 2006, 1:600 (1in=50ft) scale, City of Hutchinson.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:600 (1in=50ft) scale, was produced all or in part from Orthoimagery information as of 2006. It is described as...

  19. 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,…

  20. Unnoticed professional competence and knowledge in day care work

    DEFF Research Database (Denmark)

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

    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...

  1. 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 Center for GIS.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:2400 (1in=200ft) scale, was produced all or in part from Other information as of 2012. It is described as 'This...

  2. Day Care Programs: A Part of the Educational Continuum.

    Science.gov (United States)

    Blackwell, Jacqueline; Leeper, Sarah H.

    In order to determine the effect of day care center sponsorship on children's development, the authors examined the ways in which programs, objects and materials, and teacher/child interactions affected the preoperational behavior of 4-year-old black children in publicly and privately supported day care centers. A total of 120 4-year-olds (30 from…

  3. CURRICULUM GUIDE, CHILD CARE CENTERS.

    Science.gov (United States)

    California State Dept. of Education, Sacramento.

    CALIFORNIA CHILD CARE CENTERS WERE ESTABLISHED IN 1943 TO SUPPLY SERVICES TO CHILDREN OF WORKING MOTHERS. THE CHILD CARE PROGRAM PROVIDES, WITHIN NURSERY AND SCHOOLAGE CENTERS, CARE AND EDUCATIONAL SUPERVISION FOR PRESCHOOL AND ELEMENTARY SCHOOL AGE CHILDREN. THE PHILOSOPHY OF THE CHILD CENTER PROGRAM IS BASED UPON THE BELIEF THAT EACH CHILD…

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

    Directory of Open Access Journals (Sweden)

    Terhi Tapiainen

    Full Text Available BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

  5. Prevalence of the Precocious Caries in Infancy in Children of 6 the 36 Months in Public Day-Care Centers of Caruaru/PE, Brazil

    Directory of Open Access Journals (Sweden)

    Shirley Suely Veras Vieira MACIEL

    2007-03-01

    Full Text Available Objective: Describe the prevalence of the precocious caries in infancy in children of 6 the 36 months in public day-care centers of Caruaru-PE, and its association with characteristics of the child, as well as analyzing the knowledge of the responsible parents or related the buccal health. Method: The study drawing is of the type transversal cut (to cross-over. Had been collected through information on knowledge related to the buccal health, as well as had been examined to the dental conditions of the children and through the Sinasc the characteristics of the gestation, the childbirth and the child had been collected. For the tests of association for chi-squared (x2 to evaluate the relationship between the dependent variable (ceo-d and the independent variable, the Program was used Epi-info version 6.04. Results: Of the total of 168 studied children, on average examined 14.65 teeth for child. Of these 62.3% were healthy and carious only 3.3%. 92.9% of the parents had knowledge of that the teeth of its children were of milk and knew of its importance; 78.6% already brushed teeth of the children; 74.4% knew as they were the teeth of the children, although only 16.2% to identify carie would indent and 6.0% to tell that the son had tooth ache. But 12.5% had been to the dentist, being 27.3% for revision and control. Of 22.6% of the children who had caries, 79.4% of them consumed nocturnal baby’s bottle, being that 40.7% of them sweetened; 30.4% consumed candies between the meals increasing this consumption to the 25 months of age. Conclusion: The dental caries increases in function of the age in consequence of the increase of the eruption tooth number and the consumption of sugar in the diet.

  6. Varicella zoster in children attending day care centers Varicela-zóster em crianças que frequentam creches

    Directory of Open Access Journals (Sweden)

    Ricardo Marcitelli

    2006-04-01

    Full Text Available OBJECTIVE: To describe morbidity associated to varicella in children attending day care centers. METHODS: Descriptive study carried out through inquiries with parents of 664 children who acquired varicella after admission to day care centers in Taubaté (population: 244,165, census of 2004, a prosperous city in the State of São Paulo. RESULTS: The median age was 36 months (range 6 to 80 months; 8.4% of the children had varicella before 1 year of age. The main symptoms were: exanthema (100.0%, fever (85.4% anorexia (39.6%, and headache (15.3%. 517 children (77.9% had at least 1 medical visit, and 80.6% received at least 1 medication; 73 (11.0% received nonsteroidal antiinflammatory drugs, and 52 (7.8% received antibiotics. Complications occurred in 38 children (5.7%; 95% confidence interval: 3% - 8%; 8 (1.2% were hospitalized, and 5 (0.7% had sequelae. Complications and hospitalizations rates were 3 times more frequent in children with less than 1 year of age than in older children. More than half of the children and of the working parents were absent from their regular activities for more than a week. CONCLUSIONS: Varicella was associated with significant morbidity, affected younger children, was complicated in more than 5%, and left sequelae in 0.7% of children. More than 10% of the children received nonsteroidal antiinflammatory drugs, highlighting the need to warn the population about the risks of these drugs. Although varicella vaccination is not recommended for children younger than 12 months, vaccination of the children older than a year could avoid by herd immunity the transmission to babies. Brazilian public health authorities should be alerted to this issue and offer varicella vaccine to children attending day care centers.OBJETIVO: Descrever a morbidade associada à varicela nas crianças usuárias de creches. MÉTODOS: Estudo descritivo, realizado através de inquérito com pais ou responsáveis por 664 crianças que contra

  7. 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...

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    FREITAS Ronaldo B.

    2000-01-01

    Full Text Available A total of 730 children aged less than 7 years, attending 8 day-care centers (DCCs in Belém, Brazil were followed-up from January to December 1997 to investigate the occurrence of human-herpes virus 6 (HHV-6 infection in these institutional settings. Between October and December 1997 there have been outbreaks of a febrile- and -exanthematous disease, affecting at least 15-20% of children in each of the DCCs. Both serum- and- plasma samples were obtained from 401 (55% of the 730 participating children for the detection of HHV-6 antibodies by enzyme-linked immunosorbent assay (ELISA, and viral DNA amplification through the nested-PCR. Recent HHV-6 infection was diagnosed in 63.8% (256/401 of them, as defined by the presence of both IgM and IgG-specific antibodies (IgM+/IgG+; of these, 114 (44.5% were symptomatic and 142 (55.5% had no symptoms (p = 0.03. A subgroup of 123 (30.7% children were found to be IgM-/IgG+, whereas the remaining 22 (5.5% children had neither IgM nor IgG HHV-6- antibodies (IgM-/IgG-. Of the 118 children reacting strongly IgM-positive ( > or = 30 PANBIO units, 26 (22.0% were found to harbour the HHV-6 DNA, as demonstrated by nested-PCR. Taken the ELISA-IgM- and- nested PCR-positive results together, HHV-6 infection was shown to have occurred in 5 of the 8 DCCs under follow-up. Serological evidence of recent infections by Epstein-Barr virus (EBV and parvovirus B19 were identified in 2.0% (8/401 and 1.5% (6/401 of the children, respectively. Our data provide strong evidence that HHV-6 is a common cause of outbreaks of febrile/exanthematous diseases among children attending DCCs in the Belém area.

  10. Assessment of gastroenteric viruses frequency in a children's day care center in Rio De Janeiro, Brazil: a fifteen year study (1994-2008.

    Directory of Open Access Journals (Sweden)

    Mônica Simões Rocha Ferreira

    Full Text Available This 15-year study aimed to determine the role of the main viruses responsible for acute infantile gastroenteritis cases in a day care center in the city of Rio de Janeiro, Brazil. From 1994 to 2008, 539 fecal samples were obtained from 23 outbreaks as well as sporadic cases that occurred in this period. The detection of Rotavirus group A (RVA, norovirus (NoV and astrovirus (AstV was investigated both by classical and molecular methods of viral detection. RVA was detected by enzymatic immune assay and/or polyacrylamide gel electrophoresis and genotyped by using semi-nested multiplex PCR. NoV and AstV were subsequently tested by real time PCR in all RVA-negative samples and genotyped throughout genome sequencing. Three protocols for molecular characterization of NoV nucleotide sequencing were performed with the partial nucleotide sequencing of genomic regions known as region B (polymerase gen, C and D (capsid gen.Viruses were identified in 47.7% (257/539 of the cases, and the detection rates of RVA, NoV and AstV in16.1% (87/539, 33.4% (151/452, and 6.3% (19/301, respectively. Most gastroenteritis cases were reported in autumn and winter, although NoV presented a broader monthly distribution. Viruses' detection rates were significantly higher among children aged less than 24 months old, although NoV cases were detected in all age groups. RVA genotypes as G1P[8], G9P[8], G2P[4], G3P[8] and G1+G3P[8] and RVA was no longer detected after 2005. NoV characterization revealed genotypes variability circulating in the period as GI.2, GI.3, GI.8 GII.2, GII.3, GII.4, GII.4 variants 2001 and 2006b, GII.6, GII.7, GII.12 and GII.17. AstV genotypes 1, 2, 4 and 5 were also characterized. Those data demonstrate the impact of NoV infection in cases of infantile gastroenteritis, surpassing RVA infection responsible for high morbidity rate in children under five years old.

  11. Stennis Space Center observes Disability Awareness Day

    Science.gov (United States)

    2009-01-01

    Members of STARC, a non-profit organization in Slidell, La., that seeks to help people with disabilities lead meaningful, productive lives, pose with their appreciation awards during Disability Awareness Day at Stennis Space Center on Oct. 15. The group members received appreciation awards for their dedicated service to the rocket engine testing facility. Disability Awareness Day was hosted by the Stennis Diversity Council and included guest speakers from several area agencies.

  12. Views on Pre-School Education and Day Care.

    Science.gov (United States)

    Rambusch, Nancy McCormick

    There is a clear need in our country today for early education programs aimed at accelerating the cognitive development of disadvantaged children. Another need is for centers to care for the children of working mothers. Our traditional nursery schools have deemphasized early cognitive development while day care programs have been focused on…

  13. Discourses of Professionalism in Family Day Care

    Science.gov (United States)

    Cook, Kay; Davis, Elise; Williamson, Lara; Harrison, Linda J.; Sims, Margaret

    2013-01-01

    Family day care in Australia is currently undergoing rapid "professionalisation" within a national reform agenda that seeks to raise and standardise early childhood service quality. Included within this reform is a requirement that all family day care workers obtain formal qualifications and that workers are referred to as…

  14. Wound care centers

    Science.gov (United States)

    ... different types of dressings, including: Gels Foams Gauze Films Your provider may use one or multiple types ... Care (AAWC). 2010. http://aawconline.org/wp-content/uploads/2011/08/AAWCPressureUlcerGuidelineofGuidelinesAug11.pdf. Accessed June 11, 2014. ...

  15. Diaper type and fecal contamination in child day care.

    Science.gov (United States)

    Holaday, B; Waugh, G; Moukaddem, V E; West, J; Harshman, S

    1995-01-01

    In this study, modern all-in-one, front closure, reusable cloth diapers were compared with single-use, disposable paper diapers for their effect on fecal contamination in the child day care environment. Four licensed child day care centers were surveyed from which 1722 bacterial samples were cultured. The frequency of isolation of fecal organisms ranged from a low of 12% of the total bacterial isolates at a center using cloth diapers to a high of 46% and 45%, respectively, obtained at a center using first paper and then cloth diapers. Diaper type, cloth versus paper, when the method of application and the handling are made comparable, showed no significant difference in the frequency or the intensity of fecal contamination in child day care centers, as measured in the play/sleep area, the diaper change area, or on the hands of the care givers and children. Future studies to control microbial contamination in child day care centers should focus on effective ways of reducing contamination of sink faucets, hands of the caregivers, and hands of the children. PMID:7769542

  16. Day Care: Gold Coin or Brass Check?

    Science.gov (United States)

    Levenstein, Sidney

    1972-01-01

    Because a national day care program will probably be instituted soon, the major issues should be debated before policies are set. Thus some program models are analyzed and then related to the needs of various consumer groups. (Author)

  17. 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…

  18. Day-care attendance and child development:

    DEFF Research Database (Denmark)

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

    , of total work experiences, ages and hourly wages of staff members. Those indicators show the expected correlations with children’s development outcomes, better day-care quality being linked to better child outcomes ten years later. We use rich administrative information about the children’s background......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...

  19. Unnoticed Professional Competence in Day Care Work

    DEFF Research Database (Denmark)

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

    2013-01-01

    This article presents a double perspective on social educators’ professional competence: It discusses how everyday life in day care centres (preschools) is dependent on professional competences that can be conceived as “unnoticed.” These aspects of professional competence are embedded in routines......, 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...... 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....

  20. The Burn-Out Syndrome in the Day Care Setting

    Science.gov (United States)

    Maslach, Christina; Pines, Ayala

    1977-01-01

    Results of a study of personal job-stress factors among day care center personnel focus on impact of staff-child ratio, working hours, time out, staff meetings and program structure. Recommended institutional changes for prevention of staff "burn-out" involve reduction in amount of direct staff-child contact, development of social-professional…

  1. Unnoticed professional competence and knowledge in day care work

    DEFF Research Database (Denmark)

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

    be argued that there is a pressure on these aspects of professional competence and knowledge ultimately resulting in poorer quality of work for both employees and citizens – the exact opposite of what presumably has been the goal with the steering systems. In this paper we will discuss the case of social...... 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...

  2. Health: A Key Factor in the Evaluation of Day Care.

    Science.gov (United States)

    Bollin, Gail G.

    Research has inadequately examined why health has become a problem in the day care setting. Health regulations for day care have not been researched in the day care setting per se but have been imposed on day care by the medical community working from a hospital model. Day care research has presumed that having antecedent health regulations in…

  3. Day Care: Gold Coin or Brass Check.

    Science.gov (United States)

    Levenstein, Sidney

    On the assumption that there will be a national program of day care for preschool children, the author presents the major issues involved. An attempt is made to bring together some figures on current need and available facilities, to examine policy considerations in the implementation of programs, to present some difficulties in providing adequate…

  4. 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…

  5. Day care schemes and cash for-care at home

    DEFF Research Database (Denmark)

    Eydal, Gudny; Rostgaard, Tine

    2012-01-01

    The purpose of this chapter is to analyse and compare Nordic day-care policies, i.e. ECEC services as well as cash-for-care for children under school age. The chapter examines the legislative purpose behind the provision of the services and the cash benefits as well as the take-up rates. The review...... of day-care will also look at how the programmes are organised and funded, and at the quality indicators of the care provided. In this context, the Nordic countries will be compared with the EU average. The review of cash-for-care will assess the key elements of the programmes: the length of time...

  6. "Our Heads Are the Same Size!" A Study of Quality of the Child's Life in Nordic Day Care Centres. Educational Information and Debate No. 107.

    Science.gov (United States)

    Hannikainen, Maritta; And Others

    This study used a qualitative approach in investigating one Finnish day care center, four Danish day care centers, and two Swedish day care centers. The study examined the "Nordic model" for day care, which is unique in that it combines education and care for children while parents are working. The study investigated the quality of education and…

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

    Directory of Open Access Journals (Sweden)

    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

  8. Santa Monica Children's Centers, Santa Monica, California: Low-Cost Day Care Facilities for Children of Working Mothers Made Available Through the Cooperation of the California State Government and Local School District. Model Programs--Childhood Education.

    Science.gov (United States)

    American Institutes for Research in the Behavioral Sciences, Palo Alto, CA.

    Two of the four Santa Monica Children's Centers are nursery schools for children aged 3 to 5; the other two centers serve as extended care facilities for children of school age. All centers are concerned with meeting the physical, intellectual, and emotional needs of children on a long-term basis and stress a program offering a variety of play…

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

    Directory of Open Access Journals (Sweden)

    Alessandra da Silva Pereira

    2010-12-01

    Full Text Available OBJETIVO: Descrever e comparar estudos longitudinais que permitam inferir sobre a influência da creche no estado nutricional de crianças pré-escolares. FONTES DE DADOS: Revisão sistemática de trabalhos científicos publicados entre janeiro de 1990 e dezembro de 2008. Buscaram-se os estudos nas seguintes bases de dados: Lilacs, Scielo e PubMed. Realizou-se também pesquisa manual dos artigos referenciados. A busca ocorreu no período de março de 2008 a junho de 2009, e os descritores utilizados foram: "creche", "estado nutricional", "antropometria", "consumo alimentar", "anemia" e "alimentação escolar". SÍNTESE DOS DADOS: Na primeira etapa do estudo, obtiveram-se 78 artigos, mas somente sete puderam ser incluídos. Os outros 71 não apresentaram dados para contribuir com o objetivo específico deste estudo. Entre os artigos pesquisados na literatura, existem poucos que permitem inferir sobre a influência que a creche pode ter em relação ao estado nutricional de pré-escolares. Contudo, estudos longitudinais têm mostrado a relação causal entre a presença frequente da criança na creche e a melhoria do estado nutricional. CONCLUSÕES: Existe uma relação positiva entre a frequência da criança na creche e a melhoria do estado nutricional.OBJECTIVE: To describe and compare longitudinal studies on how daycare centers influence preschoolers' nutritional status. DATA SOURCE: Systematic review of scientific papers published from January 1990 to December 2008. Studies were retrieved from the following databases: Lilacs, Scielo and PubMed. Manual search of papers was carried out as well. The review occurred between March 2008 and June 2009, and the searched terms were: "child day care center", "nutritional status", "anthropometry", "food consumption", "anemia" and "food program". DATA SYNTHESIS: In the first stage 78 papers were obtained, but only seven of them could be used. The other 71 did not have data to contribute with the specific

  10. Qualidade de ambientes de creches: uma escala de avaliação Quality of day care center environment: a rating scale

    Directory of Open Access Journals (Sweden)

    Tatiana Noronha de Souza

    2005-04-01

    the quality of care offered in collective educational environments in our context.

  11. 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

  12. Os valores organizacionais e a Síndrome de Burnout: dois momentos em uma maternidade pública Organizational values and Burnout Syndrome: two moments in a public day-care center

    Directory of Open Access Journals (Sweden)

    Livia de Oliveira Borges

    2006-01-01

    Full Text Available Estudos anteriores têm assinalado a associação da incidência da síndrome de burnout e os valores organizacionais (valores atribuídos às organizações pelos empregados em um nível ideal e real. Em tal contexto, foi desenvolvida pesquisa em uma maternidade pública em 2003, replicando uma pesquisa anterior realizada em 2000, objetivando comparar os resultados. Aplicaram-se o Inventário de Valores Organizacionais e o Inventário de Maslach sobre burnout, numa amostra de 48 profissionais de saúde, e entrevistas, numa sub-amostra. Os resultados indicaram ocorrer uma redução nas diferenças entre níveis de análise ideais e reais dos valores organizacionais, principalmente no pólo de igualitarismo. Esses resultados associam-se às mudanças na gestão organizacional. Os níveis de burnout entre os profissionais de saúde apresentaram-se estáveis. A associação entre os valores organizacionais da maternidade e a síndrome de burnout muda, porém é contraposta pela tensão oriunda no aumento da carga de trabalho e nos salários.Previous studies have shown that the association between the incidence of Burnout Syndrome and organizational values (values attributed by employees to organizations on ideal and real levels. In this context, in 2003, a research at a public day-care center was developed, replicating a previous one accomplished in 2000, with the objective to compare the results. The Inventory of Organizational Values and the Maslasch Burnout Inventory were applied with the samples of 48 health professionals. Interviews were applied too. The results indicate that a reduction of differences between ideal and real levels of organizational values occur, notably in the equalitarian pole. These results associate to changes on organizational management. Levels of burnout were stable among health professionals. The association between organizational values of the day-care center and Burnout Syndrome change, but it is refuted by the

  13. Vouchers for Day Care of Children: Evaluating a Program Model.

    Science.gov (United States)

    Parker, Michael D.

    1989-01-01

    Examined effects of a pilot voucher program on the price, supply, and quality of day care. Findings offered no conclusive evidence concerning expected benefits. Discusses vouchers' potential for easing the day care crisis. (RJC)

  14. The Day Care Challenge: The Unmet Needs of Mothers and Children.

    Science.gov (United States)

    Keyserling, Mary Dublin

    An overview of the present shortage of day care facilities in the United States is presented in this speech. Statistics cited on the number of working mothers with children under the age of 6 and the number of day care licensed homes and centers show that the shortage of licensed day care facilities is much more acute than it was five years ago.…

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

    DEFF Research Database (Denmark)

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

    for learning outcomes. For the social educators this has meant more time being spent on formal learning activities, and they have received the new demands with mixed feelings: on the one hand they can help the social educators getting more acknowledged for doing some valuable and visible work. On the other...... 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...

  16. Center to Advance Palliative Care

    Science.gov (United States)

    ... Catalogue Membership Brochure Join CAPC Central Registry National Palliative Care Registry™ Enter your data to improve performance, prove ... Log In to register Billing for Community-Based Palliative Care Virtual Office Hour Anne E. Monroe, MHA October ...

  17. Training day care staff to facilitate children's language.

    Science.gov (United States)

    Girolametto, Luigi; Weitzman, Elaine; Greenberg, Janice

    2003-08-01

    This exploratory study investigated the outcome of in-service training on language facilitation strategies of child care providers in day care centers. Sixteen caregivers were randomly assigned to experimental and control groups. Caregivers were taught to be responsive to children's initiations, engage children in interactions, model simplified language, and encourage peer interactions. At posttest, the experimental group waited for children to initiate, engaged them in turn-taking, used face to face interaction, and included uninvolved children more frequently than the control group. In turn, children in the experimental group talked more, produced more combinations, and talked to peers more often than the control group. The results support the viability of this training model in early childhood education settings and suggest directions for future research. PMID:12971819

  18. Avaliação do estado nutricional e do desenvolvimento neuropsicomotor em crianças freqüentadoras de creche Nutritional status and neurodevelopment of children enrolled in a day care center

    Directory of Open Access Journals (Sweden)

    Terezinha Soares Biscegli

    2007-12-01

    Full Text Available OBJETIVO: Avaliar o estado nutricional e o desenvolvimento neuropsicomotor em crianças freqüentadoras de uma creche. MÉTODOS: Estudo transversal de 113 crianças com seis a 70 meses de idade, que freqüentavam a creche Irmã Sheila em Catanduva, São Paulo. A avaliação nutricional foi feita por antropometria e analisada pela classificação de Waterlow e a avaliação do desenvolvimento neuropsicomotor pelo Teste de Denver II, em todas as crianças incluídas no estudo. Dados adicionais foram obtidos por meio de um questionário respondido pelos pais em 70% dos casos. RESULTADOS: Entre as crianças estudadas, observou-se 12% de desnutrição aguda, 1% de desnutrição pregressa e 16% de obesidade. O Teste de Denver II detectou 37% de suspeitos de atraso no desenvolvimento, sendo a linguagem a área mais acometida. A faixa etária mais comprometida foi a de 25 a 60 meses. O questionário mostrou que 87% das crianças receberam aleitamento materno (57% até o sexto mês, 96% das mães trabalhavam fora de casa, 54% delas possuíam ensino médio completo e 73% das famílias tinham renda máxima de dois salários-mínimos. CONCLUSÕES: A alta prevalência de distúrbios nutricionais e possíveis atrasos no desenvolvimento observados em crianças da creche Irmã Sheila mostraram a necessidade de introduzir dietas balanceadas, incentivando o desenvolvimento de hábitos alimentares saudáveis, além de alertar para a questão da interferência negativa dos fatores socioeconômicos e culturais no crescimento e desenvolvimento infantil.OBJECTIVE: Evaluate the nutritional status and neurodevelopment of children enrolled in a day care center. METHODS: This cross-sectional study enrolled 113 children aged six to 70 months, assisted in a nonprofit day care center in Catanduva, São Paulo. All children were submitted to evaluation of the nutritional status by anthropometry and classified according to Waterlow criteria. Child development was assessed

  19. Avaliação antropométrica de crianças em creches do município de Bezerros, PE Anthropometric evaluation of children from day care centers in the municipality of Bezerros, Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    Cláudia Porto S. Pinho

    2010-09-01

    Full Text Available OBJETIVO: Avaliar o estado nutricional de crianças matriculadas em creches da rede pública de ensino do município de Bezerros, Pernambuco. MÉTODOS: Estudo transversal que analisou os indicadores antropométricos de 735 crianças com idade entre um e sete anos (70% das matrículas do ano letivo de 2008 no município. Para classificação do estado nutricional, foram utilizados os índices estatura/idade (E/I e peso/estatura (P/E, expressos em valores de escore Z com base na curva do CDC (2000. O software utilizado para análise dos dados foi o Epi-Info, versão 6,04. RESULTADOS: Das crianças estudadas, 53,7% eram do sexo masculino e 72,7% provenientes de creches situadas em área urbana. A avaliação nutricional apontou uma prevalência de déficit nutricional de 6,8 e 0,7% segundo os índices E/I e P/E, respectivamente. A prevalência de obesidade segundo o P/E foi de 6,1%. Houve maior prevalência de baixa estatura entre as crianças do sexo feminino e risco para baixa estatura para o sexo masculino. Não foram observadas diferenças no estado nutricional das crianças de creches de área urbana e rural. Das crianças com déficit de E/I, 10% apresentaram obesidade associada. Calculando-se a razão entre a prevalência de obesidade e déficit de P/I, verificou-se razão de 1,7:1, sendo 1,3:1 e 5:1 para as crianças do meio urbano e rural, respectivamente. CONCLUSÕES: A baixa estatura e a obesidade foram os distúrbios nutricionais mais prevalentes na população de estudo, com maior expressividade do processo de transição nutricional nas crianças de área rural.OBJECTIVE: To evaluate the nutritional status of children from day care centers of the public educational system in the municipality of Bezerros, Pernambuco, Brazil. METHODS: This cross-sectional study examined the anthropometric indicators of 735 children aged between one and seven years old, which accounted for 70% of the children enrolled at the educational system of

  20. Assessment of risk and prophylaxis for deep vein thrombosis and pulmonary embolism in medically ill patients during their early days of hospital stay at a tertiary care center in a developing country

    Directory of Open Access Journals (Sweden)

    Ambarish Pandey

    2009-08-01

    Full Text Available Ambarish Pandey, Nivedita Patni, Mansher Singh, Randeep GuleriaDepartment of Medicine, All India Institute of Medical Sciences, New Delhi, IndiaAim: Deep vein thrombosis (DVT and pulmonary thromboembolism (PE are important causes of morbidity and mortality in medically ill patients. This study was done to assess risk factors and prophylaxis given for DVT and PE in newly admitted medically ill patients during the first two weeks of their hospital stay at a tertiary care center hospital in India.Methods: All patients within one week of their admission in intensive care unit (ICU and wards were enrolled in the study after an informed written consent. Patients who had DVT prophylaxis within the past month or any contraindications for DVT prophylaxis were excluded. A structured proforma was designed and effective risk stratification for DVT was done. Patients were followed for up to two weeks to record any changes in the risk categories and document any signs of PE or DVT if present. Any prophylaxis given for DVT or PE was noted.Results: Seventy-five percent of patients had the highest risk for DVT and PE. Only 12.5% had DVT prophylaxis within the first two days of admission. Within two weeks of admission, 30.8% of patients were discharged, and 16.2% died. 72.6% of the patients still in the wards belonged to the highest risk category. Clinical signs and symptoms of DVT and PE were present in 25.8% and 9.8% of patients, respectively after the second week of admission. 86% of symptomatic patients belonged to the highest risk category initially and none of them received any prophylaxis. 21.6% of the highest risk category patients died within two weeks of their admission. A statistically significant correlation was found between mortality and risk score of the patients for DVT and between lack of prophylaxis and mortality (p < 0.05.Conclusion: A significant risk for DVT and PE exists in medically ill patients, but only a small proportion of the patients

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

    Science.gov (United States)

    Badanes, Lisa S.; Dmitrieva, Julia; Watamura, Sarah Enos

    2012-01-01

    Full-day center-based child care has been repeatedly associated with rising cortisol across the child care day. This study addressed the potential buffering role of attachment to mothers and lead teachers in 110 preschoolers while at child care. Using multi-level modeling and controlling for a number of child, family, and child care factors,…

  2. The Day-Care Debate: A Wider View.

    Science.gov (United States)

    Kamerman, Sheila B.; Kahn, Alfred J.

    1979-01-01

    This article examines five major arguments against day care. Several approaches already in use in other countries are suggested as answers to the problems raised in the debate over care of children of working mothers. (MC)

  3. Partners HealthCare Center for Connected Health.

    Science.gov (United States)

    Ternullo, Joseph; Jethwani, Kamal; Lane, Susan; Myint-U, Khinlei; Havasy, Robert; Carter, Michael; Kvedar, Joseph

    2013-05-01

    This article reviews the history, current status, and future plans of the Partners HealthCare Center for Connected Health (the Center). Established in 1995 by Harvard Medical School teaching hospitals, the Center develops strategies to move healthcare from the hospital and doctor's office into the day-to-day lives of patients. It leverages information technology to help manage chronic conditions, maintain health and wellness, and improve adherence to prescribed regimen, patient engagement, and clinical outcomes. Since inception, it has served over 30,000 patients. The Center's core functions include videoconference-based real-time virtual visits, home vital sign monitoring, store-and-forward online consultations, social media, mobile technology, and other novel methods of providing care and enabling health and wellness remotely and independently of traditional time and geographic constraints. It offers a wide range of services, programs, and research activities. The Center comprises over 40 professionals with various technical and professional skills. Internally within Partners HealthCare, the role of the Center is to collaborate, guide, advise, and support the experimentation with and the deployment and growth of connected health technologies, programs, and services. Annually, the Center engages in a deliberative planning process to guide its annual research and operational agenda. The Center enjoys a diversified revenue stream. Funding sources include institutional operating budget/research funds from Partners HealthCare, public and private competitive grants and contracts, philanthropic contributions, ad hoc funding arrangements, and longer-term contractual arrangements with third parties. PMID:23330595

  4. Out-of-home day care and health.

    OpenAIRE

    Roberts, I

    1996-01-01

    Evidence from randomised trials indicates that out-of-home day care has important effects in domains that are integral to the health of mothers and children. The evidence that day care results in cognitive gains is compelling. These effects and the long term effects in reducing crime and violence should suffice to put the question of day care provision high on the paediatric agenda. However, some important questions remain to be answered. Evidence from a randomised trial suggests that the eff...

  5. 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.

  6. 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

    ..., 2009, at 74 FR 34295. Child and Adult Care Food Program (CACFP) Lunch and Centers Breakfast supper \\1... related notice published at 48 FR 29114, June 24, 1983.) This notice has been determined to be not... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day...

  7. Nursing Knowledge Driving Person-Centered Care.

    Science.gov (United States)

    Clarke, Pamela N; Fawcett, Jacqueline

    2016-10-01

    The dialogue between two scholars explores the concept of person-centered care in healthcare. The importance of nursing knowledge and nursing leadership to drive the integration of the broader person-focused perspective is emphasized. PMID:27641277

  8. Who Are the Clients?: Goal Displacement in an Adult Care Center for Elders with Dementia

    Science.gov (United States)

    Abramson, Corey M.

    2009-01-01

    This ethnographic study of "goal displacement" in an adult day care center explains how and why certain goals come to surpass others in the organizational practices of elder day care settings. Adult day care is often oriented towards providing family caregivers with respite rather than attempting to directly improve the lives of the elders…

  9. Playground Hazards in Atlanta Child Care Centers.

    Science.gov (United States)

    Sacks, Jeffrey J.; And Others

    1990-01-01

    Examines 71 of the 605 licensed child care centers in Atlanta for playground hazards and school accidents. Finds 684 hazards in 66 centers, including climbing equipment over 6 feet high with inadequate impact-absorbing undersurfacing that had over twice the rate of fall injuries as climbing equipment under 6 feet high. (FMW)

  10. 以“垂直农场”景观为依托的都市托老所营建%Urban Senior Day Care Center Construction Supported by "Vertical Farm

    Institute of Scientific and Technical Information of China (English)

    王丽蓉; 杨锐

    2012-01-01

    Due to rapid urbanization, lots of farmlands have been losing. Consequently the vertical farm emerges as a form of urban agriculture in the future. Currently China has entered an aging society. Owing to the shortage of services in cultural recreation and spiritual consolation, the traditional nursing mode brings negative effect to the old on physical and mental health. Contrast to people's gray impression on nursing home, Urban Senior Day Care Center brings the idea of vertical farms into nursing homes and meanwhile brings psychological joy to the old. Combined with the practice of South Lake Community in Nanjing, the paper explores a new type of community endowment pattern and specific construction of vertical farms landscape under the aging background.%快速城市化造成大量耕地的流失,未来都市农业的发展方向之一是"垂直农场"。当前我国已进入"老龄化"社会,传统的养老院模式由于在文化娱乐、精神慰藉等方面提供的服务相对欠缺,容易使老人的身心健康受到负面影响。而"都市托老所"将"垂直农场"的理念引入到养老院的建设中,观赏结合劳作,为老年人带来身心上的愉悦,改变了人们对传统养老院单调、灰色的印象。笔者结合南京南湖社区的实践,本着"都市托老"的理念,引入全民参与的养老服务体系,运用绿色生态的景观手法,积极探索老龄化背景下以"垂直农场"景观为依托的新型的社区养老模式的营建途径。

  11. Detection of anti-Giardia lamblia serum antibody among children of day care centers Detecção de anticorpos séricos anti-Giardia lamblia em crianças de creches

    Directory of Open Access Journals (Sweden)

    Semíramis Guimarães

    2002-02-01

    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.OBJETIVOS: Detectar anticorpos séricos anti-Giardia lamblia entre crianças atendidas em creches e estimar a freqüência de infecção por Giardia lamblia em área endêmica. MÉTODOS: Foram coletadas três amostras de fezes de cada uma das 147 crianças de três creches da rede municipal de Botucatu, SP, com idade variando de 0 a 6 anos, e as amostras foram processadas pelos métodos de sedimentação espontânea e flutuação pelo sulfato de zinco. Amostras de sangue foram obtidas da polpa digital, coletadas em papel de filtro e testadas pelos métodos de imunofluorescência indireta (IFI e de reação imunoenzimática (Elisa para pesquisa de IgG anti-Giardia. RESULTADOS E CONCLUSÕES: De um total de 147 crianças, 93 (63,3% apresentaram cistos de Giardia nas fezes. Dos 147 eluatos testados, 93 (63,3% e 100 (68% foram positivos para Giardia em IFI e em Elisa, respectivamente. A sensibilidade de IFI foi de 82% e de Elisa, 72%. Contudo, Elisa foi menos específica (39% do que IFI (70

  12. Anemia em crianças de uma creche pública e as repercussões sobre o desenvolvimento de linguagem Consequences of anemia on language development of children from a public day care center

    Directory of Open Access Journals (Sweden)

    Juliana Nunes Santos

    2009-03-01

    Full Text Available OBJETIVO: Comparar o desenvolvimento de linguagem de crianças anêmicas e não-anêmicas de uma creche pública de Belo Horizonte. MÉTODOS: Estudo transversal com avaliação do desenvolvimento de linguagem de crianças anêmicas (casos e não-anêmicas (controles entre dois e seis anos de idade. Todas as crianças realizaram punção digital para detecção da anemia (hemoglobina OBJECTIVE: To compare language development in anemic and non-anemic children from a public day care center in Belo Horizonte, Minas Gerais, Brazil. METHODS: Cross-sectional study with evaluation of language development of anemic (cases and non-anemic children (controls between two and six years old. All children had a digital puncture to detect anemia (hemoglobin <11.3g/dL. Cases were 22 anemic children and controls, 44 children selected by randomized paired sampling. The language development of each participant was observed and classified according to two main fields: communicative aspects (reception and emission and cognitive aspects, based on the Child Behavior Observation Guide for children from zero to six years old. Performance rates were created in order to qualify children's answers. RESULTS: The hemoglobin values observed in case and control groups were 10.6 and 12.5g/dL, respectively. The groups did not differ regarding age, gender, breastfeeding and mother's schooling. Significant differences were observed in the language evaluation in all examined fields: levels of reception (p=0,02 and emission (p<0.001 and cognitive aspects (p <0.001, with worse performance of anemic children. CONCLUSIONS: Anemic children presented worse language development when compared to non-anemic ones. In the public health context, childhood anemia should be considered as a relevant problem due to language development alterations with possible consequences on learning abilities and future social and professional performance.

  13. Avaliação dietética em creches municipais de Teresina, Piauí, Brasil Dietetic evaluation in municipal day-care centers in Teresina, Piauí, Brazil

    Directory of Open Access Journals (Sweden)

    Georgiana Feitosa da CRUZ

    2001-04-01

    Full Text Available Esta pesquisa foi conduzida para avaliar a qualidade nutricional das refeições consumida pelas crianças, pertencentes à faixa etária de 2 a 6 anos, matriculadas em creches municipais de Teresina. Os dados foram obtidos durante o período de outubro de 1997 a março de 1998, adotando-se o método da pesagem direta dos alimentos. Para o cálculo da adequação nutricional utilizaram-se as médias do consumo de energia e nutrientes, comparadas às recomendações nacionais. O estudo revelou oferta insuficiente de energia, ferro, cálcio e vitamina A, com um consumo protéico e de vitamina C excedendo as recomendações. Os carboidratos contribuíram com 58,5 ± 3,0% das energias totais, as proteínas com 16,0 ± 1,3% e as gorduras com 25,5 ± 3,7%. A deficiência de energia e a inadequação de proteínas e demais nutrientes demonstram a necessidade de um contínuo monitoramento das metas do programa e o aperfeiçoamento do serviço visando à melhoria da qualidade das dietas, com especial atenção ao atendimento das recomendações nutricionais.This investigation was carried out to evaluate the nutritional quality of the meal consumed by the children from 2 to 6 years old registered at municipal day-care centers in Teresina. The data were acquired in the period from October/97 to March/98, with the weighing of the food. For the calculation of suitability of the diets it was used the averages of the consumption of energy and nutrients, compared to the national recommendations. The study revealed insufficient offer of energy, iron, calcium and vitamin A. The protein and vitamin C were over the recommendation. The carbohydrate contributed with 58.5 ± 3.0% of the total calories, the proteins with 16.0 ± 1.3% and the fats with 25.5 ± 3.7%. The dietetic information showed a need to adopt a policy of seeking improvement of the quality of the diets, with special attention to the attendance of the nutritional recommendations.

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

    Directory of Open Access Journals (Sweden)

    Altaf Khan

    2014-01-01

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

  15. 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.

  16. Virtual health care center in Georgia.

    Science.gov (United States)

    Schrader, Thomas; Kldiashvili, Ekaterina

    2008-01-01

    Application of telemedicine systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for creation of national networks does not seem to be widely appreciated. The article describes the "Virtual Health Care Knowledge Center in Georgia" project. Its aim was the set up of an online integrated web-based platform to provide remote medical consultations and eLearning cycles. The project "Virtual Health Care Knowledge Center in Georgia" was the NATO Networking Infrastructure Grant dedicated for development of telemedicine in non-NATO countries. The project implemented a pilot to organize the creation of national eHealth network in Georgia and to promote the use of innovative telemedicine and eLearning services in the Georgian healthcare system. In June 2007 it was continued under the NATO Networking Infrastructure Grant "ePathology--Virtual Pathology Center in Georgia as the Continuation of Virtual Health Care Center". PMID:18673518

  17. 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

  18. Interpersonal relationships and group A streptococcus spread in a Mexican day-care center Relaciones interpersonales y diseminación del estreptococo del grupo A (EGA en una guardería de México

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    Alberto Villaseñor-Sierra

    2007-10-01

    Full Text Available OBJECTIVE: To study the effect of different degrees of centrality on the carrying of identical group A streptococcus (GAS clones in the nasopharynx of children from a Mexican public day-care center. MATERIAL AND METHODS: Nasopharyngeal cultures were performed in children from rooms B (RB (n = 35 and C (RC (n = 37. The Restriction Fragment Length Polymorphism (RFLP patterns were compared among GAS isolates. A social networks questionnaire was filled out for each child and 10 classmates. Structure coefficients were compared among children with and without GAS. RESULTS: Four GAS clones were identified; clone I in five children from RC; clone II in two from RC and one from RB; clone III in one from RB and one from RC; and clone IV in one from RC. Social network structure: Density of RB and RC = 0.40 (± 0.87 and 0.35 (± 0.80, respectively. In RB, the homophily pattern of interaction was different in carriers (0.00, non-carriers (0.47 and both (0.47 p = 0.35. In RC, the homophily pattern was also different in carriers (0.46, non-carriers (0.68 and mixed (0.19, p = .001. In 4/5 with clone I, the values of degree, closeness and betweenness were above the group mean. In 3/3 with clone II, the values of degree and betweenness were also above the mean. In contrast, in those with clone III and IV, the values of degree, closeness and betweenness were below the group mean. CONCLUSION: The spread of specific GAS clones was associated with groups of children having a high proportion of ties and a high centrality level. This is evidence that spread of GAS strains among children attending day-care centers is not random but dependent on the degree of communication and physical contact between pairs.OBJETIVO: Evaluar el efecto de grados diferentes de centralidad con la presencia de clonas idénticas de estreptococo del grupo A (EGA en la nasofaringe de niños de una guardería pública de México. MATERIAL Y MÉTODOS: Se realizaron cultivos nasofaríngeos en ni

  19. Organizational Structure and Behaviour in Day Care: Differences between Non-Profit and For-Profit Centres.

    Science.gov (United States)

    Canning, Patricia M.; Lyon, Mary E.; Kienapple, Kim; Young, Jeffrey

    2002-01-01

    Examined how Canadian day care centers are operated and managed, to identify differences in organizational structure and behavior between non-profit and for-profit centers and characteristics of structure and management linked with high quality care. Found that non-profit centers were more complex, more formalized, and less centralized than…

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

    OpenAIRE

    Altaf Khan

    2014-01-01

    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 associate...

  1. Infectious disease burden related to child day care in the Netherlands.

    NARCIS (Netherlands)

    Enserink, R.; Ypma, R.; Donker, G.A.; Smit, H.A.; Pelt, W. van

    2013-01-01

    Background: Studying day-care–associated infectious disease dynamics aids in formulating evidence-based guidelines for disease control, thereby supporting day-care centers in their continuous efforts to provide their child population with a safe and hygienic environment. The objective of this study

  2. 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…

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

    Science.gov (United States)

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

    2012-01-01

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

  4. Rede de significações: perspectiva para análise da inserção de bebês na creche The insertion of babies into a day care center analysed through a network of meanings

    Directory of Open Access Journals (Sweden)

    Katia de Souza Amorim

    2000-03-01

    Full Text Available A inserção de bebês em creche envolve familiares, crianças e educadoras em um complexo processo de integração, particularmente em nossa cultura, em que a educação coletiva de bebês é fenômeno recente. As representações sociais e a literatura científica reforçam a noção de que idealmente bebês devem ser cuidados em casa, pela mãe. Assim, freqüentemente, essa se sente culpada por ter que compartilhar os cuidados do(s filho(s. O período inicial do bebê em uma creche, portanto, implica a emergência de novos significados que são atribuídos e assumidos, confrontados e negociados nas interações estabelecidas pelos participantes. Uma perspectiva teórico-metodológica foi desenvolvida para analisar esse processo, baseado em um projeto de pesquisa que acompanhou a inserção de 26 bebês (5-18 meses de idade em uma creche. Registrou-se a situação a partir de gravações em vídeo, fichas de observação e entrevistas. A perspectiva referida destaca três personagens centrais: mãe, criança e educadora, em seus mútuos relacionamentos, os quais criam vários campos interconectados. O campo mãe-criança está inserido, principalmente, no cenário da família. Os outros dois, educadora-criança e mãe-educadora, no cenário da creche. Ambos os cenários estão impregnados por uma matriz socioistórica ampla, criada por complexo sistema cultural, econômico e político. Os vários elementos formam uma rede de significações semióticas, que continuamente se transforma e estrutura/desestrutura o desenvolvimento humano.The insertion of babies in a day care involves family members, child and caregivers in a complex integration process, as in our culture, collective education is a recent phenomenon. Social representations and scientific literature reinforce the notion that, by nature, babies require personal care at home, by their own mother. Consequently, she often feels guilty for leaving her baby in an institution. The baby

  5. Nutritional assessment of children at the day care center “Marineritos del Sur” in Cienfuegos province, Cuba. Evaluación nutricional de los niños del circulo infantil “Marineritos del Sur”. Cienfuegos.

    Directory of Open Access Journals (Sweden)

    Ernesto Martínez Ferrer

    2003-10-01

    Full Text Available Background: In many countries in the last few years, there has been an increasing interest for the assessment of the Nutritional System which can be defined as a systemic and permanent process of collection, transmission analysis and interpretation of the information that allows to keep updated knowledge of the nutritional state. The follow up of the children´s growth and development has the importance not only to assist the children´s needs at a determined age but also to assist them with a preventive criteria taking into account their dynamic and changing characteristics. Objectives: To assess nutritionally the children gathered at the ages from 2 to 6 years that attend the day care center ¨Marineritos del Sur¨ for more than one year during the period September 1 st - March 2000. Methods: The variables under study were age, sex, weight, folds brachial circumference and past illnesses. Results: According to the indicators weight/size, size/age, weight / age, tricipital fold/ age, brachial circumference / age, patients between 10 and 90 percentile had a predominance. The calculus of the Z point showed that 67,66 % of the children were eutrophic, 27,=6 tended to obesity and 5,28 malnourished. Giardia Lambia was the most frequent isolated parasite.
    Fundamento: En el transcurso de los últimos años está tomando creciente interés en diversos países el Sistema de Vigilancia Alimentaria y Nutricional que puede definirse como un proceso sistemático y permanente de recolección, transmisión, análisis e interpretación de información que permite mantener un conocimiento actualizado de la situación alimentaria y nutricional El seguimiento del crecimiento y desarrollo del niño no solo tiene la importancia de atender sus necesidades del niño a una edad determinada sino el asistirlo con un criterio preventivo y evolutivo teniendo en

  6. [Renal colic: new care in emergency centers].

    Science.gov (United States)

    Morandi, Eléonore; Kherad, Omar; Chollet, Yves; Dussoix, Philippe

    2016-02-01

    The prevalence of renal colic is increasing in industrialized countries, representing a frequent reason for consultation in emergencies. Most patients have simple renal colic that will require analgesia and ambulatory monitoring. Doctors working in emergency centers play a key role in the diagnosis, care and guidance of these patients. They must identify factors of gravity and request urological advice if necessary. This article summarizes the recent diagnostic and therapeutic innovations in the management and guidance of renal colic in emergency centers. PMID:26999995

  7. Stennis Space Center observes 2009 Energy Awareness Day

    Science.gov (United States)

    2009-01-01

    Stennis Space Center employees Maria Etheridge (l to r), Linda Sauland Maurice Prevost visit a Coast Electric Power Association display featuring energy-efficient light bulbs during 2009 Energy Awareness Day activities on Oct. 20. The exhibit was one of several energy-efficiency and energy-awareness displays on-site for employees to visit. Vendors included Mississippi Power Company, Coast Electric Power Association, Mississippi Development Authority - Energy Division,Jacobs FOSC Environmental, Southern Energy Technologies, and Siemens Building Technologies.

  8. Analysis of the electric heating conventional system replacement by the solar heating in day-care centers at Poco de Caldas - MG; Analise da substituicao de sistema convencional de aquecimento eletrico por aquecimento solar em creches em Pocos de Caldas -MG

    Energy Technology Data Exchange (ETDEWEB)

    Dantas, Carlos Tadeu [Escola Tecnica Limassis, Delfim Moreira, MG (Brazil); Mariotoni, Carlos Alberto [Universidade Estadual de Campinas, SP (Brazil)

    2006-07-01

    Located in the South of Minas Gerais, average altitude of 1186 m and population about 170.000 inhabitants Pocos de Caldas is one of the most developed tourist cities of Minas Gerais. Beyond this quality, that makes it one of the best cities in quality of life in Brazil, measured for the HDI, the city presents an enviable educational polar region comparing to cities of the south region. With 91 institutions of education, from children's education to superior education, Pocos de Caldas has more than 49,000 students today. From this scholar population, 1870 pupils represent the children's education in particular or municipal day-care centers, called CEI. Pocos de Caldas has its own generation of energy through the Municipal Department of Electricity, DME. The energy production today arrives the house of 58 MW reaching 100% of the population in 2005. The analysis of the substitution of conventional system of electric heating for solar heating in day-care centers has left of an unknown project, with the objective to minimize the consumption of energy unfastened during the children's baths who stay at CEI. In this context, this work presents a study carried through this project, after the implantation of the related system in four of the eleven day-care centers that the initial project composes. The data had been collected in the DME and the City department of Education. The pathological manifestations in the points of water consumption of the related day-care centers as well as the state of conservation of the systems of implanted solar heating had been investigated also. (author)

  9. 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.

  10. Day care surgery in a metropolitan government hospital setting--Indian scenario.

    Science.gov (United States)

    Dorairajan, Natarajan; Andappan, Anandi; Arun, B; Siddharth, Dorairajan; Meena, M

    2010-01-01

    Day care surgery has generated a lot of interest, among both surgeons and the common people. This study aims to explore the management and advantages, including the cost benefits and cost effectiveness, of day care surgery in a government hospital setting. A prospective, single-center, single-unit study was carried out over 1 year from August 2006 to January 2008. The total number of patients studied was 327. Surgeries for hernia, hydrocele, fibroadenoma, fissure in ano, and phimosis were included. Patients were admitted on the day of surgery and were discharged the same day or evening. Patients were analyzed with respect to failure to discharge, wound infection, duration of stay in the ward, cost benefits, cost effectiveness, and postoperative pain. A total of 157 patients were treated for hernia, 61 for hydrocele, 52 for fibroadenoma, 34 for fissure in ano, and 23 for phimosis. Day care surgery is a fast growing and well accepted way of providing care to patients. Most of the patients studied had a favorable impression of the day care surgical procedure compared with inpatient care. In a country like India, in spite of problems of financial constraints and insufficient grants for health care, we are able to enjoy all the advantages of day care surgery, even in a government hospital setting.

  11. Adult Day Care and Medical and Hospital Claims.

    Science.gov (United States)

    Chappell, Neena L.; Blandford, Audrey A.

    1987-01-01

    Examined effect of adult day care (ADC) on utilization of health care practitioner and inpatient hospital services. Data from three separate ADC studies revealed that, when operative for some time, ADC may result in dramatic decreases in hospital inpatient stays. Findings warrant further research. (Author/NB)

  12. Norway's Day-Care Initiative: A Municipal Approach

    Science.gov (United States)

    Nemeth, Beate; Lokken, Gisle

    2012-01-01

    Norway is gearing up to provide places in day care centres for all children aged between one and six and the need for more facilities has therefore increased substantially in recent years. In Tromso, the municipality has become closely involved in child-care pedagogics and architecture; a design competition it launched has brought rewarding…

  13. Relational Communications Strategies to Support Family-Centered Neonatal Intensive Care.

    Science.gov (United States)

    Benzies, Karen M

    2016-01-01

    The philosophy of family-centered care in neonatal intensive care units is intended to facilitate parental involvement, shared decision-making, and improved outcomes for infants and families. To support family-centered care, there are multiple interventions with different components and associated outcomes that have been described in the research literature. This evidence leaves many unanswered questions about how best to implement and evaluate strategies to enhance family-centered care. This article provides a brief overview of interventions designed to support family-centered care in neonatal intensive care units and offers an evidence-informed staff education strategy to enhance family-centered care. The evidence-informed relational communications strategies of circular pattern diagrams, questioning, and commendations are described, along with specific examples of how nurses can use them in in their day-to-day practice in neonatal intensive care units. PMID:27465456

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

    Directory of Open Access Journals (Sweden)

    James H. Ford II, PhD

    2015-01-01

    Full Text Available 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.

  15. Alta prevalência de crianças portadoras de Streptococcus pneumoniae resistentes à penicilina em creches públicas High prevalence of children colonized with penicillin-resistant Streptococcus pneumoniae in public day-care centers

    Directory of Open Access Journals (Sweden)

    Patrícia A. G. Velasquez

    2009-12-01

    in public day-care centers of the municipality of Umuarama, state of Paraná, Brazil. The susceptibility of the pneumococcal strains to antimicrobial agents was also studied. METHODS: Nasopharyngeal specimens from 212 children were collected from April to October 2008. After the specimens were seeded in blood agar and incubated at 37 °C for 24-48 hours, the colonies suspected of belonging to S. pneumoniae were identified using α-hemolysis, optochin sensitivity, and bile solubility test. Penicillin susceptibility was investigated using the disk diffusion and dilution tests. Susceptibility to the other antimicrobial agents indicated for the treatment of pneumococcal infections was investigated using the disk diffusion test. RESULTS: The prevalence of nasopharyngeal pneumococci was 43.4% (92/212, with higher rates in children between 2 and 5 years old (p = 0.0005. There was no significant difference between sexes. Intermediate and full resistance to penicillin were found in 34.8 (32/92 and 22.8% (21/92 isolates, respectively. Sixty-seven strains (72.8% were resistant to sulfamethoxazole-trimethoprim, eight (8.7% were resistant to erythromycin, and six (6.5% to tetracycline. One strain was resistant to clindamycin (1.1% and another was resistant to chloramphenicol (1.1%. All strains were sensitive to levofloxacin, ofloxacin, rifampicin, telithromycin, linezolid, and vancomycin. Nine strains were considered multiresistant because they were resistant to three or more classes of antimicrobial agents. CONCLUSIONS: The present study detected a high prevalence of healthy children colonized with penicillin-resistant S. pneumoniae strains who may be important reservoirs of this pathogen in the community.

  16. Children's attachment relationships with day care caregivers: Associations with positive caregiving and the child's temperament

    NARCIS (Netherlands)

    J.C. de Schipper; L.W.C. Tavecchio; M.H. van IJzendoorn

    2008-01-01

    In this study, children's attachment relationships with their professional caregivers in center day care were observed for 48 children. We explored whether more positive caregiving was associated with a more secure attachment relationship and whether this association was stronger for more temperamen

  17. Dagliga Separationer och Tidig Daghemsstart (Daily Separations and Early Entry into Day Care).

    Science.gov (United States)

    Harsman, Ingrid

    The purpose of this thesis [Swedish language with English abstract and summary] was to study the reactions of infants when they started attending day care centers and to elucidate the process of adjustment. The theoretical perspective employed is the J. Bowlby/M. Ainsworth attachment theory. U. Bronfenbrenner's ecological theory of human…

  18. Menu Planning, Food Consumption, and Sanitation Practices in Day Care Facilities.

    Science.gov (United States)

    Kuratko, Connye N.; Martin, Ruth E.; Lan, William Y.; Chappell, James A.; Ahmad, Mahassen

    2000-01-01

    In 102 day care centers, data were collected on nutritional content of menus, compliance with guidelines, children's food consumption, and safety/sanitation. Although menus exceeded recommended daily allowances, quantities of food were below recommendations. No menu components were consumed by more than 65% of children. Sanitation problems were…

  19. Children's Well-Being in Day Care Centres: An Exploratory Empirical Study.

    Science.gov (United States)

    Mayr, Toni; Ulich, Michaela

    1999-01-01

    Used educators' ratings to describe preschool children's well-being in day care centers. Identified 11 independent dimensions of well-being: empathic, prosocial behavior; social initiative and vitality; self-assertiveness, openness; pleasure in exploring; coping with stress; positive self-defense; pleasure in sensory experiences;…

  20. Moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a day care center Movendo-se da reclusão à liberdade parcial: a experiência do cuidador familiar de idoso dependente assistido num centro-dia

    Directory of Open Access Journals (Sweden)

    Silvia Cristina Mangini Bocchi

    2010-09-01

    Full Text Available 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.O estudo teve como objetivos: compreender a experiência interacional cuidador familiar-idoso dependente apoiada por um Centro-Dia (CD, segundo a perspectiva do cuidador familiar, e desenvolver um modelo teórico representativo da experiência vivida por ele. Utilizou-se como referencial metodológico a Grounded Theory e como referencial teórico o Interacionismo Simbólico. As estratégias para a obtenção dos dados foram a observação e a entrevista. Dos resultados emergiu o fenômeno: sentindo-se apoiado pelo CD, pela força do vínculo com o idoso e pela espiritualidade para continuar desempenhando o papel desafiante de cuidador familiar de idoso dependente. O trabalho permitiu

  1. Program Success of Mental Health Clients in Day Reporting Centers.

    Science.gov (United States)

    McGregor, Brian; Brown, Eleanor; Yan, Fengxia; Mitchell, Crystal; Robinson, Charles; DeGroot, James; Braithwaite, Ronald

    2016-01-01

    Day-reporting centers (DRCs) provide programming for probationers with a history of non-compliant behavior related to substance abuse, who are overrepresented among justice-involved men and women. While evaluations of DRCs demonstrate some effectiveness, results are mixed and less is known about predictors of program success. This evaluation compared indicators of program success between adult offenders with a substance use disorder (n = 144) and those with co-morbid mental illness (n = 113) at three DRCs. Analyses examined differences between and within groups on program completion, personal characteristics and subjective measures of well-being. Results indicated that program completers were more likely to be participants with substance use disorders only and to have a drug-related referring charge. No significant differences between groups on most measures of well-being were observed. Future investigations should consider tracking program dropouts to better understand program attrition and explore readiness to change in treatment programming.

  2. Adult Day Care Program(高二适用)

    Institute of Scientific and Technical Information of China (English)

    孙启禄

    2004-01-01

    David Brown and Anne are two patients in the Adult Day Care Pro-gram at Mercy Hospitals. David Brown is seventy-two years old. He'sfriendly and likes to talk. He lives with his wife in the city. But David is

  3. The Effects of Day Care: A Literature Review.

    Science.gov (United States)

    Heist, Michele E.

    This paper reviews research reported in the last 10 years on the effects of day care on children and their families. The review is organized around the following areas: attachment and emotional development; psycho-social development; intellectual and cognitive development; health and nutritional effects; the effect of caregiver stability; the…

  4. History of the Animal Care Program at Johnson Space Center

    Science.gov (United States)

    Khan-Mayberry, Noreen; Bassett, Stephanie

    2010-01-01

    NASA has a rich history of scientific research that has been conducted throughout our numerous manned spaceflight programs. This scientific research has included animal test subjects participating in various spaceflight missions, including most recently, Space Shuttle mission STS-131. The Animal Care Program at Johnson Space Center (JSC) in Houston, Texas is multi-faceted and unique in scope compared to other centers within the agency. The animal care program at JSC has evolved from strictly research to include a Longhorn facility and the Houston Zoo's Attwater Prairie Chicken refuge, which is used to help repopulate this endangered species. JSC is home to more than 300 species of animals including home of hundreds of white-tailed deer that roam freely throughout the center which pose unique issues in regards to population control and safety of NASA workers, visitors and tourists. We will give a broad overview of our day to day operations, animal research, community outreach and protection of animals at NASA Johnson Space Center.

  5. Valley Interfaith Child Care Center CMS

    OpenAIRE

    Kramolisch, Andrew; Mack, Nate

    2012-01-01

    Included files: viccc.zip, viccc2.zip, viccc3.zip, viccc_final_paper.doc. The project consisted of revamping Valley Interfaith Child Care Center's website to be more modern and feature media. The goal was to cater to two diverse audiences: the families that needed their services and the investors who helped them keep running. This system is the result of efforts to do that. To run this software locally requires: Ruby 1.9.2 or newer, the bundler gem and either SQLite or PostgreSQL. The ...

  6. 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?

    Directory of Open Access Journals (Sweden)

    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

  7. Promoting Patient- and Family-Centered Care Through Personal Stories.

    Science.gov (United States)

    Johnson, Beverley H

    2016-03-01

    Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among patients, their families, and health care professionals. It redefines the relationships in health care by placing an emphasis on collaborating with patients of all ages, and their families, at all levels of care, in all health care settings, and in organizational change and improvement. This collaboration ensures that health care is responsive to an individual's priorities, preferences, and values. In patient- and family-centered care, patients define their "family" and determine how they and their family will participate in care and decision making. While patient- and family-centered care can improve the experience of care, safety, and quality, it also can improve the learning environment for students and trainees. The author shares personal stories to illustrate the core concepts of patient- and family-centered care, when they are present in health care interactions, and when they are not. Drawing from these stories and the author's experience in working with academic medical centers and other health care organizations over many decades, recommendations for changes in medical education are suggested that can contribute to the development of a health care workforce with the skills and commitment to partner respectfully, effectively, and authentically with patients and families. The implementation of the Affordable Care Act gives new impetus for building a health care delivery system and related educational programs to support patient- and family-centered practice. PMID:26796094

  8. 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.

  9. 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

    Full Text Available OBJETIVO: Identificar e quantificar os fatores de risco de anemia em lactentes matriculados em creches públicas ou filantrópicas no município de São Paulo e discutir o impacto das ações da creche no controle desta carência nutricional específica. MÉTODO: Estudo seccional compreendendo 212 lactentes de duas creches públicas e três filantrópicas. Foram realizadas entrevistas com as mães, coleta de sangue por punção digital e antropometria. Considerou-se como anemia, hemoglobina inferior a 11g/dL. Foi ajustado um modelo de regressão logística para fatores de risco entre grupos de lactentes com e sem anemia. RESULTADOS: A prevalência de anemia foi de 51,9%. O modelo logístico final foi composto por 4 variáveis: presença de 1 ou mais irmãos menores que 5 anos (Odds Ratio=2,57; p=0,005; estar freqüentando creche de administração exclusivamente pública (Odds Ratio=2,12; p=0,020; uso de aleitamento materno exclusivo inferior a 2 meses (Odds Ratio=1,88; p=0,044, e idade inferior a 15 meses (Odds Ratio=2,32; p=0,006. CONCLUSÃO:Concluiu-se que a alta prevalência de anemia evidencia a ineficiência das creches estudadas para controlar e prevenir esta carência nutricional; portanto, cabe ao planejador de saúde considerar os riscos de anemia identificados e quantificados quando da elaboração de programas de controle e prevenção.OBJECTIVE: To identify and quantify the risk factors for anemia in infants enrolled in public or philanthropic day care centers in São Paulo city and discuss the impact of the actions of day care centers in controlling this specific nutritional deficiency. METHODS: Cross-sectional study comprising 212 infants of two public and three philanthropic day care centers. Interviews with the mothers, collection of blood by digital puncture and anthropometry were performed. Anemia was characterized by hemoglobin levels below 11g/dL. A logistic regression model for risk factors between groups of infants with

  10. Parent Run Day Care Centres: The Growth of a French Community Initiative. Studies and Evaluation Papers No. 8.

    Science.gov (United States)

    Combes, Josette

    This report examines how parent involvement in running day care centers in France has increased in recent years, and investigates the role that the Association des Collectifs Enfants Parents Professionnels (ACEPP) has played in making this form of child care more acceptable. After a discussion of the historical development and current choices of…

  11. Solving the Puzzle of Child Care: Report of the Cuyahoga County Child Day Care Planning Project.

    Science.gov (United States)

    Child Day Care Planning Project, Cleveland, OH.

    This report describes the Child Day Care Planning Project, which was developed by private and public representatives to meet the needs for child care in Cuyahoga County, Ohio. The project consisted of five major components. The first component, the Data Project, documented the needs and resources of the community. The second component, the Quality…

  12. Unnoticed professional competence in day care work and the challenge of neoliberalism

    DEFF Research Database (Denmark)

    Ahrenkiel, Annegrethe; Warring, Niels; Schmidt, Camilla;

    New Public Management and neoliberalism has had a huge impact on care and health work imposing demands for documentation, standardization and evaluation. These demands seem to be in contrast with core aspects of the professional competence that are unnoticed. The paper explores how social educator......’s work in day care centers can be explored, developed and potentially democratized acknowledging the unnoticed aspects of daily work practices and professional competence. The paper draws on empirical examples from two research projects (Ahrenkiel et al. 2009, 2011) and discuss how noticing and...... developing the professional competences of pedagogues holds the potential to develop alternatives to neoliberal regulation....

  13. Unnoticed professional competence in day care work and the challenge of neoliberalism

    DEFF Research Database (Denmark)

    Ahrenkiel, Annegrethe; Warring, Niels; Schmidt, Camilla;

    New Public Management and neoliberalism has had a huge impact on care and health work imposing demands for documentation, standardization and evaluation. These demands seem to be in contrast with core aspects of the professional competence that are unnoticed. The paper explores how social educator......’s work in day care centers can be explored, developed and potentially democratized acknowledging the unnoticed aspects of daily work practices and professional competence. The paper draws on empirical examples from two research projects (Ahrenkiel et al. 2009, 2011) and discuss how noticing...... and developing the professional competences of pedagogues holds the potential to develop alternatives to neoliberal regulation....

  14. Intestinal parasites in metropolitan Toronto day-care centres.

    OpenAIRE

    Keystone, J. S.; Yang, J; Grisdale, D; Harrington, M.; Pillon, L.; Andreychuk, R

    1984-01-01

    In 1981, 900 children (aged 3 months to 10 years) and 146 staff attending 22 day-care centres in metropolitan Toronto chosen at random provided a stool specimen in a survey for intestinal parasites. Of the children, 4% to 36% were infected in 20 of 22 centres. Overall, 19% of the children and 14% of the staff had intestinal parasites: 8.6% and 4.0% respectively had Dientamoeba fragilis, and 7.8% and 2.0% respectively had Giardia lamblia. The highest prevalence of dientamebiasis was in the 7- ...

  15. The economics of early childhood education and day-care

    Science.gov (United States)

    Psacharopoulos, George

    1982-03-01

    This article discusses the economic rationale of providing educational and day-care facilities to young children, using an expanded social cost-benefit frame-work. The benefits side, in particular, includes the direct lifetime productive gains by working mothers and the indirect earnings increments of the recipients of these social services via the boosting of early abilities and eventual higher scholastic achievement. Recently compiled statistics in OECD Member Countries are used to support the argument that we know very little about the socio-economic effects of providing kindergarten and nursery facilities. An interdisciplinary research agenda is proposed to increase our understanding in this elusive area of social policy.

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

    Science.gov (United States)

    Moe, Nina; Pedersen, Bård; Nordbø, Svein Arne; Skanke, Lars Høsøien; Krokstad, Sidsel; Smyrnaios, Anastasios; Døllner, Henrik

    2016-01-01

    Background Respiratory viruses often have been studied in children with respiratory tract infection (RTI), but less knowledge exists about viruses in asymptomatic children. We have studied the occurrence of a broad panel of respiratory viruses in apparently healthy children attending day care, taking into account the influence of possible confounding factors, such as age, clinical signs of respiratory tract infection (RTI), location (day-care section) and season. Methods We have studied 161 children in two day-care centers, each with separate sections for younger and older children, during four autumn and winter visits over a two-year period. A total of 355 clinical examinations were performed, and 343 nasopharyngeal samples (NPS) were analyzed by semi-quantitative, real-time, polymerase chain reaction (PCR) tests for 19 respiratory pathogens. Result Forty-three percent of all NPS were PCR-positive for ≥ 1 of 13 virus species, with high species variation during visits. Rhinovirus 26% (88/343 NPS), enterovirus 12% (40/343) and parechovirus 9% (30/343) were detected in every visit, and the rates varied in relation to age, day-care section and season. Ten other viruses were detected in ≤ 3% of the NPS. Generally, viruses occurred together in the NPS. In 24% (79/331) of the clinical examinations with available NPS, the children had clear signs of RTI, while in 41% (135/331) they had mild signs, and in 35% (117/331) the children had no signs of RTI. Moreover, viruses were found in 70% (55/79) of children with clear signs of RTI, in 41% (55/135) with mild signs and in 30% (35/117) without any signs of RTI (p < 0.001). Conclusions Positive PCR tests for respiratory viruses, particularly picornaviruses, were frequently detected in apparently healthy children attending day care. Virus detection rates were related to age, presence of clinical signs of RTI, location in day care and season. PMID:27433803

  17. Scoping review of patient-centered care approaches in healthcare

    OpenAIRE

    Constand, Marissa K; MacDermid, Joy C; Dal Bello-Haas, Vanina; Law, Mary

    2014-01-01

    Background The purpose of this scoping review was to describe how three tenants of patient-centered care provision: communication, partnership, and health promotion are addressed in patient-centered care models/frameworks across the literature. Methods A scoping review of literature published in English since 1990 was conducted using Medline, CINAHL, and EMBASE. A key term search strategy was employed using “patient-centered care”, “client-centered care”, “framework” and “model” to identify r...

  18. [The challenges of comprehensive care in a Psychosocial Care Center and the development of therapeutic projects].

    Science.gov (United States)

    Mororó, Martha Emanuela Martins Lutti; Colvero, Luciana de Almeida; Machado, Ana Lúcia

    2011-10-01

    The object of this study is the development of therapeutic projects by the team working in a Psychosocial Care Center (CAPS III). It takes into consideration the creation and expansion process of the Brazilian public health system (SUS) and Psychiatric Reform. In this context, workers are challenged to develop care through an individual therapeutic project that considers the true needs and life context of the people involved. The objective of the study was to analyze and describe the strengths and weaknesses of a to develop the therapeutic projects based on the cartographic model and on the focal group technique. Participants were workers from a CAPS III center from Diadema, São Paulo. By analyzing the data collected through focal groups, the authors found, above all, a rupture between the night and day teams, and a lack of systematic space for conversation to develop and discuss on the therapeutic projects. PMID:22031379

  19. Climate Prediction Center Weekly Corn Growing Degree Days

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — A corn growing degree day (GDD) is an index used to express crop maturity. The index is computed by subtracting a base temperature of 50?F from the average of the...

  20. Microepidemia de tinha do couro cabeludo por Microsporum canis em creche de Vitória - Espírito Santo (Brasil Tinea capitis micro-epidemic by Microsporum canis in a day care center of Vitória - Espírito Santo (Brazil

    Directory of Open Access Journals (Sweden)

    Thaiz Gava Rigoni Gürtler

    2005-06-01

    Full Text Available Tinha do couro cabeludo é infecção da pele e cabelos dessa área, causada pelos dermatófitos do gênero Microsporum e Trichophyton. Acomete preferencialmente crianças pré-escolares e escolares, devido ao maior contato com fontes de infecção. Os autores relatam uma microepidemia de tinha do couro cabeludo em 11 crianças de uma creche pública de Vitória (ES, entre dois e seis anos de idade, 61% do sexo masculino. Apresentavam lesões arredondadas, escamosas, tonsurantes, grandes e únicas, nas regiões frontal, occipital, parietal, e, em dois casos, o couro cabeludo estava difusamente acometido. Os micológicos diretos mostravam parasitismo tipo ectotrix, e 45,5% das culturas foram positivas para Microsporum canis, justificadas pela história de contato entre algumas crianças da creche e cães errantes pelo bairro.Tinea capitis of the scalp is an infection of the skin and hair of this area caused by the dermatophytes of the Microsporum and Trichophyton genus. It preferentially attacks pre-school and school children due to their greater contact with infection sources. The authors report a micro-epidemic of Tinea capitis of the scalp in 11 children of a day care center of Vitória (ES, between two and six years of age, 61% of masculine sex. They presented rounded, scaly lesions with tonsured hair, large and unique in the frontal, occipital and parietal regions. In two cases the scalp was diffusely attacked. The direct mycology showed parasitism of the ectothrix type, and 45.5% of the cultures were positive for Microsporum canis, justified by the history of contact between some children of the day care center and stray dogs of the district.

  1. Improving personal health records for patient-centered care

    Science.gov (United States)

    Feldman, Henry J; Ross, Stephen E; Safran, Charles

    2010-01-01

    Objective To assess the patient-centeredness of personal health records (PHR) and offer recommendations for best practice guidelines. Design Semi-structured interviews were conducted in seven large early PHR adopter organizations in 2007. Organizations were purposively selected to represent a variety of US settings, including medium and large hospitals, ambulatory care facilities, insurers and health plans, government departments, and commercial sectors. Measurements Patient-centeredness was assessed against a framework of care that includes: (1) respect for patient values, preferences, and expressed needs; (2) information and education; (3) access to care; (4) emotional support to relieve fear and anxiety; (5) involvement of family and friends; (6) continuity and secure transition between healthcare providers; (7) physical comfort; (8) coordination of care. Within this framework we used evidence for patient preferences (where it exists) to compare existing PHR policies, and propose a best practice model. Results Most organizations enable many patient-centered functions such as data access for proxies and minors. No organization allows patient views of clinical progress notes, and turnaround times for PHR reporting of normal laboratory results can be up to 7 days. Conclusion Findings suggest patient-centeredness for personal health records can be improved, and recommendations are made for best practice guidelines. PMID:20190063

  2. A day in the life: a case series of acute care palliative medicine--the Cleveland model.

    Science.gov (United States)

    Lagman, Ruth; Walsh, Declan; Heintz, Jessica; Legrand, Susan B; Davis, Mellar P

    2008-01-01

    Palliative care in advanced disease is complex. Knowledge and experience of symptom control and management of multiple complications are essential. An interdisciplinary team is also required to meet the medical and psychosocial needs in life-limiting illness. Acute care palliative medicine is a new concept in the spectrum of palliative care services. Acute care palliative medicine, integrated into a tertiary academic medical center, provides expert medical management and specialized care as part of the spectrum of acute medical care services to this challenging patient population. The authors describe a case series to provide a snapshot of a typical day in an acute care inpatient palliative medicine unit. The cases illustrate the sophisticated medical care involved for each individual and the important skill sets of the palliative medicine specialist required to provide high-quality acute medical care for the very ill.

  3. 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

    Directory of Open Access Journals (Sweden)

    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.

  4. Efficacy of primary care in a nursing center.

    Science.gov (United States)

    Helvie, C O

    1999-01-01

    Nursing opportunities have expanded beyond the traditional bedside role. Nurses serve in a variety of roles such as administrators, teachers, or primary care givers in a variety of settings. The role of primary care giver is a more recent role; it involves relatively independent nursing practice with clients who have acute or chronic illnesses. Client groups may include the elderly in high rise buildings, mothers and children at schools, or homeless and low-income populations at homeless shelters. This care is often provided in a nursing center. Nursing centers are nurse-managed centers in which nurses are accountable and responsible for care of clients; they are the primary provider of care and the one most seen by clients. Case managers may be in a position to refer patients to nursing centers or to work directly with nurse practitioners in nursing centers. However, questions about the primary care provided in nursing centers must be addressed for healthcare providers, insurance companies, and patients to be confident in the efficacy of this delivery system. Is the primary care comprehensive? Is it of high quality? Is it cost effective? Is it satisfactory to clients? These and other questions about the primary care provided in nursing centers must be answered to effect political and other changes needed to fulfill the role of nursing centers envisioned by early leaders of the movement. This article addresses questions related to the efficacy of primary care provided in nursing centers by family nurse practitioners. After defining efficacy, the discussion focuses on the components identified and studied in one nursing center and includes information on opportunities for case managers to utilize nursing centers for referral and appropriate follow-up of their patients.

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

    Science.gov (United States)

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

    2010-01-01

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

  6. A patient-centered care ethics analysis model for rehabilitation.

    Science.gov (United States)

    Hunt, Matthew R; Ells, Carolyn

    2013-09-01

    There exists a paucity of ethics resources tailored to rehabilitation. To help fill this ethics resource gap, the authors developed an ethics analysis model specifically for use in rehabilitation care. The Patient-Centered Care Ethics Analysis Model for Rehabilitation is a process model to guide careful moral reasoning for particularly complex or challenging matters in rehabilitation. The Patient-Centered Care Ethics Analysis Model for Rehabilitation was developed over several iterations, with feedback at different stages from rehabilitation professionals and bioethics experts. Development of the model was explicitly informed by the theoretical grounding of patient-centered care and the context of rehabilitation, including the International Classification of Functioning, Disability and Health. Being patient centered, the model encourages (1) shared control of consultations, decisions about interventions, and management of the health problems with the patient and (2) understanding the patient as a whole person who has individual preferences situated within social contexts. Although the major process headings of the Patient-Centered Care Ethics Analysis Model for Rehabilitation resemble typical ethical decision-making and problem-solving models, the probes under those headings direct attention to considerations relevant to rehabilitation care. The Patient-Centered Care Ethics Analysis Model for Rehabilitation is a suitable tool for rehabilitation professionals to use (in real time, for retrospective review, and for training purposes) to help arrive at ethical outcomes.

  7. 7 CFR 226.13 - Food service payments to sponsoring organizations for day care homes.

    Science.gov (United States)

    2010-01-01

    ... CARE FOOD PROGRAM Payment Provisions § 226.13 Food service payments to sponsoring organizations for day... amount of food service payments shall be disbursed to each day care home on the basis of the number of meals served, by type, to enrolled children. For tier II day care homes, the full amount of food...

  8. Risk factors for gastroenteritis in child day care.

    Science.gov (United States)

    Enserink, R; Mughini-Gras, L; Duizer, E; Kortbeek, T; Van Pelt, W

    2015-10-01

    The child day-care centre (DCC) is often considered as one risk factor for gastroenteritis (GE) rather than a complex setting in which the interplay of many factors may influence the epidemiology of GE. This study aimed to identify DCC-level risk factors for GE and major enteropathogen occurrence. A dynamic network of 100 and 43 DCCs participated in a syndromic and microbiological surveillance during 2010-2013. The weekly incidence of GE events and weekly prevalence of five major enteropathogens (rotavirus, norovirus, astrovirus, Giardia lamblia, Cryptosporidium hominis/parvum) were modelled per DCC using mixed-effects negative binomial/Poisson regression models. Sixteen hundred children were surveyed up to 3 years, during which 1829 GE episodes were reported and 5197 faecal samples were analysed. Identified risk factors were: large DCC capacity, crowding, having animals, nappy changing areas, sandpits, paddling pools, cleaning potties in normal sinks, cleaning vomit with paper towels (but without cleaner), mixing of staff between child groups, and staff members with multiple daily duties. Protective factors were: disinfecting fomites with chlorine, cleaning vomit with paper towels (and cleaner), daily cleaning of bed linen/toys, cohorting and exclusion policies for ill children and staff. Targeting these factors may reduce the burden of DCC-related GE. PMID:25592679

  9. Day-care hypospadias surgery: Single surgeon experience

    Directory of Open Access Journals (Sweden)

    Chandrasekharam V.V.S.S

    2007-01-01

    Full Text Available Aim: To report the results of the early discharge of children after hypospadias repair with an indwelling catheter. Materials and Methods: To facilitate early the discharge of children after hypospadias repair, the author adopted the technique of draining the indwelling urinary catheter into diapers in children undergoing this operation. Home catheter care was taught to the mother; the dressings and catheters were subsequently managed in the outpatient clinic. Results: Over a 2-year period, 43 children were managed by this technique and were sent home within 24-48 h after the operation with an indwelling catheter. Minor problems requiring outpatient visits to the surgeon occurred in nine (20% children after discharge from the hospital. All the nine children were successfully managed as outpatients and no child required rehospitalisation. The catheter remained in position for 5 days in all the children. The overall results were satisfactory with an acceptable (7% fistula rate. Conclusions: It is possible to reduce the duration of the hospital stay of children after hypospadias repair without compromising on the final results.

  10. Factors associated with acute respiratory illness in day care children.

    Science.gov (United States)

    Hatakka, Katja; Piirainen, Laura; Pohjavuori, Sara; Poussa, Tuija; Savilahti, Erkki; Korpela, Riitta

    2010-09-01

    The aim of this study was to investigate the relationship between child characteristics, parental and environmental factors and the occurrence of acute respiratory illness (ARI) and acute otitis media (AOM) among Finnish children attending day care centres (DCCs). The study was a cross-sectional questionnaire of 594 children aged 1-6 y from 18 DCCs in Helsinki, Finland. Recurrent (> or =4 diseases/y) ARI was present in 44% of the 1-3-y-olds and 23% of the 4-6-y-olds, and recurrent AOM in 15% and 2.5%, respectively. Parent atopic disease (odds ratio (OR) 1.53, p = 0.033), mother's academic education (OR 1.77, p = 0.008) and a medium length of DCC attendance compared to a short period (OR 1.67, p = 0.049) increased, while furry pets (OR 0.44, p = 0.003) and older child age (OR 0.38, p or =6 months (OR 0.20, p = 0.002) and older child age (OR 0.05, p < 0.001) reduced the risk of recurrent AOM. Parental and environmental factors had a significant impact on recurrent ARI and AOM episodes in children attending DCCs. These risk factors should be considered in future studies intending to reduce DCC infections.

  11. Estado nutricional e carência de ferro em crianças freqüentadoras de creche antes e 15 meses após intervenção nutricional Nutritional status and iron deficiency among children enrolled in a day care center before and after 15 months of nutritional management

    Directory of Open Access Journals (Sweden)

    Terezinha Soares Biscegli

    2008-06-01

    Full Text Available OBJETIVO: Comparar o estado nutricional e a prevalência de carência de ferro em crianças freqüentadoras de creche antes e 15 meses após orientação nutricional e intervenção terapêutica. MÉTODOS: Estudo coorte com 52 crianças de 32 a 78 meses de idade, freqüentadoras de uma creche em Catanduva, São Paulo, avaliadas em dois períodos: antes e 15 meses após receberem tratamento para anemia e correção das alterações no estado nutricional. O estado nutricional das crianças foi avaliado por meio da curva da Organização Mundial de Saúde (2006. O diagnóstico de carência de ferro foi realizado por dosagem de hemoglobina e nível de ferritina sérica. Dados adicionais das crianças não eutróficas foram obtidos por meio de entrevistas com suas mães. RESULTADOS: Observou-se 2% de desnutrição aguda e 8% de obesidade, não havendo diferença significante entre os dois períodos. 12% das crianças apresentaram anemia, havendo diminuição do número de crianças com anemia após o tratamento. Dois novos casos de obesidade e cinco de carência de ferro surgiram durante o período de intervenção nutricional. Das oito crianças com alterações nutricionais no período inicial, 63% das mães procuraram atendimento médico para tratamento. CONCLUSÕES: O tratamento dos distúrbios nutricionais e da carência de ferro diminuiu o número de crianças afetadas. O aparecimento de novos casos de obesidade e anemia serve de alerta para a necessidade de outras medidas preventivas tanto na creche como no âmbito familiar.OBJECTIVE: To compare the nutritional status and the prevalence of iron deficiency among children enrolled in a day care center before and after 15 months of nutritional management. METHODS: Cohort study of 52 children, aged 32 to 78 months, evaluated before and after treatment of anemia and nutritional disturbs in a no-profit day care center in Catanduva, São Paulo, Brazil. The nutritional status was classified according

  12. [Teaching patient-centered holistic care].

    Science.gov (United States)

    Wung, Hwang-Ling; Chen, Huei-Ling; Hwu, Yueh-Juen

    2007-06-01

    Nursing education aims to help students understand concepts and gain competencies in holistic care. The purpose of this paper was to present a nursing curriculum that adapted and introduced holistic care into an adult nursing curriculum taught at a university of science and technology. The course framework included both holistic and nursing domains. The holistic aspect addressed client physical psychological-spiritual needs and related factors, health related factors, and the status of Maslow's hierarchy of needs and related factors. The nursing aspect addressed the way in which nursing was applied to identify client problems and provide individualized, integrated and continuous care in hospital, family or community based settings employing primary, secondary, or tertiary prevention. Scenario with problem based learning and concept mapping were used in class to guide students to consider in depth the concepts that underpin holistic care.

  13. PREVALENCE OF VARIOUS MUSCULOSKELETAL DISORDERS IN CHILD CARE WORKERS IN DAY CARE SETTINGS

    Directory of Open Access Journals (Sweden)

    Mariet Caroline, MPT,

    2014-08-01

    Full Text Available Child care workers are those who take care of children in the absence of their parents. Child care workers are exposed to various kinds of occupational injuries which include infections, sprains and strains, trauma like bites from children, trip falls and noise exposure. The risks of injury among these workers are due to their nature of the job. One of the common occupational risks found in these workers is musculoskeletal injury, it occurs as a result of working in awkward postures such as bending, twisting, lifting and carrying in incorrect positions, which may result in various injuries like strain, sprain and soft tissue ruptures. Workers with poor physical conditioning may tend to undergo these changes very rapidly. The purpose of this study was to find out the prevalence of various musculoskeletal disorders in child care workers who are taking care of the babies. The study was conducted around various day care centres, among 160 women from who were chosen for the study and were given musculoskeletal analysis questionnaires (Nordic musculoskeletal questionnaire , The Questionnaires were evaluated using descriptive statistics, analysed using SPSS and the results were computed in percentage. Following the analysis, it was concluded that low back injury was predominant among 44% of workers followed by 18% with neck pain, 11% of shoulder pain, 9% of knee pain, 7% of elbow, 6% of wrist, 4% of others and surprisingly 1 % had no musculoskeletal complaints.

  14. A Data-Feedback Method Used by Staff in Day-Care Centres to Improve the Quality of Their Work.

    Science.gov (United States)

    Hedin, Anna; Ekholm, Bodil

    1989-01-01

    A data feedback method based on observations of daily activities was tested in 11 Swedish day care centers. Advantages and disadvantages of the use of data collectors from different organizational levels were studied. Hindrances to the change process are discussed. (NH)

  15. Freqüência e atividade enzimática de Candida albicans isoladas da mucosa bucal de crianças de uma creche da prefeitura de Fortaleza Frequency and enzymatic activity of Candida albicans isolated from the buccal mucosa of children of a day-care center of the city hall of Fortaleza, Ceará, Brazil

    Directory of Open Access Journals (Sweden)

    Everardo Albuquerque Menezes

    2005-02-01

    Full Text Available As candidíases bucais (também chamadas sapinhos que ocorrem em crianças são causadas por uma deficiência imunológica, bem como por outros fatores tais como má higiene bucal e esterilização inadequada dos utensílios utilizados pelas mesmas, que potencializam a ocorrência dessa infecção fúngica. Considerando esse fato, foram avaliadas a freqüência e a atividade enzimática de Candida sp. isoladas em crianças de uma creche pública (Aprisco na cidade de Fortaleza, Ceará. Foram coletadas amostras da mucosa bucal de 364 alunos de 1 a 5 anos de idade. Elas foram semeadas em ágar Sabouraud dextrose com cloranfenicol, incubadas por 72 horas a 37ºC e identificadas por testes micológicos. Verificou-se que 67 (18% apresentaram leveduras do gênero Candida. A Candida albicans foi a mais freqüente, com 30 isolados (45%, seguida pelas C. tropicalis (31%, C. guilliermondii (17%, C. glabrata (4,5% e C. stellatoidea (1,5%. Com relação às atividades enzimáticas das cepas de Candida albicans, 20% produziram a enzima proteinase e 33%, a fosfolipase. As Candida albicans isoladas da mucosa bucal de crianças dessa creche da prefeitura apresentaram uma fraca atividade enzimática. Assim, conclui-se que essas cepas parecem ter uma baixa virulência.Immunedefficiency is one of the main causes of buccal candidiasis, also called thrush, in children. Other factors like inadequate mouth hygiene and inappropriate sterilization utensils potentialize this fungal infection. Considering these facts, Candida sp. frequency and enzymatic activity were evaluated in 364 stocks from mouth mucous of one to five year-old children from a public day care center in Fortaleza, Ceará (Brazil. The samples were cultured in dextrose Sabouraud with chloranfenicol agar and incubated for 72 hours at 37°C. They were identified by mycological tests. It was verified that 67 samples (18% presented Candida sp. and the most frequent genus was Candida albicans (30

  16. Quality Adjusted Cost Functions for Child Care Centers

    OpenAIRE

    H. Naci Mocan

    1995-01-01

    Using a newly compiled data set, this paper estimates multi- product translog cost functions for 399 child care centers from California, Colorado, Connecticut, and North Carolina. Quality of child care is controlled by a quality index, which has been shown to be positively related to child outcomes by previous research. Nonprofit centers that receive public money, either from the state or federal government, (which is tied to higher standards), have total variable costs that are 18 percent hi...

  17. Occurence of Giardia lamblia in children of municipal day-care centers from Botucatu, São Paulo State, Brazil Ocorrência de Giardia lamblia em crianças atendidas em creches municipais de Botucatu, Estado de São Paulo, Brasil

    Directory of Open Access Journals (Sweden)

    Semíramis Guimarães

    1995-12-01

    Full Text Available Considering that the number of day-care centers for pre-school-age children has expanded rapidly in developing countries, and that these institutions presenting conditions that facilitate the transmission of many enteric agents, a parasitological survey was carried out in three municipal day-cares from Botucatu: two in the urban area (one in downtown area and the other one in the city periphery area and the third in the rural area. Three separate stool specimens were collected from 147 children ranging from 0 to 72 months old and 20 staff members. Each stool specimen was processed by Lutz and zinc sulfate flotation methods. The frequency of giardiasis observed among children of downtown, periphery and rural day-cares was 69.6%, 52.7% and 69.6%, respectively. Only one employee was positive for G. lamblia. The examination of three stool specimens increased the positivity for G. lamblia: from the ninety three final positive examinations, 24 (25.5% and 8 (8.5% were positives only after examination of the second and third samples, respectively. Others intestinal organisms like Ascaris lumbricoides (20.4%, Trichuris trichiura (19.0%. Hymenolepis nana (8.8%, Entamoeba coli (22.4% and Blastocystis hominis (32.0% were frequently found in the children. There was no significant association among localization of the day-cares, sex of the children and the levels of G. lamblia infection. According to the age, G. lamblia was found mainly in children between 12 to 47 months old.Foi realizado um levantamento parasitológico em três creches da rede municipal: duas na área urbana, uma no centro da cidade e a outra na periferia, e a terceira na zona rural. Três amostras de fezes, coletadas com intervalo de 7 dias, foram obtidas de 147 crianças com idade variando de 0 a 6 anos e de 20 funcionários. Cada amostra foi processada pelos métodos de sedimentação espontânea e centrífugo - flutuação com sulfato de zinco. Os resultados demonstraram que das 147

  18. St. Luke's Medical Center: technologizing health care

    International Nuclear Information System (INIS)

    The computerization of the St. Luke's Medical Center improved the hospital administration and management, particularly in nuclear medicine department. The use of computer-aided X-ray simulator machine and computerized linear accelerator machine in diagnosing and treating cancer are the most recent medical technological breakthroughs that benefited thousands of Filipino cancer patients. 4 photos

  19. Daily activities and living at a Therapeutic Residential Care Center

    Directory of Open Access Journals (Sweden)

    Luciane Prado Kantorki

    2014-12-01

    Full Text Available This study describes and analyzes day-to-day issues in a Therapeutic Residential Care Center and the daily life characteristics of its residents. This case study was conducted in Caxias do Sul, based on an evaluation of the fourth generation together with a Methodology for Analyzing Everyday Life Networks. The following categories emerged: possibilities in the territory, participation and flexibility in household tasks, situations that mark living, employees who are mediators in conflict resolution, staff committed to the resident, freedom as a therapeutic tool, difficulties in daily life, and building of alliances. This study helped to get to know the structure of everyday life experienced by the residents, identifying some difficulties they face and the mechanisms used to overcome them, in addition to noticing that the professionals can be instrumental in strengthening a daily living that can be pluralized, busy, and enriched, while still respecting the uniqueness of each resident. doi: 10.5216/ree.v16i4.22923.

  20. Managing the Patient with Pulmonary Hypertension: Specialty Care Centers, Coordinated Care, and Patient Support.

    Science.gov (United States)

    Chakinala, Murali M; Duncan, Maribeth; Wirth, Joel

    2016-08-01

    Pulmonary hypertension remains a challenging condition to diagnose and manage. Decentralized care for pulmonary arterial hypertension (PAH) has led to shortcomings in the diagnosis and management of PAH. The Pulmonary Hypertension Association-sponsored Pulmonary Hypertension Care Center program is designed to recognize specialty centers capable of providing multidisciplinary and comprehensive care of PAH. Ideally, Pulmonary Hypertension Care Centers will comanage PAH patients with community-based practitioners and address the growing needs of this emerging population of long-term PAH patients. PMID:27443143

  1. Family-Centered Care in Neonatal Intensive Care Unit: A Concept Analysis

    Science.gov (United States)

    Ramezani, Tahereh; Hadian Shirazi, Zahra; Sabet Sarvestani, Raheleh; Moattari, Marzieh

    2014-01-01

    Background: The concept of family- centered care in neonatal intensive care unit has changed drastically in protracted years and has been used in various contexts differently. Since we require clarity in our understanding, we aimed to analyze this concept. Methods: This study was done on the basis of developmental approach of Rodgers’s concept analysis. We reviewed the existing literature in Science direct, PubMed, Google Scholar, Scopus, and Iran Medex databases from 1980 to 2012. The keywords were family-centered care, family-oriented care, and neonatal intensive care unit. After all, 59 out of 244 English and Persian articles and books (more than 20%) were selected. Results: The attributes of family-centered care in neonatal intensive care unit were recognized as care taking of family (assessment of family and its needs, providing family needs), equal family participation (participation in care planning, decision making, and providing care from routine to special ones), collaboration (inter-professional collaboration with family, family involvement in regulating and implementing care plans), regarding family’s respect and dignity (importance of families’ differences, recognizing families’ tendencies), and knowledge transformation (information sharing between healthcare workers and family, complete information sharing according to family learning style). Besides, the recognized antecedents were professional and management-organizational factors. Finally, the consequences included benefits related to neonate, family, and organization. Conclusion: The findings revealed that family centered-care was a comprehensive and holistic caring approach in neonatal intensive care. Therefore, it is highly recommended to change the current care approach and philosophy and provide facilities for conducting family-centered care in neonatal intensive care unit.  PMID:25349870

  2. Food Sanitation and Safety Self-assessment Instrument for Child Care Centers.

    Science.gov (United States)

    1990

    This self-assessment instrument for day care center staff is designed to help caregivers provide safe food to children. The nine sections of the instrument, presented in checklist format, concern: (1) personal hygiene; (2) purchasing, receiving, and inspecting of food; (3) food storage; (4) food service equipment; (5) food preparation; (6) infant…

  3. Day Care Doesn't Encourage Weight Gain in Kids

    Science.gov (United States)

    ... Services, or federal policy. More Health News on: Obesity in Children Recent Health News Related MedlinePlus Health Topics Child Care Obesity in Children About MedlinePlus Site Map FAQs Contact Us Get ...

  4. [Family-centered care and post-traumatic stress disorder].

    Science.gov (United States)

    Lin, Chia-Huei; Sun, Yin-Jhen; Tzeng, Wen-Chii; Chiang, Li-Chi

    2012-06-01

    A year has passed since a major earthquake and tsunami hit northeastern Honshu, Japan in March 2011. Amidst mourning for the tens of thousands of victims, survivors have just begun the difficult and urgent tasks of rebuilding. Many survivors suffer from post-traumatic stress disorder (PTSD). PTSD causes chronic, long-term suffering for patients and their families and inevitably burdens social and medical care systems. This article tries to integrate PTSD evidence-based treatment experiences into a practical and detailed nursing intervention protocol for PTSD. We also elicit the function and effect of "family-centered care." We hope that nursing professionals apply family-centered care principles to PTSD treatment and care approaches in order to promote PTSD patient resilience. Nurses can thus enhance PTSD care efficacy and improve the opportunity for PTSD patients to overcome their symptoms and recover their life.

  5. The History and Current Status of Federal Legislation Pertaining to Day Care Programs.

    Science.gov (United States)

    Searcy, Ellen O.; Ouellet, Ronald

    This report is a brief summary of the history of Federal Day Care provisions through the sixties and an analysis of the child care legislation pending in Congress during 1971. The 92nd Congress, in attempts to answer the growing demands for Federally-sponsored child care, introduced four separate bills dealing with child care financing: HR. 1…

  6. Comparing day care at green care farms and at regular day care facilities with regard to their effects on functional performance of community-dwelling older people with dementia

    NARCIS (Netherlands)

    Bruin, de S.R.; Oosting, S.J.; Tobi, H.; Enders-Slegers, M.J.; Zijpp, van der A.J.; Schols, J.M.G.A.

    2012-01-01

    Day care at green care farms (GCFs) is a new care modality for community-dwelling older people with dementia. In view of the more physical and normal daily life activities available at GCFs than at RDCFs, we investigated whether functional decline differed between subjects from both day care setting

  7. Translating person-centered care into practice

    DEFF Research Database (Denmark)

    Zoffmann, Vibeke; Hörnsten, Åsa; Storbækken, Solveig;

    2016-01-01

    self-determination [GSD]. METHODS: Comparative analysis included eight components: (1) philosophical origin; (2) development in original clinical setting; (3) theoretical underpinnings; (4) overarching goal and supportive processes; (5) general principles, strategies or tools for engaging peoples; (6......) health care professionals' background and training; (7) fidelity assessment; (8) reported effects. RESULTS: Although all approaches promoted autonomous motivation, they differed in other ways. Their original settings explain why IIS and GSD strive for life-illness integration, whereas MI focuses...... on managing ambivalence. IIS and GSD were based on grounded theories, and MI was intuitively developed. All apply processes and strategies to advance professionals' communication skills and engagement; GSD includes context-specific reflection sheets. All offer training programs; MI and GSD include fidelity...

  8. Day Care Babies Catch Stomach Bugs Earlier, but Get Fewer Later

    Science.gov (United States)

    ... of whom attended day care before age 1 -- Dutch scientists found a 13 percent higher rate of ... chair of pediatrics and director of pediatric infectious diseases at Christiana Care Health System, in Wilmington, Del., ...

  9. The Day Care Needs of the Indigent Children of West Virginia, with Recommendations for a Model Day Care Program and Delivery System. Volume 2.

    Science.gov (United States)

    Hodges, Walter L.; And Others

    This volume describes and discusses six major proposals for a complete model system of day care for indigent children in West Virginia. The recommendations include: (1) developing more specific objectives to be accomplished for children, parents, care providers, and the state; (2) developing a public education program designed to help parents…

  10. Local day-care quality and maternal employment: Evidence from East and West Germany

    OpenAIRE

    Pia S. Schober; Spieß, C. Katharina

    2014-01-01

    By investigating how locally available early childhood education and care quality relates to maternal employment choices, this study extended the literature which has mostly focused on the importance of day-care availability or costs. We provided differentiated analyses by the youngest child’s age and for West and East Germany to examine moderating influences of varying day-care supply and work-care cultures. The empirical analysis linked the Socio-Economic Panel and the ‘Families in Germany‘...

  11. Primary care nursing role and care coordination: an observational study of nursing work in a community health center.

    Science.gov (United States)

    Anderson, Daren R; St Hilaire, Daniel; Flinter, Margaret

    2012-05-01

    Care coordination is a core element of the Patient-Centered Medical Home and requires an effective, well educated nursing staff. A greater understanding of roles and tasks currently being carried out by nurses in primary care is needed to help practices determine how best to implement care coordination and transform into PCMHs. We conducted an observational study of primary care nursing in a Community Health Center by creating a classification schema for nursing responsibilities, directly observing and tracking nurses' work, and categorizing their activities. Ten nurses in eight different practice sites were observed for a total of 61 hours. The vast majority of nursing time was spent in vaccine and medication administration; telephone work; and charting and paper work, while only 15% of their time was spent in activity that was classified broadly as care coordination. Care coordination work appeared to be subsumed by other daily tasks, many of which could have been accomplished by other, lesser trained members of the health care team. Practices looking to implement care coordination need a detailed look at work flow, task assignments, and a critical assessment of staffing, adhering to the principal of each team member working to the highest level of his or her education and license. Care coordination represents a distinct responsibility that requires dedicated nursing time, separate from the day to day tasks in a busy practice. To fully support these new functions, reimbursement models are needed that support such non visit-based work and provide incentives to coordinate and manage complex cases, achieve improved clinical outcomes and enhance efficiency of the health system. This article describes our study methods, data collection, and analysis, results, and discussion about reorganizing nursing roles to promote care coordination. PMID:22686111

  12. Preschool Education and Day Care for Swedish Children.

    Science.gov (United States)

    Mueller, Jeanne

    A comprehensive study of the types of care provided for Swedish children is presented. The point is made that the three major frameworks which support the Swedish philosophy of early childhood education are those of Arnold Gesell, Jean Piaget, and Erik H. Erikson. From all three sources, preschool teachers learn the concept of epigenesis, the…

  13. 'Have a nice day': consumerism, compassion and health care.

    Science.gov (United States)

    Sturgeon, David

    Plans to implement a quality measurement framework that will rate nurses according to the level of care and compassion they demonstrate have been proposed and discussed in a number of Department of Health documents. From September 2010 degree-level nursing students in Wales will receive regular feedback on their communication skills and whether they are exhibiting sufficient levels of compassion. This article examines the reasons why there have been such moves by both politicians and health professionals to demonstrate, in quantifiable terms, that they are able to measure something that is frequently contextual and subject to individual interpretation. It explores how these moves have been influenced by the disclosure of unacceptable standards of care by the Patients Association report and the enquiry into Mid-Staffordshire NHS Foundation Trust. It also discusses how the adoption of targets to evaluate care and compassion seems to reflect a market-driven and bureaucratic approach to health care that has resulted in a system in which measurability and outcome are considered the most important indicator of quality.

  14. Consumerism: forcing medical practices toward patient-centered care.

    Science.gov (United States)

    Ozmon, Jeff

    2007-01-01

    Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

  15. Fatores associados ao desenvolvimento mental e motor de crianças de quatro creches públicas de Recife, Brasil Factors associated with mental and psychomotor development of infants in four public day care centers in the municipality of Recife, Brazil

    Directory of Open Access Journals (Sweden)

    Sophie Helena Eickmann

    2009-09-01

    Full Text Available OBJETIVO: Identificar os fatores associados aos índices de desenvolvimento mental e motor em lactentes que frequentam creches da rede municipal em Recife. MÉTODOS: Estudo de corte transversal realizado entre fevereiro e abril de 2005 em uma amostra de 108 crianças com idade entre quatro e 24 meses, pertencentes a quatro creches municipais do Recife. O desenvolvimento mental e motor foi avaliado pela Escala de Desenvolvimento Infantil de Bayley II. Por meio de entrevistas às mães, foram obtidas informações sobre as condições socioeconômicas e demográficas das famílias e as características biológicas das crianças ao nascer (peso, sexo e idade gestacional. O estado nutricional foi avaliado através dos índices peso/idade, comprimento/idade, peso/comprimento e da concentração de hemoglobina. RESULTADOS: As médias dos índices de desenvolvimento mental e motor foram 88±11 e 95±12 pontos, respectivamente. A idade gestacional apresentou associação significativa com o desenvolvimento mental e motor e o peso ao nascer e o estado nutricional atual, avaliado pelo índice peso/comprimento, se associaram ao desenvolvimento motor. CONCLUSÕES: As crianças analisadas apresentaram desenvolvimento neuropsicomotor ainda na faixa de normalidade, mas aquém do esperado para a idade, comparado a populações de referência em países desenvolvidos. Os fatores associados ao baixo desempenho do desenvolvimento nessa população estão relacionados aos fatores biológicos, destacando-se os déficits nutricionais, cuja redução deve ser uma prioridade para gestores em saúde e educação.OBJECTIVE: To identify factors associated with mental and psychomotor development of infants enrolled at public day care centers of Recife, Pernambuco, Brazil. METHODS: This is a cross-sectional study conducted with 108 infants aged four to 24 months attending four public day care centers of the Municipality of Recife from February to April 2005. Mental and

  16. Attendance at day care centers increases the risk of childhood pneumonia among the urban poor in Fortaleza, Brazil Práticas relacionadas aos cuidados da criança aumentam o risco de pneumonia nas crianças menores de dois anos em Fortaleza, Brasil

    Directory of Open Access Journals (Sweden)

    Walter Fonseca

    1996-06-01

    Full Text Available We carried out a case-control study to investigate risk factors for childhood pneumonia in two groups of 650 children aged under two years in the city of Fortaleza, Ceará, Brazil. The cases were children recruited at the main pediatric hospital with a radiological diagnosis of pneumonia, and controls were children of the same age group recruited from the neighbourhood of the cases. In this paper we focus on variables related to childcare practices. Working mothers, proportion of time the mother had worked since the child was born, and use of day care centers emerged as important risk factors with estimated relative risks of 1.58, 1.76 and 5.22, respectively. Also important were the number of children living in the house and presence of grandparents. However, the presence of siblings under two years and the birth order were not associated with pneumonia. All analysis included adjustment for confounding by income, parents' education, and other risk factors as appropriate. This is the first study from a developing country to identify attendance at day care centers as a risk factor for increased childhood morbidity, in this case pneumonia. This finding is of significant public health importance for countries such as Brazil with growing urban populations and an increasing need by mothers to find work outside the home.Estudou-se o risco de pneumonia nas crianças menores de dois anos na região metropolitana de Fortaleza entre junho/89 e maio/90. Foram investigadas as práticas relacionadas aos cuidados da criança como possíveis fatores de risco de pneumonia. Fatores maternos, ambientais e sócio-econômicos foram também estudados devido a sua possível relação com as práticas no cuidado da criança. Foi utilizada metodologia de caso-controle, sendo casos as crianças com diagnóstico clínico e radiológico de pneumonia, e controles aquelas crianças com diferença de idade inferior a dois meses que não apresentassem sintomas de infec

  17. [Trials for early intervention in Mie Prefectural Mental Care Center].

    Science.gov (United States)

    Harada, Masanori; Adachi, Takako; Iwasa, Takashi; Kurita, Kouji; Nakamura, Tomoki; Hama, Yukinobu; Yamamoto, Ayako; Maegawa, Sanae

    2013-01-01

    Mie Prefectural Mental Care Center is a public psychiatric hospital that has 400 beds and 250 outpatients a day. The main catchment area is Tsu City (population: 290,000). Our hospital started early intervention in Aug 2008, and opened the Youth Mental Support Center MIE (YMSC MIE) in Oct 2008. This article reports an early intervention trial in a regional area of Japan. The mission of YMSC MIE is the education, consultation, staff training, and intervention for mental health problems and early psychosis of youths. In Jul 2009, we set up the Youth Assist Clinic (YAC) to support youths with mental health problems and early psychoses. Our activities consist of school-based, community-based, and hospital-based approaches. Specific programs are as follows: 1) School-based approaches: Outreach consultation to school. Mental health lessens. Creating mental health textbooks. Education for parents and teachers. 2) Community-based approaches: To enlighten primary physicians and mental clinic psychiatrists about the importance of early psychosis. To survey their concerns regarding early psychosis. Promoting awareness of community staff and the general public. 3) Hospital-based approaches: YAC. Case manager system. Family meetings for the family including the young with mental disorders. Peer group. Looking back over our 3-year trials, especially in school and the community, we find several problems, as follows: 1) Lack of consultation skills of medical staff outside the hospital. 2) Limiting number of schools which have mental support system. 3) Support for school attendance and learning. 4) Lack of concern about early psychosis of primary physicians and mental clinic psychiatrists. 5) Staff training for early intervention. We are now getting close to improving these issues.

  18. Nasopharyngeal colonization by Haemophilus influenzae in children attending day-care centers, in Ribeirão Preto, State of São Paulo, Brazil Colonização da nasofaringe por Haemophilus influenzae em crianças que freqüentam creches em Ribeirão Preto, Estado de São Paulo, Brasil

    Directory of Open Access Journals (Sweden)

    Maria E.N. Bonifácio da Silva

    2006-03-01

    Full Text Available Nasopharyngeal carriage of Haemophilus influenzae (Hi was studied in 114 healthy children A colonização da nasofaringe por Haemophilus influenzae (Hi foi estudada em 114 crianças saudáveis com menos de 3 anos de idade e que freqüentam creches (day-care centers DCC em Ribeirão Preto, estado de São Paulo, Brasil. Para cada uma das cepas isoladas foram determinados o biótipo, o sorotipo (por antisoro especifico e PCR e a sensibilidade a 14 antibióticos. A freqüência de colonização por Hi foi de 72,0%. As cepas isoladas foram identificadas como pertencentes aos biótipos II (36,5%, I (21,5%, V (18,2% e III (16,1%. A freqüência encontrada de cepas encapsuladas foi de 3,2% para o tipo f, 1,0% para o tipo b, 1,0% para o tipo d e 1,0% para o tipo e. A resistência para trimetoprim-sulfametoxazole e ampicilina foi de 46,2% e 10,7% respectivamente. Resistência múltipla foi encontrada em 14 (15,0% das cepas analisadas. 13,9% das cepas analisadas eram produtoras de beta-lactamase, e não foi recuperada nenhuma cepa beta-lactamase negativa e ampicilina resistente. DCCs são considerados locais de risco, com um alto potencial de disseminação de microrganismos e por isto devem ser continuadamente monitorados com a finalidade de detectar a eliminação da colonização da nasofaringe por cepas H. influenzae tipo b das crianças que freqüentam DCC, ou detectar a sua substituição por outro tipo de cepa.

  19. A violência familiar no mundo da criança de creche e pré-escola La violencia familiar bajo la visión del niño que va a los jardines infantiles y pre-escuela Family violence in the perspective of the child who goes to day care center and pre-school

    Directory of Open Access Journals (Sweden)

    Lana Ermelina da Silva dos Santos

    2007-10-01

    Full Text Available A presente pesquisa utiliza o estudo descritivo e transversal e também a análise de conteúdo para conhecer a violência familiar em crianças de creches e pré-escolas. A população e os sujeitos são constituídos de educadores infantis, professores e monitores. Verificam-se nos resultados a presença da violência doméstica, praticada principalmente pela mãe, a criança agressiva está presente no ambiente das escolas como uma forma de reprodução de comportamento e também da negligência com relação aos cuidados e a atenção à criança no cotidiano. Esses comportamentos podem gerar outras formas de violência, mantendo a criança sempre em ambientes de risco durante várias fases da vida.La presente investigación utiliza el estudio descriptivo y también la análisis del contenido para conocer la violencia familiar en niños de jardines infantiles y Pre-escuela. La población y los sujetos son constituidos de educadores infantiles, profesores y monitores. Verificase en los resultados la presencia de la violencia doméstica, practicada principalmente por la madre, el niño agresivo está presente en el ambiente de las escuelas como una forma de reproducción de comportamiento y también, la negligencia con relación a los cuidados y la atención al niño en el cotidiano. Estos comportamientos pueden generar otras formas de violencia, manteniendo el niño siempre en ambientes de riesgo durante varias fases de la vida.The present research uses the descriptive and traversal study and also the content analysis to know the family violence in children of day care center and pre-schools. The population and the subjects are constituted of infantile educators, teachers and monitors. It is verified in the results the presence of the domestic violence, practiced mainly by the mother, the aggressive child is present in the atmosphere of the schools as a form of reproduction of behavior and also, the negligence regarding the cares and the

  20. 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......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...... 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....

  1. The Day Care Assignment: A Dynamic Matching Problem

    OpenAIRE

    John Kennes Jr.; Daniel Monte Jr.; Norovsambuu Tumennasan Jr.

    2014-01-01

    We study the problem of centralized allocation of children to public daycare centers, illustrated by the case of Denmark. Our framework applies to problems of dynamic matching in which there is entry and exit of agents over time; for example, the school choice problem once student mobility is taken into account. We show that there does not exist any mechanism that is both stable and strategy-proof. We also show that the well-known Top Trading Cycles mechanism is neither Pareto efficient nor s...

  2. Professionalism--A Breeding Ground for Struggle. The Example of the Finnish Day-Care Centre

    Science.gov (United States)

    Kinos, Jarmo

    2008-01-01

    This article examines the Finnish day-care centre out of a neo-Weberian-Bourdieuan frame of reference. The leading idea is that the day-care centre field is continuously shaping as a result of both inner struggles and struggles with other fields. The state, the education system, and trade unions act as the dealers of professional playing cards.…

  3. When Risk Becomes Invisible in the Everyday Life of Day Care

    Science.gov (United States)

    Villumsen, Anne Marie; Kristensen, Ole Steen

    2016-01-01

    Both the identification of children at risk in day care and multidisciplinary collaboration with other professions have a political focus. This study was designed as an organizational field study and attempts to establish a coherent practice of multidisciplinary collaboration between day care and social services. This article focuses on the…

  4. Recursos/Resources: A Bibliography of Spanish-Language Family Day Care Training Materials.

    Science.gov (United States)

    California Child Care Resource and Referral Network, San Francisco.

    This bibliography provides descriptions and contact information regarding resources produced by American and Canadian family day care training projects and other educational organizations for agencies working with Spanish-speaking family day care providers. Included are resources in the following areas: (1) "Recruitment Resources"; (2) "Family Day…

  5. High Detection Rates of Enteropathogens in Asymptomatic Children Attending Day Care

    NARCIS (Netherlands)

    Enserink, Remko; Scholts, Rianne; Bruijning-Verhagen, Patricia; Duizer, Erwin; Vennema, Harry; de Boer, Richard; Kortbeek, Titia; Roelfsema, Jeroen; Smit, Henriette; Kooistra-Smid, Mirjam; van Pelt, Wilfrid

    2014-01-01

    Background: Gastroenteritis morbidity is high among children under the age of four, especially amongst those who attend day care. Objective: To determine the prevalence of a range of enteropathogens in the intestinal flora of children attending day care and to relate their occurrence with characteri

  6. Challenging Our Assumptions: Helping a Baby Adjust to Center Care.

    Science.gov (United States)

    Elliot, Enid

    2003-01-01

    Contends that assumptions concerning infants' adjustment to child center care need to be tempered with attention to observation, thought, and commitment to each individual baby. Describes the Options Daycare program for pregnant teens and young mothers. Presents a case study illustrating the need for openness in strategy and planning for…

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

    OpenAIRE

    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 hygiene guidelines is generally low. In order to develop successful interventions to improve hand hygiene compliance and reduce gastrointestinal and respiratory infections among children attending day care...

  8. Impact of a 2-Day Critical Care Ultrasound Course during Fellowship Training: A Pilot Study

    OpenAIRE

    Vi Am Dinh; Giri, Paresh C.; Inimai Rathinavel; Emilie Nguyen; David Hecht; Ihab Dorotta; H. Bryant Nguyen; Chrissian, Ara A.

    2015-01-01

    Objectives. Despite the increasing utilization of point-of-care critical care ultrasonography (CCUS), standards establishing competency for its use are lacking. The purpose of this study was to evaluate the effectiveness of a 2-day CCUS course implementation on ultrasound-naïve critical care medicine (CCM) fellows. Methods. Prospective evaluation of the impact of a two-day CCUS course on eight CCM fellows' attitudes, proficiency, and use of CCUS. Ultrasound competency on multiple organ system...

  9. Factors influencing occupational engagement in day centers for people with psychiatric disabilities.

    Science.gov (United States)

    Tjörnstrand, Carina; Bejerholm, Ulrika; Eklund, Mona

    2015-01-01

    Occupational engagement is a vital factor in people's lives since it has been shown to be important for health and well-being. Community-based day centers (DCs), both meeting place-oriented and work-oriented ones, are common service alternatives in many western countries for enabling engagement in productive and leisure occupations among people with psychiatric disabilities. Little is, however, known about factors influencing occupational engagement in such settings. We aimed to investigate how factors pertaining to day center attendance, socio-demographics, motivation, clinical and self-related characteristics were related to how day center attendees rated their occupational engagement in productive occupations. These variables were assessed among day center attendees in meeting place-oriented (n = 39) and work-oriented (n = 54) DCs in Sweden through questionnaires and interviews. Logistic regression models showed that (1) less general psychopathology and more time spent on day center occupations were indicators of belonging to the group with a high level of occupational engagement according to a median cut; (2) higher perceived self-mastery was the only important factor with respect to ratings of occupational engagement above the third quartile. The models may be seen as creating a stepwise indication on which factors are important for reaching a medium level of occupational engagement (less severe general psychopathology and time spent at the day center) and for reaching a still higher level (a high level self-mastery), respectively, of occupational engagement. The findings may also be discussed in relation to different levels of engagement in a recovery process. PMID:25062905

  10. Clustering of serotypes in a longitudinal study of Streptococcus pneumoniae carriage in three day care centres

    Directory of Open Access Journals (Sweden)

    Tanskanen Antti

    2008-12-01

    Full Text Available Abstract Background Streptococcus pneumoniae (pneumococcus causes a wide range of clinical manifestations that together constitute a major burden of disease worldwide. The main route of pneumococcal transmission is through asymptomatic colonisation of the nasopharynx. Studies of transmission are currently of general interest because of the impact of the new conjugate-polysaccharide vaccines on nasopharyngeal colonisation (carriage. Here we report the first longitudinal study of pneumococcal carriage that records serotype specific exposure to pneumococci simultaneously within the two most important mixing groups, families and day care facilities. Methods We followed attendees (N = 59 with their family members (N = 117 and the employees (N = 37 in three Finnish day care centres for 9 months with monthly sampling of nasopharyngeal carriage. Pneumococci were cultured, identified and serotyped by standard methods. Results Children in day care constitute a core group of pneumococcal carriage: of the 36 acquisitions of carriage with documented exposure to homologous pneumococci, the attendee had been exposed in her/his day care centre in 35 cases and in the family in 9 cases. Day care children introduce pneumococci to the family: 66% of acquisitions of a new serotype in a family were associated with simultaneous or previous carriage of the same type in the child attending day care. Consequently, pneumococcal transmission was found to take place as micro-epidemics driven by the day care centres. Each of the three day care centres was dominated by a serotype of its own, accounting for 100% of the isolates of that serotype among all samples from the day care attendees. Conclusion The transmission of pneumococci is more intense within than across clusters defined by day care facilities. The ensuing micro-epidemic behaviour enhances pneumococcal transmission.

  11. Clustering of serotypes in a longitudinal study of Streptococcus pneumoniae carriage in three day care centres

    Science.gov (United States)

    Leino, Tuija; Hoti, Fabian; Syrjänen, Ritva; Tanskanen, Antti; Auranen, Kari

    2008-01-01

    Background Streptococcus pneumoniae (pneumococcus) causes a wide range of clinical manifestations that together constitute a major burden of disease worldwide. The main route of pneumococcal transmission is through asymptomatic colonisation of the nasopharynx. Studies of transmission are currently of general interest because of the impact of the new conjugate-polysaccharide vaccines on nasopharyngeal colonisation (carriage). Here we report the first longitudinal study of pneumococcal carriage that records serotype specific exposure to pneumococci simultaneously within the two most important mixing groups, families and day care facilities. Methods We followed attendees (N = 59) with their family members (N = 117) and the employees (N = 37) in three Finnish day care centres for 9 months with monthly sampling of nasopharyngeal carriage. Pneumococci were cultured, identified and serotyped by standard methods. Results Children in day care constitute a core group of pneumococcal carriage: of the 36 acquisitions of carriage with documented exposure to homologous pneumococci, the attendee had been exposed in her/his day care centre in 35 cases and in the family in 9 cases. Day care children introduce pneumococci to the family: 66% of acquisitions of a new serotype in a family were associated with simultaneous or previous carriage of the same type in the child attending day care. Consequently, pneumococcal transmission was found to take place as micro-epidemics driven by the day care centres. Each of the three day care centres was dominated by a serotype of its own, accounting for 100% of the isolates of that serotype among all samples from the day care attendees. Conclusion The transmission of pneumococci is more intense within than across clusters defined by day care facilities. The ensuing micro-epidemic behaviour enhances pneumococcal transmission. PMID:19116005

  12. Hypertension care at primary health care centers: A report from Abha, Saudi Arabia

    OpenAIRE

    Al-Homrany Mohammed; Khan Mohd; Al-Khaldi Yahia; Al-Gelban Khalid; Al-Amri Hasan

    2008-01-01

    It is well known that effective management of hypertension reduces the incidence of myo-cardial infarction, stroke and vascular complications. The Ministry of Health, Kingdom of Saudi Arabia, introduced the Quality Assurance Guidelines with the hope to improve the management of hypertension in its centers. We conducted an audit of two Primary Health Care Centers namely, Al-Manhal (MPHCC) and Al-Numais (NPHCC), to evaluate how well hypertension was managened at these centers. A check list was ...

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

    Science.gov (United States)

    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.

  14. Assessment of Children’s Health and Indoor Air Contaminants of Day Care Centre in Industrial Area

    Directory of Open Access Journals (Sweden)

    Tezara CIONITA

    2015-10-01

    Full Text Available Background: Carbon dioxide (CO2 is one of the most commonly used indicators of indoor air quality (IAQ in industrial area. The higher concentration level of CO2 and particulate matter (PM10 in day care centre could affect children’s health. The objective of this study was to assess children’s health symptom, and measure the CO2 and PM10 concentration level as IAQ parameters in different locations of day care centres near the industrial area at Kuala Lumpur, Selangor and Hulu Langat as urban, suburban and rural areas respectively.Methods: The data of children’s health symptom were collected from the distributed questionnaire.Results: The day care centres (DCC in Kuala Lumpur has the highest number of children’s illness frequency of more than four times annually (11%, followed by the highest number of children who experienced asthma (5.3%, wheezing (3.3% and coughing (10%. The results of data collection of day care centres in Kuala Lumpur, Selangor and Hulu Langat ranged between 629-830 ppm, 587-823 ppm and 600-830 ppm for CO2 level, and 60.80-78.60 mg/m3, 56.90-80.50 mg/m3 and 59.90-79.10 mg/m3 for PM10 level. The statistical analysis for CO2 level between areas was significantly different (P<0.05.Conclusion: Day care centers in Kuala Lumpur have the highest mean rate of CO2 and PM10 as well as frequency of children’ illness which could identify traffic congestion and less greenery of a densely populated city. Keywords: Day care centre (DCC, IAQ, CO2, PM10, Health symptoms

  15. Improving care at cystic fibrosis centers through quality improvement.

    Science.gov (United States)

    Kraynack, Nathan C; McBride, John T

    2009-10-01

    Quality improvement (QI) using a clinical microsystems approach provides cystic fibrosis (CF) centers the opportunity to make a significant positive impact on the health of their patients. The availability of center-specific outcomes data and the support of the Cystic Fibrosis Foundation are important advantages for these quality improvement efforts. This article illustrates how the clinical microsystems methodology can improve care delivery and outcomes by describing the gradual application of quality improvement principles over the past 5 years by the CF team at the Lewis Walker Cystic Fibrosis Center at Akron Children's Hospital in Akron, Ohio. Using the example of a project to improve the pulmonary function of the pediatric patients at our center as a framework, we describe the QI process from the initial team-building phase, through the assessment of care processes, standardization of care, and developing a culture of continuous improvement. We outline how enthusiastic commitment from physician leadership, clinical managers and central administration, the availability of coaches, and an appreciation of the importance of measurement, patient involvement, communication, and standardization are critical components for successful process improvement. PMID:19760542

  16. Detection of Cryptosporidium sp. in non diarrheal faeces from children, in a day care center in the city of São Paulo, Brazil Detecção de Cryptosporidium sp. em fezes não diarréicas de crianças, em uma escola de educação infantil de São Paulo, Brasil

    Directory of Open Access Journals (Sweden)

    Therezinha T. Carvalho-Almeida

    2006-02-01

    Full Text Available The protozoan Cryptosporidium sp. has been frequently detected in faeces from children with persistent diarrhoea. This work achieved to investigate an outbreak of cryptosporidiosis, in a day care center, attending children of high socio-economic level, between 0 and six years old. The outbreak was detected through the network of public health, when stool samples, not diarrhoeic, were examined at the Parasitology Service of the Adolfo Lutz Institute. Among the 64 examined children, 13 (20.3% showed oocysts of Cryptosporidium sp. in the faeces examined by Kinyoun technique: seven children one year old, three, two years old and three, three years old. Among the 23 examined adults, only a 22 years old woman, possibly having an immunocomprometiment, was positive. Clinical and epidemiological aspects were investigated by questionnaires, highlighting the occurrence of the outbreak in a very dry period.O protozoário Cryptosporidium sp. tem sido detectado com freqüência em fezes de crianças com diarréia persistente. Este trabalho teve como objetivo investigar um surto de criptosporidiose, em uma escola de educação infantil, que atende crianças de classe média alta, de 0 a seis anos de idade. O surto foi detectado a partir de amostras fecais não diarréicas encaminhadas ao Instituto Adolfo Lutz através da rede de saúde pública. Das 64 crianças 13 (20,3% apresentaram oocistos de Cryptosporidium nas fezes, examinadas pelo método de Kinyoun, sendo sete crianças com um ano de idade, três com dois anos de idade e três, com três anos de idade. Dos 23 adultos examinados, apenas uma mulher de 22 anos, com possível imunocomprometimento, foi positiva. Aspectos epidemiológicos e clínicos foram investigados por meio de questionários, ressaltando-se que o surto ocorreu em período muito seco.

  17. Estimating Criminal Justice System Costs and Cost-Savings Benefits of Day Reporting Centers

    Science.gov (United States)

    Craddock, Amy

    2004-01-01

    This paper reports on the net cost-savings benefits (loss) to the criminal justice system of one rural and one urban day reporting center, both of which serve high risk/high need probationers. It also discusses issues of conducting criminal justice system cost studies of community corrections programs. The average DRC participant in the rural…

  18. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations...

  19. 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

    ..., 2010, at 75 FR 41793. Child and Adult Care Food Program (CACFP) [Per meal rates in whole or fractions... 48 FR 29114, June 24, 1983.) This notice has been determined to be not significant and was reviewed... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day...

  20. 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.

  1. Researching family through the everyday lives of children across home and day care in Denmark

    DEFF Research Database (Denmark)

    Kousholt, Dorte

    2011-01-01

    The article investigates family as a conflictual community with a specific starting point in exploring children's lives across day-care institution and home. Children's development is theorised in relation to taking part in different communities across different contexts. The article draws...... on an ethnographically inspired research project with 6 families living in a small town in Denmark. The analysis points to how the children's possibilities of participation are created across their different life contexts and that the social interplay and conflicts between the children in the day-care institution have...... and connections between the day-care institution and home....

  2. The effectiveness and safety of short-contact dithranol therapy in paediatric psoriasis: a prospective comparison of regular day care and day care with telemedicine

    NARCIS (Netherlands)

    Oostveen, A.M.; Beulens, C.A.; Kerkhof, P.C.M. van de; Jong, E.M.G.J. de; Seyger, M.M.B.

    2014-01-01

    BACKGROUND: Evidence on the effectiveness and safety of short-contact dithranol therapy in paediatric psoriasis is sparse and based only on retrospective data. The best results are achieved in a time-consuming day-care setting. OBJECTIVES: To study prospectively the effectiveness and safety of short

  3. Cancer patient-centered home care: a new model for health care in oncology

    Science.gov (United States)

    Tralongo, Paolo; Ferraù, Francesco; Borsellino, Nicolò; Verderame, Francesco; Caruso, Michele; Giuffrida, Dario; Butera, Alfredo; Gebbia, Vittorio

    2011-01-01

    Patient-centered home care is a new model of assistance, which may be integrated with more traditional hospital-centered care especially in selected groups of informed and trained patients. Patient-centered care is based on patients’ needs rather than on prognosis, and takes into account the emotional and psychosocial aspects of the disease. This model may be applied to elderly patients, who present comorbid diseases, but it also fits with the needs of younger fit patients. A specialized multidisciplinary team coordinated by experienced medical oncologists and including pharmacists, psychologists, nurses, and social assistance providers should carry out home care. Other professional figures may be required depending on patients’ needs. Every effort should be made to achieve optimal coordination between the health professionals and the reference hospital and to employ shared evidence-based guidelines, which in turn guarantee safety and efficacy. Comprehensive care has to be easily accessible and requires a high level of education and knowledge of the disease for both the patients and their caregivers. Patient-centered home care represents an important tool to improve quality of life and help cancer patients while also being cost effective. PMID:21941445

  4. Dental Care Every Day: A Caregiver's Guide. Practical Oral Care for People with Developmental Disabilities

    Science.gov (United States)

    National Institute of Dental and Craniofacial Research (NIDCR), 2009

    2009-01-01

    Taking care of someone with a developmental disability requires patience and skill. As a caregiver, you know this as well as anyone does. You also know how challenging it is to help that person with dental care. It takes planning, time, and the ability to manage physical, mental, and behavioral problems. Dental care isn't always easy, but you can…

  5. Oncology nurse communication barriers to patient-centered care.

    Science.gov (United States)

    Wittenberg-Lyles, Elaine; Goldsmith, Joy; Ferrell, Betty

    2013-04-01

    Although quality communication has been identified as a necessary component to cancer care, communication skills training programs have yet to focus on the unique role of nurses. This study explored communication barriers as reported by seven nurse managers to better identify communication skills needed for oncology nurses to practice patient-centered care. Thematic analysis of transcripts was used to identify barriers to patient and family communication and desirable patient-centered nursing communication skills. Overall, the nurse managers reported that nurses experience patient and family communication difficulties as a result of inconsistent messages to patients and family from other healthcare staff. Physician assumptions about nursing left nurses feeling uncomfortable asking for clarification, creating a barrier to team communication processes. Patient-centered communication and care cannot be actualized for nurses unless team roles are clarified and nurses receive training in how to communicate with physicians, patients, and family. Therefore, the authors of this article created the COMFORT communication training protocol, and key concepts and resources for nurse communication training through COMFORT are detailed in this article.

  6. Factors related to the performance of Specialized Dental Care Centers

    Directory of Open Access Journals (Sweden)

    Flávia Christiane de Azevedo Machado

    2015-04-01

    Full Text Available The Specialized Dental Care Centers (SDCC have the mission to expand access to public medium complexity dental care and support the primary health care actions at this level of complexity. However, it is necessary to ensure the quality of services and to evaluate such services continuously to identify weaknesses and strengths that support the processes of leadership/management. Nevertheless, there is a dearth of studies on the assessment of oral health in specialized care that may indicate which factors should be investigated. Therefore, this integrated literature review sought to explore the plethora of publications on the evaluation of SDCC in the LILACS and MEDLINE data bases in October 2013 to identify factors possibly related to the performance of such health services. Thus, 13 references were included in this review pointing to forms of organization and management of work processes related to the creation of healthcare networks (operation of regulation centers and setting up of health consortiums. They include the contextual characteristics of the places where SDCCs are located (population size, Family Health Strategy coverage, Municipal Human Development Index, governance, governing capacity were factors that influenced the SDCCs performance.

  7. Factors related to the performance of Specialized Dental Care Centers.

    Science.gov (United States)

    Machado, Flávia Christiane de Azevedo; Silva, Janmille Valdevino; Ferreira, Maria Ângela Fernandes

    2015-04-01

    The Specialized Dental Care Centers (SDCC) have the mission to expand access to public medium complexity dental care and support the primary health care actions at this level of complexity. However, it is necessary to ensure the quality of services and to evaluate such services continuously to identify weaknesses and strengths that support the processes of leadership/management. Nevertheless, there is a dearth of studies on the assessment of oral health in specialized care that may indicate which factors should be investigated. Therefore, this integrated literature review sought to explore the plethora of publications on the evaluation of SDCC in the LILACS and MEDLINE data bases in October 2013 to identify factors possibly related to the performance of such health services. Thus, 13 references were included in this review pointing to forms of organization and management of work processes related to the creation of healthcare networks (operation of regulation centers and setting up of health consortiums). They include the contextual characteristics of the places where SDCCs are located (population size, Family Health Strategy coverage, Municipal Human Development Index, governance, governing capacity) were factors that influenced the SDCCs performance. PMID:25923626

  8. 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...... 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...... and yet hidden, unnoticed and invisible (Bech Jørgensen 1988, Bloch 1988, Baagøee Nielsen 2005). This is a central work condition for the kindergar-ten teachers who work in day care institutions. A central hypothesis in our research project, “Developing and strengthening the professional competences...

  9. Improving the financial viability of primary care health centers.

    Science.gov (United States)

    Finkler, S A; Knickman, J R; Hanson, K L

    1994-01-01

    This article presents findings from a national demonstration program to improve the long-term financial viability of small not-for-profit primary care health centers. The program initiatives and their implementation are described in some detail. A standard pre/post study design was used to measure the impact of the initiatives on general outcome measures, financial ratios, and the utilization of management techniques. Overall, demonstration centers showed improvement over the study period. Notable short-term improvements included significant growth in the volume of patient visits and increased profit. Observed changes also revealed an increased use of sophisticated management techniques, expected to positively affect longer-term financial health. The findings suggest that improving the financial viability of health centers need not be expensive.

  10. VERIFICATION OF THE PRESENCE OF CAPSULE GENE SEQUENCES IN NASOPHARYNGEAL ISOLATES OF NONTYPEABLE HAEMOPHILUS INFLUENZAE FROM HEALTHY CHILDREN AT A BRAZILIAN DAY CARE CENTER Verificação da presença de seqüências do gene da cápsula em cepas não tipáveis de Haemophilus influenzae isoladas da nasofaringe de crianças saudáveis em uma creche brasileira

    Directory of Open Access Journals (Sweden)

    Maria Emilia Bonifácio da Silva

    2001-10-01

    Full Text Available Fifty-eight nasopharyngeal isolates of Haemophilus influenzae were collected from healthy children at a day care center, and nontypeable isolates were examined by Southern blot for the presence of capsule gene sequences. Seven isolates (12% demonstrated homology with capsule-specific sequences. One isolate was characterized as an H. influenzae type b capsule-deficient strain.Cinqüenta e oito cepas de Haemophilus influenzae foram isoladas da nasofaringe de crianças saudáveis que freqüentam uma creche, e através da técnica de Southern blot foi pesquisada nas cepas acapsuladas a presença de seqüências do gene capsular. Sete cepas (12% caracterizadas sorologicamente como acapsuladas mostraram homologia com seqüências específicas da cápsula. Uma cepa foi caracterizada com uma linhagem H. influenzae tipo b cápsula deficiente.

  11. 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 hygiene

  12. Child-to-Teacher Ratio and Day Care Teacher Sickeness Absenteeism

    DEFF Research Database (Denmark)

    Gørtz, Mette; Andersson, Elvira

    2014-01-01

    The literature on occupational health points to work pressure as a trigger of sickness absence. However, reliable, objective measures of work pressure are in short supply. This paper uses Danish day care teachers as an ideal case for analysing whether work pressure measured by the child-to-teache...... for nursery care teachers, but not for preschool teacher...

  13. Measuring Therapeutic Alliance with Children in Residential Treatment and Therapeutic Day Care

    Science.gov (United States)

    Roest, Jesse; van der Helm, Peer; Strijbosch, Eefje; van Brandenburg, Mariëtte; Stams, Geert Jan

    2016-01-01

    Purpose: This study examined the construct validity and reliability of a therapeutic alliance measure (Children's Alliance Questionnaire [CAQ]) for children with psychosocial and/or behavioral problems, receiving therapeutic residential care or day care in the Netherlands. Methods: Confirmatory factor analysis of a one-factor model ''therapeutic…

  14. Child Caregivers' Contingent Responsiveness Behaviors during Interactions with Toddlers within Three Day Care Contexts

    Science.gov (United States)

    Rhyner, Paula M.; Guenther, Katie L.; Pizur-Barnekow, Kris; Cashin, Susan E.; Chavie, Amy L.

    2013-01-01

    Increasingly, children spend much of their day in the care of adults other than their parents, such as child care providers. Consequently, it is important to analyze nonparental adults' use of strategies suggested to foster language development, such as contingent responsiveness, during interactions with young children. This study examined…

  15. Thriving Children, Striving Families: A Blueprint for Streamlined Delivery of Child Day Care Collaboration Plan.

    Science.gov (United States)

    Bassler, Elissa J.; And Others

    Upcoming federal and state changes in welfare and social services will have a profound effect on the delivery of early childhood care and education in Illinois. In October, 1995, the Day Care Action Council of Illinois convened a meeting of early childhood experts and advocates. From this retreat, a vision for a new system of the delivery of child…

  16. Day-care expansion and parental subjective well-being: Evidence from Germany

    OpenAIRE

    Pia S. Schober; Schmitt, Christian

    2013-01-01

    This study investigates whether the expansion of day-care places for under-three-year-old children in East and West Germany from 2007 to 2011 has improved the subjective wellbeing for mothers and fathers with a youngest child in this age group. We extend existing cross-sectional country comparisons and single country policy evaluations by comparing regional variations over time in two different contexts in terms of work-care ideals, labour market, and child care policies. The empirical analys...

  17. Stress in Persons with Dementia: Benefits of a Memory Center Day Program.

    Science.gov (United States)

    Williams, Christine; Tappen, Ruth; Wiese, Lisa; Newman, David; Corbett, Maria; Pinos, Suzanne; Curtis, Barbara; Murray, Belinda

    2016-10-01

    Most persons with dementia are cared for by family members who are so overwhelmed that their mental and physical health declines. Adult day care programs (ADC) are growing in number to meet caregivers' needs for respite but little is known about their effect on enrollee mental health. We examined mental health of enrollees (stress, anxiety, mood, emotions) and arousal (blood pressure and salivary cortisol) from day program enrollment to 3 months following enrollment. Results showed significant decreases in morning cortisol level at 1 and 3 months (p=.047). Perceived stress decreased at 1 and 3 months measured by Perceived Stress Scale (p=.03) and Index of Clinical Stress (p=.01). Results provide support for ADC as a stress-reducing environment for individuals with mild to moderate cognitive impairment. Future studies should be conducted to examine which elements of ADC are beneficial. PMID:27654233

  18. Day Care for Working Families Act of 1987. Hearing on S. 1271 To Provide Comprehensive Federal Assistance for Day Care, before the Subcommittee on Labor of the Committee on Labor and Human Resources. United States Senate, One Hundredth Congress, First Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    Recognizing the importance of the need for quality day care for children of working mothers, handicapped children, and children of low income families, the U.S. Senate Subcommittee on Labor and Human Resources met to address this issue in the Child Care Center of Owens Technical College, in Toledo, Ohio. The Subcommittee interviewed or heard…

  19. Child voice and noise: a pilot study of noise in day cares and the effects on 10 children's voice quality according to perceptual evaluation.

    Science.gov (United States)

    McAllister, Anita M; Granqvist, Svante; Sjölander, Peta; Sundberg, Johan

    2009-09-01

    The purpose of this investigation was to study children's exposure to background noise at the ears during a normal day at the day care center and also to relate this to a perceptual evaluation of voice quality. Ten children, from three day care centers, with no history of hearing and speech problems or frequent infections were selected as subjects. A binaural recording technique was used with two microphones placed on both sides of the subject's head, at equal distance from the mouth. A portable digital audio tape (DAT) recorder (Sony TCD-D 100, Stockholm, Sweden) was attached to the subject's waist. Three recordings were made for each child during the day. Each recording was calibrated and started with three repetitions of three sentences containing only sonorants. The recording technique allowed separate analyses of the background noise level and of the sound pressure level (SPL) of each subjects' own voice. Results showed a mean background noise level for the three day care centers at 82.6dBA Leq, ranging from 81.5 to 83.6dBA Leq. Day care center no. 2 had the highest mean value and also the highest value at any separate recording session with a mean background noise level of 85.4dBA Leq during the noontime recordings. Perceptual evaluation showed that the children attending this day care center also received higher values on the following voice characteristics: hoarseness, breathiness, and hyperfunction. Girls increased their loudness level during the day, whereas for boys no such change could be observed.

  20. Role of spirituality and religious expereinces of Black Sheep Day Center

    OpenAIRE

    Masih, Anwar

    2012-01-01

    Masih, Anwar Aslam. “The role of spirituality and religious experiences of service users” at Black Sheep Day Center Tampere. 64 p; 2 appendices. Language: English, Järvenpää.Autumn 2012. Diaconia University of Applied Sciences, Degree programme in Social services. Degree: Bachelor of Social services. This thesis is an action oriented project. It includes a written report on the process and results of the explanatory thesis.The aim of the study were to produce informative material fo...

  1. Factors Influencing Occupational Engagement in Day Centers for People with Psychiatric Disabilities.

    OpenAIRE

    Tjörnstrand, Carina; Bejerholm, Ulrika; Eklund, Mona

    2015-01-01

    Occupational engagement is a vital factor in people's lives since it has been shown to be important for health and well-being. Community-based day centers (DCs), both meeting place-oriented and work-oriented ones, are common service alternatives in many western countries for enabling engagement in productive and leisure occupations among people with psychiatric disabilities. Little is, however, known about factors influencing occupational engagement in such settings. We aimed to investiga...

  2. COSTS AND BENEFITS OF DAY TREATMENT WITH COMMUNITY CARE FOR SCHIZOPHRENIC-PATIENTS

    NARCIS (Netherlands)

    WIERSMA, D; KLUITER, H; NIENHUIS, FJ; RUPHAN, M; GIEL, R

    1991-01-01

    The feasibility of day treatment with community care for schizophrenic patients was tested by means of a longitudinal randomized experiment with 34 experimentals and 16 controls: 38 percent could be treated satisfactorily in a day program that included a very active ambulatory service. The new appro

  3. Day Hospital and Residential Addiction Treatment: Randomized and Nonrandomized Managed Care Clients

    Science.gov (United States)

    Witbrodt, Jane; Bond, Jason; Kaskutas, Lee Ann; Weisner, Constance; Jaeger, Gary; Pating, David; Moore, Charles

    2007-01-01

    Male and female managed care clients randomized to day hospital (n=154) or community residential treatment (n=139) were compared on substance use outcomes at 6 and 12 months. To address possible bias in naturalistic studies, outcomes were also examined for clients who self-selected day hospital (n=321) and for clients excluded from randomization…

  4. Cortisol Response to Physical Activity in African American Toddlers Attending Full-Time Day Care

    Science.gov (United States)

    Wall, Sarah J.; Rudisill, Mary E.; Gladden, L. Bruce

    2009-01-01

    The purpose of this study was to examine African American toddlers' cortisol response to acute physical play activity within a full-time subsidized day care environment. Saliva samples were taken from participants (N = 22, ages 26-45.5 months) before and after physical play and control play conditions at the same time of day. Actiheart[TM]monitors…

  5. Estado nutricional de crianças assistidas em creches e situação de (insegurança alimentar de suas famílias Nutritional status of children attended in day-care-centers and food (insecurity of their families

    Directory of Open Access Journals (Sweden)

    Maercio Mota de Souza

    2012-12-01

    Full Text Available Examinar fatores associados a excesso de peso, déficit de estatura e déficit de peso em crianças assistidas em creches estaduais de João Pessoa e descrever a situação de (insegurança alimentar das suas famílias. Trata-se de um estudo transversal com amostra de 250 crianças. Foram estudadas variáveis socioeconômicas, maternas e das crianças. O estado nutricional das crianças foi avaliado considerando os índices estatura-para-idade e peso-para-estatura. A segurança alimentar familiar foi avaliada com a utilização da Escala Brasileira de Insegurança Alimentar. As proporções de déficit de estatura, déficit de peso e excesso de peso foram 7,6%, 1,6% e 6,4%, respectivamente. Os fatores associados à baixa estatura foram baixa estatura materna e esquema vacinal incompleto. Com relação ao baixo peso, o fator associado foi idade materna inferior a 20 anos. O excesso de peso infantil apresentou associação com o excesso de peso materno e baixa estatura materna. Em 59,6% das famílias, observou-se situação de insegurança alimentar e nutricional, sendo mais frequente a forma leve (32,4%. Excesso de peso e déficit de estatura foram os distúrbios nutricionais mais frequentes neste estudo, constituindo prioridades que devem ser consideradas nas políticas públicas atuais.The scope of this study was to examine associated factors with overweight, stunting and underweight in children attending state day care centers of João Pessoa, as well as to describe the situation of food (insecurity of their families. A cross-sectional study was conducted with a sample of 250 children. Socioeconomic, maternal and child variables were studied. The nutritional status of children was evaluated considering the height-for-age and weight-for-height indices. Household food security was assessed using the Brazilian Scale of Food Insecurity. The proportions of stunting, underweight and overweight were 7.6%, 1.6% and 6.4% respectively. The associated

  6. Fatores interferentes na alimentação de crianças de 17 a 25 meses de uma creche municipal Aspects interfering in the feeding of children from 17 to 25 months of a municipal day-care center

    Directory of Open Access Journals (Sweden)

    Ana Paola Nicolielo

    2009-01-01

    Full Text Available OBJETIVO: verificar fatores interferentes no padrão de alimentação de crianças de 17 a 25 meses. MÉTODOS: dados de avaliações fonoaudiológicas de todas as crianças do berçário (n=14 de uma creche no município de Bauru/SP. Aplicação de questionário aos pais a respeito das condições de saúde geral e desenvolvimento neuromotor, aleitamento natural ou artificial, hábitos orais e problemas respiratórios. Analisou-se a morfofuncionalidade dos constituintes do sistema estomatognático e características clínico-fisiológicas da mastiga��ão e deglutição. A análise estatística foi descritiva. RESULTADOS: constatou-se alteração em diversos aspectos da saúde nas crianças (92,8%; presença de má oclusão (28,6%; alterações morfológicas para lábio (21,4% e língua (21,4%; alterações de tonicidade de bochechas (57,1%, mento (21,4% e lábios (42,8%; respiração oral ou oronasal (42,8%; alterações na mastigação (35,7% e na deglutição de sólido (50% e líquido (42,8%. CONCLUSÃO: para esse grupo, a presença de hábitos orais, assim como as alterações morfológicas e de tonicidade influenciam o padrão de alimentação das crianças analisadas, evidenciando a necessidade de prevenir e detectar precocemente tais fatores para que a alimentação nas crianças ocorra de forma adequada, promovendo assim condições de saúde para um desenvolvimento hígido.PURPOSE: to check interfering aspects in the feeding standard of children from 17 to 25 months. METHODS: data of speech language pathology evaluation related to 14 children that attended a day-care center in the city of Bauru/SP. A questionnaire was applied in order to get information about general health conditions and neuromotor development, natural or artificial feeding, oral habits and breathing problems. The analysis was made under the following aspects: morpho-functionality of the physician-physiological characteristic constituting the stomatognathic system

  7. Cancer patient-centered home care: a new model for health care in oncology

    Directory of Open Access Journals (Sweden)

    Tralongo P

    2011-09-01

    Full Text Available Paolo Tralongo1, Francesco Ferraù2, Nicolò Borsellino3, Francesco Verderame4, Michele Caruso5, Dario Giuffrida6, Alfredo Butera7, Vittorio Gebbia81Medical Oncology Unit, Azienda Sanitaria Provinciale, Siracusa; 2Medical Oncology Unit, Ospedale San Vincenzo, Taormina; 3Medical Oncology Unit, Ospedale Buccheri La Ferla, Palermo; 4Medical Oncology Unit, Ospedale Giovanni Paolo II, Sciacca; 5Medical Oncology Unit, Istituto Humanitas, Catania; 6Medical Oncology Unit, Istituto Oncologico del Mediterraneo, Catania; 7Medical Oncology Unit, Ospedale San Giovanni di Dio, Agrigento; 8Medical Oncology Unit, Dipartimento Oncologico, La Maddalena, Università degli Studi, Palermo, ItalyAbstract: Patient-centered home care is a new model of assistance, which may be integrated with more traditional hospital-centered care especially in selected groups of informed and trained patients. Patient-centered care is based on patients' needs rather than on prognosis, and takes into account the emotional and psychosocial aspects of the disease. This model may be applied to elderly patients, who present comorbid diseases, but it also fits with the needs of younger fit patients. A specialized multidisciplinary team coordinated by experienced medical oncologists and including pharmacists, psychologists, nurses, and social assistance providers should carry out home care. Other professional figures may be required depending on patients' needs. Every effort should be made to achieve optimal coordination between the health professionals and the reference hospital and to employ shared evidence-based guidelines, which in turn guarantee safety and efficacy. Comprehensive care has to be easily accessible and requires a high level of education and knowledge of the disease for both the patients and their caregivers. Patient-centered home care represents an important tool to improve quality of life and help cancer patients while also being cost effective.Keywords: cancer, home care

  8. The effect of exercise intervention on frail elderly in need of care: half-day program in a senior day-care service facility specializing in functional training.

    Science.gov (United States)

    Sakamoto, Ryota; Miura, Yasushi

    2016-07-01

    [Purpose] This study investigated the long-term effect of a half-day exercise intervention program on health-related quality of life, life function, and physical function in frail elderly in need of care. The program was conducted at a senior day-care facility specializing in functional training. [Subjects and Methods] Subjects included 41 elderly in need of care who had visited the service facility for at least 1 year. Physical function and life function were evaluated at baseline, 6 months, and 12 months. Quality of life was evaluated with the Short Form-36 at baseline and 12 months. [Results] Improvements in balance, walking speed and endurance, complex performance abilities, self-efficacy during the activities, and the level and sphere of activity were observed at 6 months and maintained up to 12 months. Moreover, improvements in agility, activities of daily living, life function, and quality of life were also observed at 12 months. Improvements in muscle strength, walking ability, self-efficacy over an action, and activities of daily living were related to the improvement in quality of life. [Conclusion] The use of individualized exercise programs developed by physiotherapists led to improvements in activities of daily living and quality of life among elderly in need of care. PMID:27512243

  9. Status of Day Care in Canada: A Review of the Major Findings of the National Day Care Study, 1974. (Situation De La Garde De Jour Au Canada: Une Revue des Principales Constatations Sur La Garde De Jour, 1974).

    Science.gov (United States)

    Department of National Health and Welfare, Ottawa (Ontario).

    This booklet presents (in both French and English) the results of a 1974 survey which assessed the growth of day care services in Canada. Similar national surveys had been conducted in 1971 and 1973. Results indicated that the number of day care spaces and the number of children of working mothers in day care increased substantially from 1973 to…

  10. Seasonal variation, weather and behavior in day-care children: a multilevel approach

    Science.gov (United States)

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

    2013-11-01

    This study analyzes the effect of weather variables, such as solar radiation, indoor and outdoor air temperature, relative humidity and time spent outdoor, on the behavior of 2-year-old children and their affects across different seasons: winter, spring and summer. Participants were a group of 61 children (33 males and 28 females) attending four day-care centers in Florence (Central Italy). Mean age of children at the beginning of the study was 24.1 months ( SD = 3.6). We used multilevel linear analyses to account for the hierarchical structure of our data. The study analyzed the following behavioral variables: Activity Level, Attentional Focusing, Frustration, and Aggression. Results showed a different impact of some weather variables on children’s behavior across seasons, indicating that the weather variable that affects children’s behavior is usually the one that shows extreme values during the studied seasons, such as air temperature and relative humidity in winter and summer. Studying children and their reactions to weather conditions could have potentially wide-reaching implications for parenting and teaching practices, as well as for researchers studying social relationships development.

  11. Psychiatric Diagnostic Uncertainty: Challenges to Patient-Centered Care.

    Science.gov (United States)

    Aultman, Julie M

    2016-01-01

    In this case and commentary, a patient's request to be treated for depression without a stigmatizing diagnostic label of bipolar II disorder challenges a clinician's obligation to provide a clinically and ethically appropriate diagnosis and safe treatment consistent with the patient's family medical history. Sensitively recognizing and responding to patients' concerns and values, even when they might conflict with the delivery of reasonable psychiatric care, is essential when gauging the appropriateness of such therapeutic practices. Furthermore, developing honest and open communication; recognizing that patients, like some psychiatric diagnoses, do not fit into discrete boundaries or cannot be categorized by a single label; and placing the patient at the center of care can all serve to resolve value conflicts, protect patient privacy, and promote accurate diagnostic and treatment practices. PMID:27322991

  12. [Systematization of nursing care in the obstetrical center].

    Science.gov (United States)

    dos Santos, Raquel Bezerra; Ramos, Karla da Silva

    2012-01-01

    This is a descriptive and exploratory study with a quantitative approach, aiming to propose a protocol for the systematization of nursing care to women in the process of giving birth in the Obstetrical Center of a public hospital in Recife, Pernambuco, Brazil. A semi-structured instrument was applied to forty women in the process of giving birth, in order to obtaining the nursing history; from which the nursing diagnoses were identified, having as a basis the International Classification for Nursing Practice (ICNP®), version 1, and their respective results and nursing interventions were established. The protocol consists in two stages: the first one is the nursing consultation, which involves the anamnesis and physical examination; and the second, involves the judicious identification of the nursing diagnoses, which will guide the planning of the nursing care to provide the individualized attention to women in the process of giving birth, using a universal terminology.

  13. Climate Prediction Center (CPC) 8 to 14 Day Probabilistic Precipitation Outlook for the Contiguous United States and Alaska

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Climate Prediction Center (CPC) issues 8 to 14 day probabilistic precipitation outlooks for the United States. The 8-14 day Outlook gives the confidence that a...

  14. Climate Prediction Center (CPC) 6 to 10 Day Probabilistic Temperature Outlook for the Contiguous United States and Alaska

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Climate Prediction Center (CPC) issues 6 to 10 day probabilistic temperature outlooks for the United States. The 6-10 day Outlook gives the confidence that a...

  15. Climate Prediction Center (CPC) 8 to 14 Day Probabilistic Temperature Outlook for the Contiguous United States and Alaska

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Climate Prediction Center (CPC) issues 8 to 14 day probabilistic temperature outlooks for the United States. The 8-14 day Outlook gives the confidence that a...

  16. Improving coordination of care centers for the elderly through IT support

    DEFF Research Database (Denmark)

    Johansen, Andreas Kaas; Lauridsen, Frederik Vahr Bjarnø; Manea, Vlad;

    2015-01-01

    In Denmark, care of elderly people involves numerous and relatively autonomous care providers, including care centers, activity centers, physiotherapists, doctors, and other specialists. However, due to a poor coordination of activities, many elderly experience a lack of continuity of care, missed...

  17. Use of Articaine in loco-regional anesthesia for day care surgical procedures

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2012-01-01

    Full Text Available The popularity of day case surgical procedures has increased immensely over the last few years. Though various techniques are available for carrying out day-case anesthesia, preference for a technique depends upon the type of procedure, patient profile, associated co-morbidities, available infrastructure and back-up facilities, monitoring devices and comfort of the attending anesthesiologist with the technique. Day-case spinal anesthesia for ambulatory surgery has gained a wider acceptance and numerous drugs are available for use in loco-regional anesthesia. Articaine is one such amide local anesthetic drug which is increasingly being used in day care surgeries. Properties of articaine such as faster onset, shorter elimination time and rapid recovery from sensory and motor blockade make it a very useful agent in local and regional anesthesia for day care surgical procedures. This article aims to review these properties of articaine so as to evaluate how useful articaine can be for ambulatory surgical procedures.

  18. Solid health care waste management status at health care centers in the West Bank - Palestinian Territory

    International Nuclear Information System (INIS)

    Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank - Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7 m3 (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.

  19. 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

    ... June 30, 2013, on July 24, 2012, in the Federal Register at 77 FR 43229. Adjusted Payments The... related notice published at 48 FR 29114, June 24, 1983.) This notice has been determined to be not... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day...

  20. Music benefits on postoperative distress and pain in pediatric day care surgery

    OpenAIRE

    Valeria Calcaterra; Selene Ostuni; Irene Bonomelli; Simonetta Mencherini; Marco Brunero; Elisa Zambaiti; Savina Mannarino; Daniela Larizza; Riccardo Albertini; Carmine Tinelli; Gloria Pelizzo

    2014-01-01

    Postoperative effect of music listening has not been established in pediatric age. Response on postoperative distress and pain in pediatric day care surgery has been evaluated. Forty-two children were enrolled. Patients were randomly assigned to the music-group (music intervention during awakening period) or the non-music group (standard postoperative care). Slow and fast classical music and pauses were recorded and played via ambient speakers. Heart rate, blood pressure, oxygen saturation, g...

  1. Indoor allergens in Minnesota schools and child care centers.

    Science.gov (United States)

    Tranter, Daniel C; Wobbema, Amanda Teresa; Norlien, Kathleen; Dorschner, Dale F

    2009-09-01

    Elevated concentrations of allergens in the indoor environment may cause allergic sensitization and symptoms. Occupant exposure to indoor allergens in educational facilities should and can be controlled. This study (1) assessed the presence of indoor allergens in Minnesota schools and child care centers, (2) characterized the distribution of allergens in different materials, and (3) evaluated the effect of building and maintenance interventions on allergen concentrations. Settled dust samples were collected from carpet, vinyl tile floors, and upholstered furniture in six schools and seven child care centers before and after interventions. Interventions included changes to cleaning, ventilation, entry mats, furnishings, flooring, and classroom items. The amount of total dust, culturable fungi, and indoor allergens--cockroach, dust mite, cat, and dog--were quantified in the dust samples. Cockroach and dust mite allergens were generally low and below the detection limit, but one dust mite allergen was detected in some areas. Cat and dog allergens were frequently detected at elevated levels, with half the samples above the provisional sensitization risk thresholds and a few samples above the symptom thresholds. Allergen concentrations were highest in upholstered furniture, followed by carpeting and then vinyl floor tile. Cat and dog allergens were lower after the interventions. Cat and dog allergens, but not dust mite and cockroach allergens, seem to be ubiquitous in child care and elementary schools of the U.S. Midwest. These allergens may contribute to sensitization in atopic individuals and occasionally cause symptoms in sensitized allergic individuals. Fleecy materials that are not adequately cleaned, such as upholstered furniture, appear to be the most significant allergen reservoirs. Modest environmental interventions can be implemented by building staff, which should result in lower allergen concentrations. PMID:19585331

  2. Impact of a 2-Day Critical Care Ultrasound Course during Fellowship Training: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Vi Am Dinh

    2015-01-01

    Full Text Available Objectives. Despite the increasing utilization of point-of-care critical care ultrasonography (CCUS, standards establishing competency for its use are lacking. The purpose of this study was to evaluate the effectiveness of a 2-day CCUS course implementation on ultrasound-naïve critical care medicine (CCM fellows. Methods. Prospective evaluation of the impact of a two-day CCUS course on eight CCM fellows’ attitudes, proficiency, and use of CCUS. Ultrasound competency on multiple organ systems was assessed including abdominal, pulmonary, vascular, and cardiac systems. Subjects served as self-controls and were assessed just prior to, within 1 week after, and 3 months after the course. Results. There was a significant improvement in CCM fellows’ written test scores, image acquisition ability, and pathologic image interpretation 1 week after the course and it was retained 3 months after the course. Fellows also had self-reported increased confidence and usage of CCUS applications after the course. Conclusions. Implementation of a 2-day critical care ultrasound course covering general CCUS and basic critical care echocardiography using a combination of didactics, live models, and ultrasound simulators is effective in improving critical care fellows’ proficiency and confidence with ultrasound use in both the short- and long-term settings.

  3. Impact of a 2-Day Critical Care Ultrasound Course during Fellowship Training: A Pilot Study.

    Science.gov (United States)

    Dinh, Vi Am; Giri, Paresh C; Rathinavel, Inimai; Nguyen, Emilie; Hecht, David; Dorotta, Ihab; Nguyen, H Bryant; Chrissian, Ara A

    2015-01-01

    Objectives. Despite the increasing utilization of point-of-care critical care ultrasonography (CCUS), standards establishing competency for its use are lacking. The purpose of this study was to evaluate the effectiveness of a 2-day CCUS course implementation on ultrasound-naïve critical care medicine (CCM) fellows. Methods. Prospective evaluation of the impact of a two-day CCUS course on eight CCM fellows' attitudes, proficiency, and use of CCUS. Ultrasound competency on multiple organ systems was assessed including abdominal, pulmonary, vascular, and cardiac systems. Subjects served as self-controls and were assessed just prior to, within 1 week after, and 3 months after the course. Results. There was a significant improvement in CCM fellows' written test scores, image acquisition ability, and pathologic image interpretation 1 week after the course and it was retained 3 months after the course. Fellows also had self-reported increased confidence and usage of CCUS applications after the course. Conclusions. Implementation of a 2-day critical care ultrasound course covering general CCUS and basic critical care echocardiography using a combination of didactics, live models, and ultrasound simulators is effective in improving critical care fellows' proficiency and confidence with ultrasound use in both the short- and long-term settings. PMID:26346694

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

    DEFF Research Database (Denmark)

    Villumsen, Anne Marie; Kristensen, Ole Steen

    2016-01-01

    and their life circumstances become invisible in the everyday life of day care. Due to defensive routines as well as an organizational culture that frames and creates a non-explicitly structured practice using intuitive processes, the problems of children at risk become invisible in the everyday life of day care....... When risk become invisible, it not only impedes the mono-professional help the children receive, it also inhibits a crucial multidisciplinary collaborative provision of support to children at risk and their families. The identification of children at risk seems to be based on an unexamined selection...

  5. Hypertension care at primary health care centers: A report from Abha, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Al-Homrany Mohammed

    2008-01-01

    Full Text Available It is well known that effective management of hypertension reduces the incidence of myo-cardial infarction, stroke and vascular complications. The Ministry of Health, Kingdom of Saudi Arabia, introduced the Quality Assurance Guidelines with the hope to improve the management of hypertension in its centers. We conducted an audit of two Primary Health Care Centers namely, Al-Manhal (MPHCC and Al-Numais (NPHCC, to evaluate how well hypertension was managened at these centers. A check list was derived from the Quality Assurance Manual to audit the process and to assess the health outcome. A retrospective study on a chosen sample of 120 files of hypertensive patients, out of 256 from both the Primary Health Care Centers was performed, during the last three months of the year 2000. Results showed that 61% of the patients were between 45-64 years of age, 56% were females, 85% were married, 54% were illiterate and 7.5% were smokers. A total of 92% of the patients had primary hypertension and 25% had a positive family history of hypertension. Beta-blockers were the most commonly used drugs in both the centers. Although the recording of the information was not perfect, there was no statistical difference in the socio-demongraphic data and also the means of the total score in both the centres. On the other hand, carrying out the important procedures for hypertensive patients was found to be better at MPHCC in com-parison to NPHCC (p < 0.05. The commonly missed procedures were chest x-rays, electrolytes and ECG. Hypertension was well controlled in 63% of the patients, 58% were found to have obesity, 9% suffered from hypertension-related complications while almost 50% had good compliance to appointment in both the centers. Our study reveals that the process of hypertension care at the two Primary Health Care Centres in Aseer region was not in accordance with the recommended national standards. The reasons include lack of updating systems, recall system and

  6. "We prefer greeting rather than eating:" life in an elder care center in Ethiopia.

    Science.gov (United States)

    Teka, Alemnesh; Adamek, Margaret E

    2014-12-01

    In Ethiopia where family care is a centuries-long tradition, living in an elder care institution invariably brings social devaluation. Accordingly, this study explored the psychosocial needs of older adults in a residential elder care center in Ethiopia from the perspective of both staff and residents. Three focus group discussions of 24 residents and interviews with 5 staff persons revealed that elders were living a subsistence lifestyle, eating the same meal every day, mostly cutoff from the surrounding community, and lacking basic amenities. Despite the absence of basic amenities, residents yearned even more so for meaningful social interaction. Psychosocial support was both undervalued and underutilized by staff members, and thus, residents' psychosocial well-being appeared to be at risk. The addition of social workers in institutional care in Ethiopia may help to promote improved living standards. Advocacy is needed on behalf of residents to establish and implement guidelines on care and support of residents in old age homes. As elders in developing countries are living longer--a growing number with disabilities--at the same time that informal supports are waning, the need for developing long term care policies is becoming critical.

  7. Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers

    OpenAIRE

    Alhamdan , A.A.; Alshammari , S.A.; Al-Amoud, M.M.; Hameed , T.A.; Al-Muammar , M.N.; Bindawas , S.M.; Al-Orf , S.M.; Mohamed , A.G.; Al-Ghamdi , E.A.; P.C. Calder

    2015-01-01

    Objectives: to evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Methods: between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by o...

  8. Hypertension care at primary health care centers: a report from Abha, Saudi Arabia.

    Science.gov (United States)

    Al-Homrany, Mohammed A; Khan, Mohd Yunus; Al-Khaldi, Yahia Mater; Al-Gelban, Khalid S; Al-Amri, Hasan Saed

    2008-11-01

    It is well known that effective management of hypertension reduces the incidence of myo-cardial infarction, stroke and vascular complications. The Ministry of Health, Kingdom of Saudi Arabia, introduced the Quality Assurance Guidelines with the hope to improve the management of hypertension in its centers. We conducted an audit of two Primary Health Care Centers namely, Al-Manhal (MPHCC) and Al-Numais (NPHCC), to evaluate how well hypertension was managened at these centers. A check list was derived from the Quality Assurance Manual to audit the process and to assess the health outcome. A retrospective study on a chosen sample of 120 files of hypertensive patients, out of 256 from both the Primary Health Care Centers was performed, during the last three months of the year 2000. Results showed that 61% of the patients were between 45-64 years of age, 56% were females, 85% were married, 54% were illiterate and 7.5% were smokers. A total of 92% of the patients had primary hypertension and 25% had a positive family history of hypertension. Beta-blockers were the most commonly used drugs in both the centers. Although the recording of the information was not perfect, there was no statistical difference in the socio-demongraphic data and also the means of the total score in both the centres. On the other hand, carrying out the important procedures for hypertensive patients was found to be better at MPHCC in comparison to NPHCC (p services and all these factors need to be addressed to improve care. PMID:18974594

  9. VHA Support Service Center Primary Care Management Module (PCMM)

    Data.gov (United States)

    Department of Veterans Affairs — The Primary Care Management Module (PCMM) was developed to assist VA facilities in implementing Primary Care. PCMM supports both Primary Care and non-Primary Care...

  10. COSTS AND BENEFITS OF HOSPITAL AND DAY TREATMENT WITH COMMUNITY CARE OF AFFECTIVE AND SCHIZOPHRENIC DISORDERS

    NARCIS (Netherlands)

    WIERSMA, D; KLUITER, H; NIENHUIS, FJ; RUPHAN, M; GIEL, R

    1995-01-01

    Background. A randomised controlled trial of day treatment with community care for patients with schizophrenic and affective disorders, referred for in-patient psychiatric treatment, was conducted to evaluate patterns of treatment and the course of illness with its psychosocial consequences over a p

  11. Food Sanitation and Safety Self-assessment Instrument for Family Day-Care Homes.

    Science.gov (United States)

    1990

    This self-assessment instrument for family day care providers is designed to help caregivers provide safe food to children. The eight sections of the instrument, presented in checklist format, concern: (1) personal hygiene; (2) purchasing and inspecting of food; (3) food storage; (4) kitchen equipment; (5) food preparation; (6) infant food…

  12. Disadvantaged Single Teenage Mothers and Their Children: Consequences of Free Educational Day Care.

    Science.gov (United States)

    Campbell, Frances A.; And Others

    1986-01-01

    Examined the benefits of providing free educational day care to children of single teen-age mothers. Results indicated that the children benefitted intellectually from the program, scoring significantly higher than controls on a general cognitive index. Mothers had an increased likelihood of completing high school, obtaining postsecondary…

  13. DURATION OF STAY AND WORK PERFORMANCE OF MENTALLY HANDICAPPED IN A DAY CARE CENTRE

    OpenAIRE

    Gopinath, P.S.; Radhakrishnan, V.K.; Chaturvedi, S K; Murali, T.; Salim, P.P.; Sarmukudam, Sanjeev

    1987-01-01

    SUMMARY Work performance and duration of stay of 79 mentally handicapped persons attending a day care centre was evaluated and correlated with demographic and clinical variables. Work performance was below average in 37% and average in 30%. No definite relationship was established between duration of stay or work performance with any of the demographic or clinical variables.

  14. One- to Three-Year-Old Children's Experience of Subjective Wellbeing in Day Care

    Science.gov (United States)

    Seland, Monica; Sandseter, Ellen Beate Hansen; Bratterud, Åse

    2015-01-01

    The aim of the study on which this paper is based was to explore in which situations and contexts Norwegian 1-3-year-olds experience subjective wellbeing in day care. The data in this study was collected through qualitative phenomenological observations of 18 children, and an inductive process of analysis was conducted. The results show that…

  15. Thin Blue Lines and Red Crosses: Signposts to Quality in Family Day Care?

    Science.gov (United States)

    White, Jayne

    2005-01-01

    This paper explores some of the findings of a study focussing on constructions of family day care from the perspectives of caregivers/educators and coordinators as they engaged in a quality review process using a recently developed resource--The Quality Journey/He haerenga whai hua (2000). The paper positions quality review as a part of a…

  16. Improving Nutrition in a Day Care Program through a Multidimensional Approach.

    Science.gov (United States)

    Mohanty, Pranoti S.

    This practicum project sought to improve nutrition in a day care program serving children ages 2 through 14 years by increasing staff, student, and parent knowledge about nutrition. The primary goal was to increase knowledge and interest in nutrition and its relation to wellness of students, staff, and parents. The second goal was to provide…

  17. Public School Aggression among Children with Varying Day-Care Experience.

    Science.gov (United States)

    Haskins, Ron

    1985-01-01

    Fifty-nine children with varying amounts and types of day-care experience were followed over their first 2 or 3 years of public schooling. Schoolteachers rated aggressiveness of several types and in several situations and supplied information about managing the children, their use of conflict-avoiding strategies, and other associated skills and…

  18. My personal experiences at the BEST Medical Center: A day in the clinic-the afternoon.

    Science.gov (United States)

    Cohen, Philip R; Kurzrock, Razelle

    2016-01-01

    Dr. Ida Lystic is a gastroenterologist who recently began her new faculty position at the BEST (Byron Edwards and Samuel Thompson) Medical Center. After completing her MD degree at the prestigious Harvey Medical School (recently renamed the Harvey Provider School), she did her internal medicine residency and fellowship training at the OTHER (Owen T. Henry and Eugene Rutherford) Medical Center. Her morning in gastroenterology clinic was highlighted by: (1) being reprimanded by the clinic nurse manager for a patient who not only arrived early, before clinic had opened, but also neglected to schedule the anesthesiologist for his colonoscopy; (2) the continued challenges of LEGEND (also known as Lengthy and Excessively Graded Evaluation and Nomenclature for Diagnosis by her colleagues), the new electronic medical record system after the BEST discarded the SIMPLE (Succinct Input Making Patient's Lives Electronic) system; (3) a nurse's interruption of an office visit-once the egg timer on the examination room door ran out-because she had exceeded the allocated time for the appointment; and (4) her chairman's unanticipated arrival in the clinic to visit with the clinic nurse manager. In addition to seeing her patients, Dr. Lystic's afternoon is occupied by attending a LOST (Laboratory OverSight and Testing) Committee meeting and a visit from a wayfinding and signage specialist to depersonalize the doorpost plaques of the examination rooms. Her day ends with a demeaning email from her chairman regarding the poor results of the most recent patient satisfaction survey and being personally held accountable to develop solutions to improve not only her performance but also that of the clinic. Although Dr. Ida Lystic and the gastroenterology clinic at "the BEST Medical Center" are creations of the authors' imagination, the majority of the anecdotes mentioned in this essay are based on individual patients and their physicians, clinics in medical centers and their administration

  19. Patient-centered care: the key to cultural competence.

    Science.gov (United States)

    Epner, D E; Baile, W F

    2012-04-01

    Much of the early literature on 'cultural competence' focuses on the 'categorical' or 'multicultural' approach, in which providers learn relevant attitudes, values, beliefs, and behaviors of certain cultural groups. In essence, this involves learning key 'dos and don'ts' for each group. Literature and educational materials of this kind focus on broad ethnic, racial, religious, or national groups, such as 'African American', 'Hispanic', or 'Asian'. The problem with this categorical or 'list of traits' approach to clinical cultural competence is that culture is multidimensional and dynamic. Culture comprises multiple variables, affecting all aspects of experience. Cultural processes frequently differ within the same ethnic or social group because of differences in age cohort, gender, political association, class, religion, ethnicity, and even personality. Culture is therefore a very elusive and nebulous concept, like art. The multicultural approach to cultural competence results in stereotypical thinking rather than clinical competence. A newer, cross cultural approach to culturally competent clinical practice focuses on foundational communication skills, awareness of cross-cutting cultural and social issues, and health beliefs that are present in all cultures. We can think of these as universal human beliefs, needs, and traits. This patient centered approach relies on identifying and negotiating different styles of communication, decision-making preferences, roles of family, sexual and gender issues, and issues of mistrust, prejudice, and racism, among other factors. In the current paper, we describe 'cultural' challenges that arise in the care of four patients from disparate cultures, each of whom has advanced colon cancer that is no longer responding to chemotherapy. We then illustrate how to apply principles of patient centered care to these challenges. PMID:22628414

  20. Cuidado de ninos con necesidades especiales en el hogar: Manual de referencia para las personas que cuidan ninos en sus hogares (Children with Special Needs in Family Day Care Homes: A Handbook for Family Day Care Home Providers).

    Science.gov (United States)

    de la Brosse, Beatrice

    The Spanish translation of this guide offers information to Spanish-speaking family day care providers who desire to expand their knowledge of early childhood development in order to work with infants and young children with special needs in their day care settings. The first of four chapters answers common questions and concerns of day care…

  1. Assessment of food, nutrition, and physical activity practices in Oklahoma child-care centers.

    Science.gov (United States)

    Sisson, Susan B; Campbell, Janis E; May, Kellie B; Brittain, Danielle R; Monroe, Lisa A; Guss, Shannon H; Ladner, Jennifer L

    2012-08-01

    The purpose of the current study was to determine the obesogenic practices in all-day child-care centers caring for preschool-aged children. This study used a cross-sectional, self-reported survey mailed to centers across Oklahoma (n=314). Frequency of responses and χ(2) were calculated comparing region and star rating. Items where the majority of centers frequently report best practices include: daily fruits served (76%), daily nonfried vegetables served (71%), rarely/never served sugary drinks (92%), rarely/never used food to encourage good behaviors (88%), staff join children at table most of the time (81%), staff rarely eat different foods in view of children (69%), visible self-serve or request availability of water (93%), regular informal communication about healthy eating (86%), opportunities for outdoor play (95%), not withholding activity for punishment (91%), accessible play equipment (59% to 80% for different types of equipment), and minimization of extended sitting time (78%). Practices where centers can improve include increasing variety of vegetables (18%), reducing frequency of high-fat meats served (74% serve more than once per week), increasing high-fiber and whole-grain foods (35% offer daily), serving style of "seconds" (28% help kids determine whether they are still hungry), nonfood holiday celebrations (44% use nonfood treats), having toys and books that encourage healthy eating (27%) and physical activity (25%) in all rooms in the center, a standard nutrition (21%) and physical education (50%) curriculum, and following a written physical activity policy (43%). Practitioners can use these data to develop benchmarks and interventions, as this was the first study to assess statewide obesogenic practices in child care.

  2. Fostering innovation in medicine and health care: what must academic health centers do?

    Science.gov (United States)

    Dzau, Victor J; Yoediono, Ziggy; Ellaissi, William F; Cho, Alex H

    2013-10-01

    There is a real need for innovation in health care delivery, as well as in medicine, to address related challenges of access, quality, and affordability through new and creative approaches. Health care environments must foster innovation, not just allowing it but actively encouraging it to happen anywhere and at every level in health care and medicine-from the laboratory, to the operating room, bedside, and clinics. This paper reviews the essential elements and environmental factors important for health-related innovation to flourish in academic health systems.The authors maintain that innovation must be actively cultivated by teaching it, creating "space" for and supporting it, and providing opportunities for its implementation. The authors seek to show the importance of these three fundamental principles and how they can be implemented, highlighting examples from across the country and their own institution.Health innovation cannot be relegated to a second-class status by the urgency of day-to-day operations, patient care, and the requirements of traditional research. Innovation needs to be elevated to a committed endeavor and become a part of an organization's culture, particularly in academic health centers.

  3. [Relationship between child day-care attendance and acute infectious disease. A systematic review].

    Science.gov (United States)

    Ochoa Sangrador, Carlos; Barajas Sánchez, M Verisima; Muñoz Martín, Beatriz

    2007-01-01

    Child day-care attendance is considered to be an acute early childhood disease risk factor, the studies available however not affording the possibility of fully quantifying this risk. A systematic review of clinical trials and cohort studies was conducted, in which the effects child day-care attendance had on the health of young children based on the Cochrane Collaboration, PubMed and Spanish Medical Index databases, without any time or language-related limits, were analyzed and rounded out with analyses of referenced works and an additional EMBASE search. The methodological quality was evaluated by means of personalized criteria. Pooling measures (relative risks, incidence density ratios and weighted mean differences) were calculated with their confidence intervals, assuming random effects models. A significant increase was found to exist of a risk consistent over time and among different social and geographical environments. Considering the most methodologically-stringent studies with adjusted effect estimates, child day-care attendance was related to an increased risk of upper respiratory tract infection (RR=1,88), acute otitis media (RR=1,58), otitis media with fluid draining (RR=2,43), lower respiratory tract infections (overall RR=210; acute pneumonia RR=1.70; broncholitis RR=1,80; bronchitis RR=2,10) and gastroenteritis (RR=1,40). Child day-care attendance could be responsible for 33%-50% of the episodes of respiratory infection and gastroenteritis among the exposed population. In conclusion, it can be said that the risk for childhood health attributable to the child day-care attendance is discreet but of high-impact. This information has some major implications for research, clinical practice, healthcare authorities and society as a whole.

  4. [The founding and development of day care hospitals as integral structural subunits of therapeutic and preventive care institutions].

    Science.gov (United States)

    Ladnyĭ, A Ia; Bazilevich, Ia P; Rafaliuk, I Ia; Nakonechnyĭ, Ia R; Zubarev, G P; Telishevskaia, M G; Polataĭko, E N; Postoenko, E N; Liman, O F; Chaklosh, I N

    1990-01-01

    The experience gained in the complex approach to the organization of day hospitals at curative and preventive facilities in Lvov and Lvov region is described. The problems in the delivery of in-patient care for the population formed the basis for the drafting of programme aimed at developing the network of out-patient departments of active treatment of patients. The description is given of the main components of day hospitals activities, schedule of work, indications and contra-indications for the treatment of patients. The work indicators of day hospitals of different types are provided. Highlighted is the importance of this vasically new and highly effective type of health care for the population. The data on the problem-oriented training of medical directors and physicians of day hospitals at the Faculty of Advanced Training of Physicians of the Lvov Medical Institute is provided, the emphasis being placed on the inclusion of issues on the organization of day hospital activities into the curricula for students and interns. PMID:2333569

  5. Incidence of occupational exposures in a tertiary health care center

    Directory of Open Access Journals (Sweden)

    Amrita Shriyan

    2012-01-01

    Full Text Available Introduction: Occupational exposure to Hepatitis B virus (HBV, human immunodeficiency virus (HIV and Hepatitis C virus (HCV infection is a cause of concern to all health care workers (HCWs, especially those, in hospitals. Among the HCWs, nurses, interns, technicians, resident doctors and housekeeping staff have the highest incidence of occupational exposure. Aims: To analyze the cases of needle stick injuries and other exposures to patient′s blood or body fluids among health care workers. Materials and Methods: A detailed account of the exposure is documented which includes incidence of needle stick injuries (NSI and implementation of post-exposure prophylaxis (PEP as per the hospital guidelines. We report a two-year continuing surveillance study where 255 health care workers (HCWs were included. PEP was given to HCWs sustaining NSI or exposures to blood and body fluids when the source is known sero-positive or even unknown where the risk of transmission is high. Follow-up of these HCW′s was done after three and six months of exposure. Results: Of the 255 HCWs, 59 sustained needle stick injuries and two were exposed to splashes. 31 of the NSI were from known sources and 28 from unknown sources. From known sources, thirteen were seropositive; seven for HIV, three for HCV and three for HBV. Nineteen of them sustained needle stick during needle re-capping, six of them during clean up, six of them while discarding into the container, 17 during administration of injection, eight of them during suturing, two occurred in restless patient, 17 during needle disposal. Conclusion: So far, no case of sero-conversion as a result of needle stick injuries was reported at our center.

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

    OpenAIRE

    Werner, Claudia Denise

    2014-01-01

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

  7. Creating New Child Care Slots in Mini Child Care Centers: Big Bang for the Buck in New Jersey.

    Science.gov (United States)

    Frankel, Arthur J.; And Others

    1992-01-01

    Small grants of $7,500 with technical assistance were offered to the child care community of New Jersey to either start or increase licensed capacity in mini-child care centers. Results of a subsequent analysis showed that 26 grantees created 481 new child care slots at an average cost of $561 per slot. (Author/SM)

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

    NARCIS (Netherlands)

    Werner, Claudia Denise

    2014-01-01

    The use of center child care in Western countries has increased over the last three decades and is nowadays the most frequently used type of non-parental care for children aged zero to four (OECD, 2013). The aim of the current dissertation is to shed more light on indicators of child care quality in

  9. Identifying reasons for delays in acute hospitals using the Day-of-Care Survey method.

    Science.gov (United States)

    Reid, Erica; King, Andrew; Mathieson, Alex; Woodcock, Thomas; Watkin, Simon W

    2015-04-01

    This paper describes a new tool called 'Day-of-Care Survey', developed to assess inpatient delays in acute hospitals. Using literature review, iterative testing and feedback from professional groups, a national multidisciplinary team developed the survey criteria and methodology. Review teams working in pairs visited wards and used case records and bedside charts to assess the patient's status against severity of illness and service intensity criteria. Patients who did not meet the survey criteria for acute care were identified and delays were categorised. From March 2012 to December 2013, nine acute hospitals across Scotland, Australia and England were surveyed. A total of 3,846 adult general inpatient beds (excluding intensive care and maternity) were reviewed. There were 145 empty beds at the time of surveys across the nine sites, with 270 definite discharges planned on the day of the survey. The total number of patients not meeting criteria for acute care was 798/3,431 (23%, range 18-28%). Six factors accounted for 61% (490/798) of the reasons why patients not meeting acute care criteria remained in hospital. This survey gives important insights into the challenges of managing inpatient flow using system level information as a method to target interventions designed to address delay.

  10. DayAND#8211;Care Surgery for Pilonidal Sinus Using Sinotomy Technique and Fibrin Glue Injection

    Directory of Open Access Journals (Sweden)

    Selim Sozen

    2012-06-01

    Conclusion: An ideal surgical procedure for a pilonidal sinus should be one aiming at reducing hospital stay, minimizing tissue assault, promoting early work resumption, and preventing recurrence. The method described in this paper was found to be simple, safe, and feasible as day-care surgery. The technique of sinotomy with a good wound and surrounding skin care is an ideal approach with a high chance of cure. The patients returned to their routine within a short duration of time. [Arch Clin Exp Surg 2012; 1(3.000: 138-141

  11. Availability and Price of High Quality Day Care and Female Employment

    DEFF Research Database (Denmark)

    Simonsen, Marianne

    In this paper I analyse to what degree availability and price of high quality publicly subsidised childcare affects female employment for women living in couples following maternity leave. The results show that unrestricted access to day care has a significantly positive effct on female employment.......The price effect is significantly negative: An increase in the price of child care of C=1 will decrease the female employment with 0.08% corresponding to a price elasticity of −0.17. This effect prevails during the first 12 months after childbirth....

  12. For the Mouths of Babes: Nutrition Literacy Outreach to a Child Care Center

    OpenAIRE

    Ballance, Darra; Webb, Nancy

    2015-01-01

    Childhood obesity is at crisis levels in the United States. Risk factors for obesity can begin as early as infancy. Approximately 12 million children up to five years of age spend about 22.5 hours per week in child care centers where they receive a significant portion of their daily nutrition. Child care center personnel may not know how to select nutritious meal and snack choices. A health sciences librarian, a child care center director and a dietitian designed an outreach...

  13. What Is Known About the Benefits of Patient-Centered Care in Patients with Heart Failure.

    Science.gov (United States)

    Ulin, Kerstin; Malm, Dan; Nygårdh, Annette

    2015-12-01

    Treatment for chronic heart failure (CHF) has improved, and symptom burden has been identified as an important treatment goal. Because patient-centered care may ease the burden, we need to know its benefits for patients with CHF, hence this systematic literature review. We found that one benefit of person-centered care is an increase in quality of life in patients with CHF. Improvements were found in self-care, physical and mental status, health care costs, general uncertainty regarding illness and recovery, patient dignity, treatment, and systems of care. Improvements also were observed in symptom burden, self-efficacy, and quality of life. These findings indicate that person-centered care is a powerful approach to current and future health care. However, because an appropriate tool to measure person-centered care does not yet exist, it will be a challenge to determine whether the goal has been reached from a long-term and patient perspective. PMID:26497193

  14. Thirty-day outcome of carotid artery stenting in Chinese patients: a single-center experience

    Institute of Scientific and Technical Information of China (English)

    JIAO Li-qun; SONG Gang; LI Shen-mao; MIAO Zhong-rong; ZHU Feng-shui; JI Xun-ming; YIN Guo-yang

    2013-01-01

    Background Carotid artery stenting (CAS) as a competing treatment modality has had to adhere to limits to gain widespread acceptance in some studies.This study analyzed the clinical data of 1700 consecutive patients after CAS to retrospectively evaluate the 30-day outcome of CAS for internal carotid artery stenosis in a Chinese population.Methods Medical records of 1700 patients who underwent CAS at Xuanwu Hospital affiliated to Capital Medical University between January 2001 and August 2012 were reviewed.Postoperative 30-day complication rates were analyzed and compared with those of other studies.Univariate and multivariate Logistic regression analyses were used to identify factors associated with perioperation myocardial infarction (MI),stroke,and death.Results The overall 30-day rate of MI,stroke,and death after CAS was 2.53%.In univariate analysis,patients who were symptomatic,had a neurological deficit (modified Rankin score (mRS) ≥3; P=0.001),and who were not taking statins experienced a significantly increased rate of MI,stroke,and death (P=-0.017).In multivariate Logistic regression analysis,the presence of symptoms (odds ratio (OR)=2.485; 95% confidence interval (CI)=1.267-4.876; P=0.008) and a neurological deficit (mRS ≥3) (OR=3.025; 95% CI=1.353-6.763; P=0.007) were independent risk factors for perioperative MI,stroke,and death.Conclusions According to this single-center experience,CAS may effectively prevent and treat carotid artery stenosis that would otherwise lead to stroke.Being symptomatic and having a neurological deficit (mRS ≥3) increased the risk of perioperative MI,stroke,and death.

  15. Aortic Center: specialized care improves outcomes and decreases mortality

    Directory of Open Access Journals (Sweden)

    Marcela da Cunha Sales

    2014-12-01

    Full Text Available Objective: To compare in-hospital outcomes in aortic surgery in our cardiac surgery unit, before and after foundation of our Center for Aortic Surgery (CTA. Methods: Prospective cohort with non-concurrent control. Foundation of CTA required specialized training of surgical, anesthetic and intensive care unit teams, routine neurological monitoring, endovascular and hybrid facilities, training of the support personnel, improvement of the registry and adoption of specific protocols. We included 332 patients operated on between: January/2003 to December/2007 (before-CTA, n=157, 47.3%; and January/2008 to December/2010 (CTA, n=175, 52.7%. Baseline clinical and demographic data, operative variables, complications and in-hospital mortality were compared between both groups. Results: Mean age was 58±14 years, with 65% male. Group CTA was older, had higher rate of diabetes, lower rates of COPD and HF, more non-urgent surgeries, endovascular procedures, and aneurysms. In the univariate analysis, CTA had lower mortality (9.7 vs. 23.0%, P=0.008, which occurred consistently across different diseases and procedures. Other outcomes which were reduced in CTA included lower rates of reinterventions (5.7 vs 11%, P=0.046, major complications (20.6 vs. 33.1%, P=0.007, stroke (4.6 vs. 10.9%, P=0.045 and sepsis (1.7 vs. 9.6%, P=0.001, as compared to before-CTA. Multivariable analysis adjusted for potential counfounders revealed that CTA was independently associated with mortality reduction (OR=0.23, IC 95% 0.08 – 0.67, P=0.007. CTA independent mortality reduction was consistent in the multivariable analysis stratified by disease (aneurysm, OR=0.18, CI 95% 0.03 – 0.98, P=0.048; dissection, OR=0.31, CI 95% 0.09 – 0.99, P=0.049 and by procedure (hybrid, OR=0.07, CI 95% 0.007 – 0.72, P=0.026; Bentall, OR=0.18, CI 95% 0.038 – 0.904, P=0.037. Additional multivariable predictors of in-hospital mortality included creatinine (OR=1.7 [1.1-2.6], P=0.008, urgent

  16. Diabetes in a primary care center among Spaniards and immigrants

    Directory of Open Access Journals (Sweden)

    Roca Vilalta M

    2006-06-01

    Full Text Available Diabetes is a disease with different prevalence in different populations. Objectives: The aim of the present study is to describe diabetic patients in a primary care center with regard to their geographic origin, and to determine the status of their disease. Methods: A cross-sectional descriptive study, with data available from clinical records in South Tarrasa primary care center (Barcelona, Spain in 2004. Results: A total of 1215 diabetic patients with an average age of 65 years, 51% female, were included in the study. Regarding their origin, 97% were from Spain, 2% from Morocco, 0.8% from Latin America, and 0.2% from the rest of Europe. The average Hb1AC was 6.9%. In type 2 diabetic patients, treatment consisted of oral hypoglycemic agents (OHA for 46.6%, only dietetic restrictions for 36.5%, OHA + insulin for 7.9%, and only insulin for 9%. In the age group 30-39 years, 0.7% of Moroccans suffer from diabetes versus 0.5% of Spaniards. The values in the 40-49 year group are 3.9% of Moroccans, 3% of Spaniards, and 2.1% of Latin Americans. The values in the 50-59 year group are 13.5% of Moroccans, 10.6% of Spaniards, and 7.7% of Latin Americans. The values in the 60-69 year group are 40% of Moroccans, 18.8% of Spaniards, and 44.5% of Latin Americans. The values in the 70-79 year group are 67% of Moroccans, 26% of Spaniards, and 50% of Latin Americans. The average Hb1AC was 6.3% in Latin Americans, 6.9% in Spaniards, and 8.1% in Moroccans. In type 1 diabetic patients, the average Hb1AC was 10.2% in Moroccans and 8% in Spaniards; while in type 2 diabetes, the average Hb1AC was 7.8% in Moroccans and 6.9% in Spaniards. Gestational diabetes was observed in 6.1% of the Spanish, 10.9% of the Moroccan and 4.2% of the Latin American women. Conclusions: A higher prevalence of diabetes was detected in Moroccans than in patients from other countries. These patients present poor control of the disease.

  17. Evaluation of an Intervention to Reduce Playground Hazards in Atlanta Child-Care Centers.

    Science.gov (United States)

    Sacks, Jeffrey J.; And Others

    1992-01-01

    Revisits 58 child care centers in Atlanta (Georgia) that had received interventions alerting directors to playground safety hazards. Comparison with 71 control centers randomly selected found averages of 9.4 hazards at intervention center playgrounds and 8.0 hazards at control centers. These results indicate the ineffectiveness of the…

  18. Transformation of Care: Integrating the Registered Nurse Care Coordinator into the Patient-Centered Medical Home.

    Science.gov (United States)

    Biernacki, Pamela J; Champagne, Mary T; Peng, Shane; Maizel, David R; Turner, Barbara S

    2015-10-01

    The purpose of this quality improvement project was to implement and evaluate a care delivery model integrating the registered nurse care coordinator (RNCC) into a family practice that is certified as a patient-centered medical home (PCMH) by the National Committee for Quality Assurance. The initial target population was the 937 patients with diabetes in the family practice. A pre-post design was used to assess changes in patients' diabetic quality indicators after integrating the role of RNCC using existing staff. This 6-month project compared the following diabetic quality indicators: blood pressure post scores for A1c (P = .001, n = 790), foot exam (P = .001, n = 850), and microalbumin (P = .01, n = 850). Post intervention, patient and health care team satisfaction with the RNCC role was high (mean scores ≥3 on a 5-point Likert scale). Integrating the RNCC within a multidisciplinary team in the PCMH had a significant positive impact on diabetic quality indicators. Patient and health care team satisfaction with the RNCC role was high. PMID:25632926

  19. DISTRIBUTION OF CONGENITAL HEART DISEASES AT TERTIARY CARE CENTER: SINGLE CENTER EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Vaishali

    2016-02-01

    Full Text Available BACKGROUND The current study was undertaken at a tertiary care center, Bhopal, MP, India, with the objective of establishing frequency of occurrence of congenital heart diseases by echocardiography. MATERIALS AND METHOD 10,000 consecutive cases undergoing Echo Color Doppler in the Cardiology Department Hamidia Hospital, Bhopal, between 1st Jan 2009 and July 2011 were analysed. Echo CD was performed by consultant cardiologist using Acuson Aspen Color Doppler machine following the ASE guidelines. RESULTS AND CONCLUSIONS In the present study out of 10,000consecutive cases undergoing echo 648 were identified to having congenital heart diseases. Isolated VSD (30.5%, isolated ASD (23.6% PDA (9% and TOF (8.3% were commonest defect observed. Most common congenital heart disease found in the present study is VSD and is most prevalent in males and is highest among 0-5 yrs.

  20. Important themes in research on and education of young children in day care centres: Finnish viewpoints

    Directory of Open Access Journals (Sweden)

    Maritta Hännikäinen

    2013-10-01

    Full Text Available The aim of this article is to outline important themes, according to Finnish early childhood education researchers, that need to be addressed in researching and educating children under three years of age in Finland. To achieve this aim, the article divides into two parts. First, we present and discuss the results of a small-scale survey, conducted in Finland, on the views of key informants in the early childhood education units of Finnish universities. Second, the views presented in the survey are used as a starting point to introduce two ongoing qualitative case studies on the everyday life of toddlers in Finnish day care centres. In line with the survey findings, these case studies emphasize in particular the importance of the relational, social nature of children, the educational community, and the sensitivity of the adult for children’s wellbeing in day care groups.

  1. Patient- and family-centered care coordination: a framework for integrating care for children and youth across multiple systems.

    Science.gov (United States)

    2014-05-01

    Understanding a care coordination framework, its functions, and its effects on children and families is critical for patients and families themselves, as well as for pediatricians, pediatric medical subspecialists/surgical specialists, and anyone providing services to children and families. Care coordination is an essential element of a transformed American health care delivery system that emphasizes optimal quality and cost outcomes, addresses family-centered care, and calls for partnership across various settings and communities. High-quality, cost-effective health care requires that the delivery system include elements for the provision of services supporting the coordination of care across settings and professionals. This requirement of supporting coordination of care is generally true for health systems providing care for all children and youth but especially for those with special health care needs. At the foundation of an efficient and effective system of care delivery is the patient-/family-centered medical home. From its inception, the medical home has had care coordination as a core element. In general, optimal outcomes for children and youth, especially those with special health care needs, require interfacing among multiple care systems and individuals, including the following: medical, social, and behavioral professionals; the educational system; payers; medical equipment providers; home care agencies; advocacy groups; needed supportive therapies/services; and families. Coordination of care across settings permits an integration of services that is centered on the comprehensive needs of the patient and family, leading to decreased health care costs, reduction in fragmented care, and improvement in the patient/family experience of care.

  2. Comparative analysis of Streptococcus pneumoniae transmission in Portuguese and Finnish day-care centres

    OpenAIRE

    Pessoa, Delphine; Hoti, Fabian; Syrjänen, Ritva; Sá-Leão, Raquel; Kaijalainen, Tarja; Gomes, M. Gabriela M.; Auranen, Kari

    2013-01-01

    Background Day-care centre (DCC) attendees play a central role in maintaining the circulation of Streptococcus pneumoniae (pneumococcus) in the population. The prevalence of pneumococcal carriage is highest in DCC attendees but varies across countries and is found to be consistently lower in Finland than in Portugal. We compared key parameters underlying pneumococcal transmission in DCCs to understand which of these contributed to the observed differences in carriage prevalence. Methods Longi...

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

    OpenAIRE

    M. SOTIROVSKA-SIRVINI; Lj. NAUMOVSKA; V. RAZMOVSKA; V. VOJNOVSKA

    1997-01-01

    The Day Care Institutions for children are forms of organized protection for improvement of the psycho-physical, emotional and social development of children. In this period, the growth and development are in their most intensive phase when the outside influence plays an extraordinary role both in a positive and in negative a direction. Directed and well-organized protection is of a great importance. By inclusion of children with developmental disorders in the group and with special, individu...

  4. Comparative analysis of Streptococcus pneumoniae transmission in Portuguese and Finnish day-care centres

    OpenAIRE

    Pessoa, Delphine; Hoti, Fabian; Syrjänen, Ritva; Sá-Leão, Raquel; Kaijalainen, Tarja; Gomes, M. Gabriela M.; Auranen, Kari

    2013-01-01

    Day-care centre (DCC) attendees play a central role in maintaining the circulation of Streptococcus pneumoniae (pneumococcus) in the population. The prevalence of pneumococcal carriage is highest in DCC attendees but varies across countries and is found to be consistently lower in Finland than in Portugal. We compared key parameters underlying pneumococcal transmission in DCCs to understand which of these contributed to the observed differences in carriage prevalence. PneumoCarr Consortium...

  5. Gestalt therapy approaches with aggressive children in a day care setting

    OpenAIRE

    Maxey, Win

    1987-01-01

    This research study was designed to evaluate whether or not Gestalt therapy approaches could be used effectively when intervening with aggressive acts in a day care setting. Five focus children were observed at timed intervals as to whether or not they were aggressive, how the caretaker intervened, and how the children responded to the caretaker intervention. After a baseline of aggressive acts was established, caretakers were trained to use Gestalt therapy interventio...

  6. Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State

    Directory of Open Access Journals (Sweden)

    Reed Peter

    2012-12-01

    Full Text Available Abstract Background Growing interest in the promise of patient-centered care has led to numerous health care innovations, including the patient-centered medical home, shared decision-making, and payment reforms. How best to vet and adopt innovations is an open question. Washington State has been a leader in health care reform and is a rich laboratory for patient-centered innovations. We sought to understand the process of patient-centered care innovation undertaken by innovative health care organizations – from strategic planning to goal selection to implementation to maintenance. Methods We conducted key-informant interviews with executives at five health plans, five provider organizations, and ten primary care clinics in Washington State. At least two readers of each interview transcript identified themes inductively; final themes were determined by consensus. Results Innovation in patient-centered care was a strategic objective chosen by nearly every organization in this study. However, other goals were paramount: cost containment, quality improvement, and organization survival. Organizations commonly perceived effective chronic disease management and integrated health information technology as key elements for successful patient-centered care innovation. Inertia, resource deficits, fee-for-service payment, and regulatory limits on scope of practice were cited as barriers to innovation, while organization leadership, human capital, and adaptive culture facilitated innovation. Conclusions Patient-centered care innovations reflected organizational perspectives: health plans emphasized cost-effectiveness while providers emphasized health care delivery processes. Health plans and providers shared many objectives, yet the two rarely collaborated to achieve them. The process of innovation is heavily dependent on organizational culture and leadership. Policymakers can improve the pace and quality of patient-centered innovation by setting targets

  7. Percepções de educadores de creches acerca de práticas cotidianas na alimentação de lactentes: impacto de um treinamento Perceptions of day care center teachers about daily practices of infant feeding: the impact of training

    Directory of Open Access Journals (Sweden)

    Giovana Longo-Silva

    2013-02-01

    Full Text Available O artigo apresenta a importância da capacitação dos profissionais envolvidos com alimentação das crianças em creches, para que estes ofereçam alimentos adequados e promovam ações para que os lactentes incorporem práticas alimentares saudáveis desde o nascimento. Desta forma, o objetivo do presente trabalho foi avaliar o impacto de um treinamento de educadores de creches nas percepções e práticas acerca da alimentação infantil. Para avaliação do impacto do treinamento foi utilizada abordagem qualitativa, com aplicação da técnica do grupo focal. Foram realizados 16 grupos, sendo oito com as creches expostas ao treinamento e oito com as não-expostas, tendo em média de seis a 11 participantes por instituição, os quais apresentavam idades entre 19 e 66 anos. O discurso das educadoras que participaram do treinamento está pontuado de indícios de pequenas mudanças, ou pelo menos, de reconhecimento de que é preciso e possível mudar. Destaca-se a relevância de elaborar e executar programas de treinamento e educação nutricional para educadores de creches com supervisão contínua dos efeitos da capacitação como estratégia de saúde infantil.This article stresses the importance of the qualification of professionals involved in thefeeding of children in daycare centers, such that they offeradequate food and programs are developed in order to fosterhealthy food habits in infantsfrom birth. Thus, the scope of this paper was to evaluate the impact of a training program for these daycare teachers in their perceptions and practicesin infant feeding. A qualitative approach was used to evaluate the impact of training, with the application of the focus grouptechnique. Sixteen groups were created, eight of whichwere daycare centerswith training and eight without training, the average number of participants being 6 to 11 per institution agedbetween 19 and 66. The discourse of the teachers who took part in the training program is

  8. Healthy incentive scheme in the Irish full-day-care pre-school setting.

    LENUS (Irish Health Repository)

    Molloy, C Johnston

    2013-12-16

    A pre-school offering a full-day-care service provides for children aged 0-5 years for more than 4 h\\/d. Researchers have called for studies that will provide an understanding of nutrition and physical activity practices in this setting. Obesity prevention in pre-schools, through the development of healthy associations with food and health-related practices, has been advocated. While guidelines for the promotion of best nutrition and health-related practice in the early years\\' setting exist in a number of jurisdictions, associated regulations have been noted to be poor, with the environment of the child-care facility mainly evaluated for safety. Much cross-sectional research outlines poor nutrition and physical activity practice in this setting. However, there are few published environmental and policy-level interventions targeting the child-care provider with, to our knowledge, no evidence of such interventions in Ireland. The aim of the present paper is to review international guidelines and recommendations relating to health promotion best practice in the pre-school setting: service and resource provision; food service and food availability; and the role and involvement of parents in pre-schools. Intervention programmes and assessment tools available to measure such practice are outlined; and insight is provided into an intervention scheme, formulated from available best practice, that was introduced into the Irish full-day-care pre-school setting.

  9. Implementing Patient Family-Centered Care Grand Rounds Using Patient/Family Advisor Narratives

    Directory of Open Access Journals (Sweden)

    Maureen B Fagan DNP, MHA, FNP-BC

    2015-11-01

    Full Text Available With the emerging trend of patient family–centered care in health care, it is essential that physicians be exposed to patient and family perspectives of care during medical education and training. Grand Rounds provides an ideal format for physicians to learn about patient family–centered care. At Brigham and Women’s Hospital, we sought to bring the voice of the patient to Patient Family–Centered Grand Rounds in order to expose clinicians to rich narratives describing the medical care received by patients/families and to ultimately change physician practice to reflect patient family–centered principles. We conducted a clinician survey and found promising results indicating that patient/family narratives can be effective at educating physicians about patient family–centered care.

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

    Directory of Open Access Journals (Sweden)

    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

  11. Learning the 'SMART' way... results from a pilot study evaluating an interprofessional acute care study day.

    Science.gov (United States)

    Lewis, Robin

    2011-01-01

    A significant number of patients requiring critical care are now being managed outside of critical care facilities. There is evidence that staff looking after these patients lack the necessary knowledge and skills to care for them safely, and that effective pre-registration education can play a significant role in addressing these shortfalls in nurses' knowledge and skills. A team from Sheffield Hallam University, in collaboration with the University of Sheffield, developed a pilot one day interprofessional acute illness programme which was called SMART® (Student Management of Acute illness - Recognition and Treatment). To evaluate the pilot programme, 16 student doctors and 72 student nurses were recruited. A pre- and post-course questionnaire based on the Featherstone et al. (2005) evaluation of ALERT was used to ascertain the students' general level of knowledge of the deteriorating patient, their experiences of and confidence in caring for an acutely unwell patient, and their level of comfort with interprofessional working. The results from the pilot study indicate that the students' levels of knowledge, their levels of confidence and their comfort with interprofessional working all rose after undertaking the programme. The pilot study has a number of implications for the future teaching and learning of acute care clinical skills, within a theoretically based curriculum.

  12. The importance of capacity building and training for those working with older people in Centers-Day

    Directory of Open Access Journals (Sweden)

    Sônia Azevedo Menezes Prata Silva Fuentes

    2015-02-01

    Full Text Available Reflections discussed here originated from workshops developed to provide a space for elders to express themselves and to be heard as well to provide  better socio-cultural  interactions and improvement in their wellbeing and quality of life. These workshops were conducted at a Center Day for Elderly in São Paulo, Brazil, from September 2011 to February 2013, as part of a PhD project entitled “Geras Vitalis”. Service gaps and lack of gerontological knowledge by care-takers and directors from the institution where the work was undertaken were observed during the workshops. These shortcomings, in our view, can exacerbate inappropriate behavior, contributing to a lower quality of life of the older people, as well as those who deal with them in everyday life. As a result of this study, we suggest training programs, where gerontological interventions are oriented by components such as counseling, psychological and educational listening and, if necessary, the use of “Case Management”.

  13. Implementing Geriatric Resources for Assessment and Care of Elders Team Care in a Veterans Affairs Medical Center: Lessons Learned and Effects Observed.

    Science.gov (United States)

    Schubert, Cathy C; Myers, Laura J; Allen, Katie; Counsell, Steven R

    2016-07-01

    In a randomized clinical trial, Geriatric Resources for Assessment and Care of Elders (GRACE), a model of care that works in collaboration with primary care providers (PCPs) and patient-centered medical homes to provide home-based geriatric care management focusing on geriatric syndromes and psychosocial problems commonly found in older adults, improved care quality and reduced acute care use for high-risk, low-income older adults. To assess the effect of GRACE at a Veterans Affairs (VA) Medical Center (VAMC), veterans aged 65 and older from Marion County, Indiana, with PCPs from four of five VAMC clinics who were not on hospice or dialysis were enrolled in GRACE after discharge home from an acute hospitalization. After an initial home-based transition visit to GRACE enrollees, the GRACE team returned to conduct a geriatric assessment. Guided by 12 protocols and input from an interdisciplinary panel and the PCP, the GRACE team developed and implemented a veteran-centric care plan. Hospitalized veterans from the fifth clinic, who otherwise met enrollment criteria, served as a usual-care comparison group. Demographic, comorbidity, and usage data were drawn from VA databases. The GRACE and comparison groups were similar in age, sex, and burden of comorbidity, although predicted risk of 1-year mortality in GRACE veterans was higher. Even so, GRACE enrollment was associated with 7.1% fewer emergency department visits, 14.8% fewer 30-day readmissions, 37.9% fewer hospital admissions, and 28.5% fewer total bed days of care, saving the VAMC an estimated $200,000 per year after program costs during the study for the 179 veterans enrolled in GRACE. Having engaged, enthusiastic VA leadership and GRACE staff; aligning closely with the medical home; and accommodating patient acuity were among the important lessons learned during implementation. PMID:27305428

  14. Clinical Outcomes of Colonic Stent in a Tertiary Care Center

    Directory of Open Access Journals (Sweden)

    Mahesh Gajendran

    2014-01-01

    Full Text Available Introduction. Colonic obstruction is one of the manifestations of colon cancer for which self-expanding metal stents (SEMS have been effectively used, to restore the luminal patency either for palliative care or as a bridge to resective surgery. The aim of our study is to evaluate the efficacy and safety of large diameter SEMS in patients with malignant colorectal obstruction. Methods and Results. A four-year retrospective review of the Medical Archival System was performed and identified 16 patients. The average age was 70.8 years, of which 56% were females. The most common cause of obstruction was colon cancer (9/16, 56%. Rectosigmoid was the main site of obstruction (9/16 and complete obstruction occurred in 31% of cases. The overall technical and clinical success rates were 100% and 87%, respectively. There were no immediate complications (<24 hours, but stent stenosis due to kinking occurred within one week of stent placement in 2 patients. Stent migration occurred in 2 patients at 34 and 91 days, respectively. There were no perforations or bleeding complications. Conclusion. Large diameter SEMS provide a safe method for palliation or as a bridge to therapy in patients with malignant colonic obstruction with high technical success and very low complication rates.

  15. Advancing patient-centered care through transformative educational leadership: a critical review of health care professional preparation for patient-centered care

    Directory of Open Access Journals (Sweden)

    Lévesque MC

    2013-07-01

    Full Text Available Martine C Lévesque,1,2 Richard Bruce Hovey,2,3 Christophe Bedos2,4 1Faculté de médecine, Université de Montréal, Montréal, QC, Canada; 2Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada; 3Faculty of Medicine, University of Calgary, Calgary, AB, Canada; 4Département de médecine sociale et préventive, Faculté de médicine, Université de Montréal, Montréal, QC, Canada Abstract: Following a historical brief on the development of patient-centered care (PCC, we discuss PCC's value and role in counterbalancing the evidence-based movement in health care. We in turn make a case for a philosophical shift in thinking about the PCC concept, one based on a consideration for how knowledge is produced, used, and valued within care provision processes. A “shared epistemology” foundation is presented, defined, and promoted as essential to the authentic and ethical realization of “shared decision making” between patient and health care provider, and, more generally, of PCC. In accordance with these views, this article critically reviews the literature on health care professional education for the development of PCC. We uncover the disturbing ways in which education frequently undermines the development of patient centeredness, despite curricular emphasis on professionalism and ethical PCC. We also establish the need to raise awareness of how dominant approaches to evaluating student or practitioner performance often fail to reinforce or promote patient centeredness. Finally, we identify successful and inspiring cases of teaching and learning experiences that have achieved perspective transformation on PCC and on new ways of providing care. The pertinence of adopting the theoretical foundations of adult transformative learning is argued, and a call to action is proposed to the leadership of health professional educators across all disciplines. Keywords: patient-centered care, health professional

  16. Developmental stimulation in child care centers contributes to young infants’ cognitive development

    NARCIS (Netherlands)

    Albers, E.M.; Riksen-Walraven, J.M.A.; Weerth, C. de

    2010-01-01

    This study examined whether the quality of caregiver behavior in child care centers contributes to infant cognitive development at 9 months of age. Sixty-four infants (34 boys) were observed with their primary caregivers in child care centers at 3, 6, and 9 months of age. Caregiver behavior was rate

  17. Diabetes Stories: Use of Patient Narratives of Diabetes to Teach Patient-Centered Care

    Science.gov (United States)

    Kumagai, Arno K.; Murphy, Elizabeth A.; Ross, Paula T.

    2009-01-01

    A critical component to instituting compassionate, patient-centered diabetes care is the training of health care providers. Our institution developed the Family Centered Experience (FCE), a comprehensive 2-year preclinical program based on longitudinal conversations with patients about living with chronic illness. The goal of the FCE is to explore…

  18. Improving care efficiency in a radiotherapy center using Lean philosophy

    OpenAIRE

    Trilling, Lorraine; Pellet, Bertrand; Delacroix, Sabine; Colella Fleury, Hélène; Marcon, Eric

    2010-01-01

    In the field of health care, as in production or services, there is a need for tailor made methodology to help managers improving quality of care as well as efficiency of the organization. Quality Improvement (QI) has become a major preoccupation in the current context where hospitals and health care services need to provide a high level of care and a welcoming environment for patients while reducing costs and maintaining a pleasant work atmosphere for staff. In this paper we present how, wit...

  19. Gastroenteritis Attributable to 16 Enteropathogens in Children Attending Day Care Significant Effects of Rotavirus, Norovirus, Astrovirus, Cryptosporidium and Giardia

    NARCIS (Netherlands)

    Enserink, Remko; van den Wijngaard, Cees; Bruijning-Verhagen, Patricia; van Asten, Liselotte; Mughini-Gras, Lapo; Duizer, Erwin; Kortbeek, Titia; Scholts, Rianne; Nagelkerke, Nico; Smit, Henriette A.; Kooistra-Smid, Mirjam; van Pelt, Wilfrid

    2015-01-01

    Background: Children attending day care experience substantial gastrointestinal morbidity due to circulating seasonal enteropathogens in the day-care environment. The lack of a distinct clinical presentation of gastroenteritis (GE) in these children, in combination with the high diversity of enterop

  20. Day care attendance in early life, maternal history of asthma, and asthma at the age of 6 years

    NARCIS (Netherlands)

    Celedon, JC; Wright, RJ; Litonjua, AA; Sredl, D; Ryan, L; Weiss, ST; Gold, DR

    2003-01-01

    Among children not selected on the basis of a parental history of atopy, day care attendance in early life is inversely associated with asthma at school age. We examined the relation between day care in the first year of life and asthma, recurrent wheezing, and eczema at the age of 6 years and wheez

  1. Perspective of Parents and Caregivers on the Influence of Full-Time Day-Care Attendance on Young Children

    Science.gov (United States)

    Undheim, Anne Mari; Drugli, May Britt

    2012-01-01

    The aim of this study was to explore the experience of parents and caregivers regarding young children in day care. The tiredness of children after day-care attendance was explored. In the autumn of 2009, 41 parents and 35 caregivers of children aged 1.5 years or younger living in the city of Trondheim and nearby communities were assessed using a…

  2. Senior Centers

    Medline Plus

    Full Text Available ... Living independently at home is something many older adults would like to do as long as they can. Senior centers, adult day care, transportation, and meals programs are long- ...

  3. Optimizing Patient-centered Communication and Multidisciplinary Care Coordination in Emergency Diagnostic Imaging: A Research Agenda.

    Science.gov (United States)

    Sabbatini, Amber K; Merck, Lisa H; Froemming, Adam T; Vaughan, William; Brown, Michael D; Hess, Erik P; Applegate, Kimberly E; Comfere, Nneka I

    2015-12-01

    Patient-centered emergency diagnostic imaging relies on efficient communication and multispecialty care coordination to ensure optimal imaging utilization. The construct of the emergency diagnostic imaging care coordination cycle with three main phases (pretest, test, and posttest) provides a useful framework to evaluate care coordination in patient-centered emergency diagnostic imaging. This article summarizes findings reached during the patient-centered outcomes session of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The primary objective was to develop a research agenda focused on 1) defining component parts of the emergency diagnostic imaging care coordination process, 2) identifying gaps in communication that affect emergency diagnostic imaging, and 3) defining optimal methods of communication and multidisciplinary care coordination that ensure patient-centered emergency diagnostic imaging. Prioritized research questions provided the framework to define a research agenda for multidisciplinary care coordination in emergency diagnostic imaging.

  4. Family-centered care coordination for children with special needs across multiple settings.

    Science.gov (United States)

    Lindeke, Linda L; Leonard, Barbara J; Presler, Betty; Garwick, Ann

    2002-01-01

    Care coordination is a process that involves assessment, planning, implementation, evaluation, education, monitoring, support, and advocacy. Pediatric nurse practitioners (PNPs) are well positioned to coordinate care but may not be well educated about potential conflicts of interest in balancing cost-containment constraints with obtaining maximum quality and quantity of care for children and families with complex needs. The philosophy of family-centered care is embodied in some care coordination models and absent in others. PNPs who aim to support families of children with special health care needs need to understand the complexity of interacting with multiple care coordination models across health and educational settings. PNPs may act as change agents to infuse family-centered care principles into existing and future care coordination models. PMID:12436098

  5. Family Day Care Check-In Program: After-School Care for Children Aged 10-14. [Introduction and Guide to Operation.

    Science.gov (United States)

    Osborne, Linda B., Ed.

    The Family Day Care Check-In Program is designed to offer working parents convenient, affordable after school care for their children aged 10 to 14. It provides children with flexible supervision by caring, trained adults and gives them opportunities to grow into responsible, independent teens by planning and participating in activities on their…

  6. Incidence of diabetes mellitus type 2 complications among Saudi adult patients at primary health care center

    OpenAIRE

    Alsenany, Samira; Al Saif, Amer

    2015-01-01

    [Purpose] This study analyzed type 2 diabetes and its role in complications among adult Saudi patients. [Subjects] Patients attending four primary health care centers in Jeddah were enrolled. [Methods] A cross-sectional design study among Saudi patients attending Ministry of Health primary health care centers in Jeddah was selected for use by the Primary Health Care administration. Patients were interviewed with structured questionnaires to determine the presence of diabetes and risk factors ...

  7. Using Social Network Analysis to Identify Key Child Care Center Staff for Obesity Prevention Interventions: A Pilot Study

    OpenAIRE

    Jennifer Marks; Barnett, Lisa M.; Chad Foulkes; Penelope Hawe; Steven Allender

    2013-01-01

    Introduction. Interest has grown in how systems thinking could be used in obesity prevention. Relationships between key actors, represented by social networks, are an important focus for considering intervention in systems. Method. Two long day care centers were selected in which previous obesity prevention programs had been implemented. Measures showed ways in which physical activity and dietary policy are conversations and actions transacted through social networks (interrelationships) with...

  8. Quality of antenatal care in primary health care centers of bangladesh.

    Directory of Open Access Journals (Sweden)

    Ahmed M S A Mansur

    2014-12-01

    Full Text Available To find out the quality of ANC in the Upazila Health Complexes (PHC centres of Bangladesh.This cross sectional study was done in purposively selected three upazilas among the clients receiving antenatal care (ANC. Data were collected with questionnaire cum checklist in the context of two aspects of quality issues, namely assessment of physical arrangements for ANC (input and services rendered by the providers (process.The mean age of respondents was 24.6±4.5 years. Majority of the respondents were with primary level education (60.3%. About half (52.8% of the families had monthly income ranging from 3000-5000 taka (38-64 US$. Nearly half (48.9% had no child, little more than one third (42.3% were primigravida and 528 (57.7% were multigravida. Out of 528 multigravid respondents 360 (68.2% took ANC in their previous pregnancy whereas 168 (31.8% did not take ANC Pregnancy outcome was found to be associated with receiving ANC (χ(2=73.599; p=0.000. Respondents receiving ANC had more good pregnancy outcome. The mean waiting time for receiving ANC was 0.77±.49 hours. Out of the 13 centers, only 3 (23.1% have sufficient instruments to render ANC services. Findings showed that where the modes of ANC service delivery in the ANC centers are fairly satisfactory. Though some of the points of standard operation procedures (SOPs on ANC are not covered by some ANC centers, those were not considered necessary. But, regarding the physical facilities available for rendering ANC services, it is seen that facilities are not quite satisfactory. Number of doctors and nurses are not very satisfactory. One of the centers under this study has no doctor, where ANC services are given by nurses.It can be concluded that the ANC services at the primary health care level is not adequate in Bangladesh. To ensure further improvement of the quality of ANC services, instruments used in logistics and supplies should be enhanced.

  9. A Survey of Primary Care Offices: Triage of Poisoning Calls without a Poison Control Center

    OpenAIRE

    Travis Austin; Brooks, Daniel E.; Sharyn Welch; Frank LoVecchio

    2012-01-01

    Poison control centers hold great potential for saving health care resources particularly by preventing unnecessary medical utilization. We developed a four-question survey with three poisoning-related scenarios, based on common calls to our poison center, and one question regarding after-hours calls. We identified primary care provider offices in our poison center's region from an internet search. We contacted these offices via telephone and asked to speak to an office manager or someone res...

  10. Reducing unnecessary hospital days to improve quality of care through physician accountability: a cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Caminiti Caterina

    2013-01-01

    Full Text Available Abstract Background Over 20% of hospital bed use is inappropriate, implying a waste of resources and the increase of patient iatrogenic risk. Methods This is a cluster, pragmatic, randomised controlled trial, carried out in a large University Hospital of Northern Italy, aiming to evaluate the effect of a strategy to reduce unnecessary hospital days. The primary outcome was the percentage of patient-days compatible with discharge. Among secondary objectives, to describe the strategy’s effect in the long-term, as well as on hospital readmissions, considered to be a marker of the quality of hospital care. The 12 medical wards with the longest length of stay participated. Effectiveness was measured at the individual level on 3498 eligible patients during monthly index days. Patients admitted or discharged on index days, or with stay >90 days, were excluded. All ward staff was blinded to the index days, while staff in the control arm and data analysts were blinded to the trial’s objectives and interventions. The strategy comprised the distribution to physicians of the list of their patients whose hospital stay was compatible with discharge according to a validated Delay Tool, and of physician length of stay profiles, followed by audits managed autonomously by the physicians of the ward. Results During the 12 months of data collection, over 50% of patient-days were judged to be compatible with discharge. Delays were mainly due to problems with activities under medical staff control. Multivariate analysis considering clustering showed that the strategy reduced patient-days compatible with discharge by 16% in the intervention vs control group, (OR=0.841; 95% CI, 0.735 to 0.963; P=0.012. Follow-up at 1 year did not yield a statistically significant difference between the percentages of patient-days judged to be compatible with discharge between the two arms (OR=0.818; 95% CI, 0.476 to 1.405; P=0.47. There was no significant difference in 30-day

  11. Creating and Maintaining a Wellness Environment in Child Care Centers Participating in the Child and Adult Care Food Program

    Science.gov (United States)

    Lofton, Kristi L.; Carr, Deborah H.

    2010-01-01

    Purpose/Objectives: This study identifies issues associated with creating and maintaining a wellness environment in child care centers (CCCs) participating in the Child and Adult Care Food Program (CACFP). Methods: Structured interviews and focus groups were conducted with CCC professionals and state agency personnel to develop a survey to assess…

  12. Commitment, Community, and Passion: Dimensions of a Care-Centered Approach to Teacher Education.

    Science.gov (United States)

    Goldstein, Lisa S.

    2002-01-01

    Builds on Nel Noddings' work on caring encounters to develop a care-centered approach to teacher education. This model emphasizes the important contributions to the process of preparing caring teachers made by enhanced interpersonal commitment, membership in a community of learners, and passion for the creative, intellectual aspects of teaching.…

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

    Directory of Open Access Journals (Sweden)

    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

  14. Unwritten Rules For Safety And Performance In An Oncology Day Care Unit: Testing The Resilience Markers Framework

    OpenAIRE

    Furniss, Dominic; Back, Jonathan; Blandford, Ann

    2013-01-01

    This paper has two complementary objectives: 1) exploring resilience behaviours in an Oncology Day Care Unit; and 2) testing the Resilience Markers Framework as a tool for facilitating resilience analysis. Data gathering in the Day Care Unit took place over five days, which included observing 31 infusion pump interactions. With specific use of the framework we identify and describe six resilience episodes that impacted on the potential for error in the system. The framework’s focus and elemen...

  15. Employer-Supported Child Care in Ontario.

    Science.gov (United States)

    Ontario Ministry of Community and Social Services, Toronto.

    Six case studies describing current employer-supported child care services in Ontario are presented. The studies describe the PLADEC Day Care Center of the Kingston Psychiatric Hospital, the day care center at the Chedoke-McMaster Hospitals in Hamilton, the Early Learning Centre at Durham College in Oshawa, the Hydrokids day care center at the…

  16. Avaliação do consumo alimentar em creches públicas em São Paulo, Brasil Evaluación del consumo alimentar en guarderías públicas en São Paulo, Brasil Evaluation of food consumption at public day care centers in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Giovana Longo-Silva

    2012-01-01

    edades entre 12 y 29 meses. La recolección de los datos se realizó por el método de pesaje directo durante tres días no consecutivos. Para el cálculo nutricional, se utilizó el software DietWin Profissional 2.0®, siendo posteriormente calculada la adecuación del consumo de energía, proteína, hierro, vitamina A y vitamina C. Para el cálculo de proteína, hierro, vitaminas A y C, se utilizó como referencia la necesidad mediana estimada (Estimated Average Requirement del National Research Council (2002. El calcio se evaluó por la ingestión adecuada (Adequate Intake, 1999. La evaluación de la ingestión de energía se realizó con base en la necesidad energética estimada (Estimated Energy Requirement, 2002. Los datos fueron analizados en el programa Epi-Info 2000, versión 3.4.3. RESULTADOS: Se identificaron déficits medianos para energía (49,78%, hierro (81,67%, calcio (57,44%, excesos de proteína (183,27% y vitaminas A (126,86% y C (57,44%. La distribución de los porcentuales de adecuación de los macronutrientes se mostró inadecuada para lípidos. CONCLUSIONES: Aunque los menús servidos en guarderías sean planeados por nutricionistas, los resultados apuntan a posibles fallas en el proceso de la alimentación infantil relacionadas a la preparación, proporcionamiento y/o prácticas de oferta de los alimentos. Tales hallazgos refuerzan la necesidad de acciones de educación y supervisión en salud para garantizar el suministro de alimentación adecuada a este grupo poblacional.OBJECTIVE: To evaluate the energy intake and dietary adequacy of children attending nurseries of public and not-for-profit daycare centers in the city of São Paulo, Brazil. METHODS: Cross-sectional study conducted at 16 nurseries, attended by 236 children between the ages of 12 and 29 months. Data collection was carried out by the direct weighing method over three nonconsecutive days. The DietWin® 2.0 Professional software was used for nutritional calculations. The adequacy of

  17. Shared Decision Making and Effective Physician-Patient Communication: The Quintessence of Patient-Centered Care

    Directory of Open Access Journals (Sweden)

    Huy Ming Lim

    2015-03-01

    Full Text Available The Institute of Medicine’s (IOM 2001 landmark report, Crossing the Quality Chasm: A New Health System for the 21st Century, identified patient-centeredness as one of the fundamental attributes of quality health care, alongside safety, effectiveness, timeliness, efficiency, and equity. The IOM defined patient-centeredness as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.” This concept of patient-centered care represents a paradigm shift from the traditional disease-oriented and physician-centered care, grounding health care in the subjective experience of illness and the needs and preferences of individual patients rather than the evaluation and treatment of diseases which emphasizes on leveraging clinical expertise and evidence derived from population-based studies. Regrettably, despite the ubiquitous talk about patient-centered care in modern health care, shared decision-making and effective physician-patient communication—the two cruxes of patient-centered care—are yet to become the norms. Strategies to promote and enhance shared decision-making and effective communication between clinicians and patients should be rigorously implemented to establish a health care system that truly values patients as individuals and turn the rhetoric of patient-centered care into reality.

  18. Clinical and epidemiological characteristics of patients with uveitis in an emergency eye care center in Brazil

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    Eduardo Nery Rossi Camilo

    2014-01-01

    Full Text Available Purpose: To analyze the clinical and epidemiological characteristics of patients with uveitis in an emergency eye care center. Methods: We conducted a prospective, observational study of patients with active uveitis admitted between May 2012 and July 2012 to an emergency eye care center. Results: The majority of patients were male (63.2%, with a mean age of 43.2 years; 66.2% patients were of mixed ethnicity, 22.5% were Caucasian, and 11.3% were black. Anterior uveitis was observed in 70.1% patients, posterior uveitis in 26.5%, and panuveitis in 3.4%; no patient was diagnosed with intermediate uveitis. All patients had a sudden and acute presentation. The most frequent symptoms were ocular pain (76.9%, redness (59.8%, and visual blurring (46.2%. The majority of patients had unilateral disease (94.9% with a mean symptom duration of 6.2 days. Diffuse and anterior uveitis were associated with ocular pain (p<0.001. Scotomata and floaters were more frequent in patients with posterior uveitis (p=0.003 and p=0.016, respectively. Patients with anterior uveitis presented with better visual acuity (p=0.025. Granulomatous keratotic precipitates were more frequent in patients with posterior uveitis (p=0.038. An etiological diagnosis based on the evaluation at the emergency center was made in 45 patients (38.5%. Conclusions: Acute anterior uveitis was the most frequent form of uveitis. Initial patient evaluation provided sufficient information for deciding primary therapy and aided in arriving at an etiological diagnosis in a considerable number of patients.

  19. Implementation of an Interdisciplinary, Team-Based Complex Care Support Health Care Model at an Academic Medical Center: Impact on Health Care Utilization and Quality of Life

    OpenAIRE

    Christine Ritchie; Robin Andersen; Jessica Eng; Garrigues, Sarah K.; Gina Intinarelli; Helen Kao; Suzanne Kawahara; Kanan Patel; Lisa Sapiro; Anne Thibault; Erika Tunick; Barnes, Deborah E.

    2016-01-01

    Introduction The Geriatric Resources for the Assessment and Care of Elders (GRACE) program has been shown to decrease acute care utilization and increase patient self-rated health in low-income seniors at community-based health centers. Aims To describe adaptation of the GRACE model to include adults of all ages (named Care Support) and to evaluate the process and impact of Care Support implementation at an urban academic medical center. Setting 152 high-risk patients (≥5 ED visits or ≥2 hosp...

  20. Assessing Patient-Centered Communication in Cancer Care: Stakeholder Perspectives

    OpenAIRE

    Mazor, Kathleen M.; Gaglio, Bridget; Nekhlyudov, Larissa; Alexander, Gwen L.; Stark, Azadeh; Hornbrook, Mark C.; Walsh, Kathleen; Boggs, Jennifer; Lemay, Celeste A.; Firneno, Cassandra; Biggins, Colleen; Blosky, Mary Ann; Arora, Neeraj K.

    2013-01-01

    Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices.

  1. Helping cancer patients across the care continuum: the navigation program at the Queen's Medical Center.

    Science.gov (United States)

    Allison, Amanda L; Ishihara-Wong, Debra D M; Domingo, Jermy B; Nishioka, Jocelyn; Wilburn, Andrea; Tsark, JoAnn U; Braun, Kathryn L

    2013-04-01

    Research suggests that cancer patient navigation improves care, but few reports describe the variety of patients managed by a hospital-based navigation program. Differences in navigated patients by the intensity (low, medium, or high) of navigation services they received were examined. The 835 clients seen by the navigators in a hospital-based cancer center were first stratified by quarter and by four ethnic groups. Randomized selection from each group assured there would be equal representation for analysis of Hawaiians, Filipinos, Japanese, and Whites and even numbers over all time intervals. Five professionals extracted data from these case records on demographics, type/stage of cancer, diagnosis and treatment dates, barriers, and navigator actions. Clients had breast (30.0%), lung (15.8%), esophageal (6.7%), colon (5.8%), ovarian (4.2%), prostate (3.3%), and other cancers (34.2%). The median number of actions taken on behalf of a client was 4 (range 1-83), and the median number of days a case was open was 14 (range 1-216). High intensity cases (those receiving more assistance over longer periods of time) were more likely than low-intensity cases to need help with education and reassurance, transportation, care coordination, and covering costs. Although there were no demographic differences across intensity groups, Neighbor Island patients from Hawai'i, Maui, Moloka'i, Lana'i and Kaua'i were more likely to need help with arranging travel, care coordination, and costs associated with getting treatment (all at P=.05), and patients on public insurance were more likely to have stage 4 cancer (P=.001) and to need help with costs (P=.006). Findings suggest that this hospital-based navigation program is filling a real need of patients across the cancer care continuum. A triage protocol and an integrated data capture system could help improve the targeting and documentation of cancer patient navigation services. PMID:23795311

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

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    Auranen Kari

    2009-06-01

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

  3. Communication About Sexuality in Advanced Illness Aligns With a Palliative Care Approach to Patient-Centered Care.

    Science.gov (United States)

    Leung, Margaret W; Goldfarb, Shari; Dizon, Don S

    2016-02-01

    Treatment-related sexual complications are common in cancer patients although rarely discussed in the palliative care setting. Sexuality is an important survivorship issue and remains relevant even in the terminal setting. There are multiple barriers in dialoguing about intimacy and sexual functioning from the patient and provider perspectives. Palliative care providers, while not expected to be sexual health experts, can provide comprehensive patient-centered care by including sexual health as part of their evaluation. They can explore how sexual dysfunction can impair functioning and utilize an interdisciplinary approach to manage symptoms. Palliative care providers can help patients identify their goals of care and explore what anticipated sexual changes and treat-related side effects are tolerable and intolerable to the patient's quality of life. Principles on addressing sexuality in the palliative setting and practical ways of incorporating sexual history into the palliative care assessment are provided.

  4. [Mental health care: listening to patients discharged from a day hospital].

    Science.gov (United States)

    Ferreira, Maria Solange de Castro; Pereira, Maria Alice Ornellas

    2012-01-01

    This is a qualitative study aiming at understanding how patients discharged from a Mental Health Day Hospital view the service, at learning whether such service contributed to changes in their lives and at whether those individuals continued treatment. Semi-structured interviews and documental research were used for nine patients who had completed treatment at the service in 2008. Thematic analysis was adopted for organization of the data obtained, which were analyzed according to the Psychosocial Rehabilitation framework. It emphasizes the importance of looking for the various subjective aspects of human existence, requiring from services and professionals the establishment of a caring relationship that enables the reconstruction of trajectories interrupted by the onset of the disease, through actions that consider the integrality and intersectionality.

  5. Visiting nursery, kindergarten and after-school day care as astronomy for development

    Science.gov (United States)

    Tomita, Akihiko

    2015-08-01

    One of the frontiers of astronomy for development is astronomy education for young children. Note that it is not too-much-going-ahead education nor education for so-called gifted children. It is for all children in various situations. As an example, I present "Uchu no O-hanashi," a visiting activity which includeds slide show, story telling, and enjoying pictures on large sheets for children. Not only just for young children, but this activity also aims at intercultural understanding. Sometimes guest educator from abroad join the activity. Video letter exchange was successful even though there is a language barrier. For assessment of the activity, I have recorded the voice of children. I will present various examples of written records and their analysis of activites, at nursery, kindergarten, preschool, after-school day care for primary school children, and other sites. I hope exchanging the record will make a worldwide connection among educators for very young children.

  6. Early Full-Time Day Care, Mother-Child Attachment, and Quality of the Home Environment in Chile: Preliminary Findings

    Science.gov (United States)

    Cárcamo, Rodrigo A.; Vermeer, Harriet J.; van der Veer, René; van IJzendoorn, Marinus H.

    2016-01-01

    Research Findings: Two longitudinal studies are reported examining the effects of full-time day care in Mapuche and non-Mapuche families in Chile. First, the Magellan-Leiden Childcare Study (MLCS) used a sample of 95 mothers with children younger than 1 year old (n = 36 in day care). Second, we partially cross-validated our results in a large and…

  7. [A behavioural rating scale of activity engagement in psychogeriatric day care].

    Science.gov (United States)

    Diesfeldt, H F A

    2014-09-01

    The Participation Scale was developed as an observational measure of activity engagement (as rated by group facilitators) of adult day care clients with mild to moderate dementia. In a consecutive sample of 448 subjects Mokken scaling procedure was conducted to assess the latent structure of 27 questionnaire items. The study included an exploratory and a confirmatory approach. For that purpose the sample was randomly divided into two halves. Exploratory analysis revealed three dimensions of participation that adequately captured the item structure: motivation (10 items; Loevinger's H = 0.48), competence (7 items; H = 0.56) and self-confidence (4 items; H = 0.57). The structure was validated in a confirmatory analysis. In a stepwise multiple regression model 49% of the variance in motivation was explained by independent behavioural measures of apathy and affect. Apathy and cognitive impairment were significant predictors of competence in participation (R(2) = 31.2%). Negative affect was the main predictor of reduced self-confidence (R(2) = 37.9%). Cross-validation of these exploratory regression models on the confirmatory sample explained 39.6%, 29.2% and 23.1% of the variance in motivation, competence and self-confidence, respectively. Test-retest intraclass correlation coefficients (ICC2(A,1)) as determined in a random subsample of 56 participants, were 0.77 (motivation), 0.85 (competence) and 0.76 (self-confidence). The three measures allow the differentiation and ordering of individual participants on separate dimensions of activity engagement in psychogeriatric day care. PMID:25007866

  8. [SOROKA UNIVERSITY MEDICAL CENTER: THE ROAD TO LEADERSHIP IN QUALITY OF MEDICAL CARE, SERVICE AND RESEARCH].

    Science.gov (United States)

    Davidson, Ehud; Sheiner, Eyal

    2016-02-01

    Soroka University Medical Center is a tertiary hospital, and the sole medical center in the Negev, the southern part of Israel. Soroka has invested in quality, service and research. The region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. In this editorial we describe the path to leadership in quality of medical care, service and research.

  9. Oral health knowledge of health care workers in special children’s center

    OpenAIRE

    Wyne, Amjad; Hammad, Nouf; Splieth, Christian

    2015-01-01

    Objective: To determine the oral health knowledge of health care workers in special children’s center. Methods: A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. Results: All 60 health care workers in the ...

  10. Music benefits on postoperative distress and pain in pediatric day care surgery

    Directory of Open Access Journals (Sweden)

    Valeria Calcaterra

    2014-09-01

    Full Text Available Postoperative effect of music listening has not been established in pediatric age. Response on postoperative distress and pain in pediatric day care surgery has been evaluated. Forty-two children were enrolled. Patients were randomly assigned to the music-group (music intervention during awakening period or the non-music group (standard postoperative care. Slow and fast classical music and pauses were recorded and played via ambient speakers. Heart rate, blood pressure, oxygen saturation, glucose and cortisol levels, faces pain scale and Face, Legs, Activity, Cry, Consolability (FLACC Pain Scale were considered as indicators of response to stress and pain experience. Music during awakening induced lower increase of systolic and diastolic blood pressure levels. The non-music group showed progressive increasing values of glycemia; in music-group the curve of glycemia presented a plateau pattern (P<0.001. Positive impact on reactions to pain was noted using the FLACC scale. Music improves cardiovascular parameters, stress-induced hyperglycemia. Amelioration on pain perception is more evident in older children. Positive effects seems to be achieved by the alternation of fast, slow rhythms and pauses even in pediatric age.

  11. Music benefits on postoperative distress and pain in pediatric day care surgery.

    Science.gov (United States)

    Calcaterra, Valeria; Ostuni, Selene; Bonomelli, Irene; Mencherini, Simonetta; Brunero, Marco; Zambaiti, Elisa; Mannarino, Savina; Larizza, Daniela; Albertini, Riccardo; Tinelli, Carmine; Pelizzo, Gloria

    2014-08-12

    Postoperative effect of music listening has not been established in pediatric age. Response on postoperative distress and pain in pediatric day care surgery has been evaluated. Forty-two children were enrolled. Patients were randomly assigned to the music-group (music intervention during awakening period) or the non-music group (standard postoperative care). Slow and fast classical music and pauses were recorded and played via ambient speakers. Heart rate, blood pressure, oxygen saturation, glucose and cortisol levels, faces pain scale and Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale were considered as indicators of response to stress and pain experience. Music during awakening induced lower increase of systolic and diastolic blood pressure levels. The non-music group showed progressive increasing values of glycemia; in music-group the curve of glycemia presented a plateau pattern (PMusic improves cardiovascular parameters, stress-induced hyperglycemia. Amelioration on pain perception is more evident in older children. Positive effects seems to be achieved by the alternation of fast, slow rhythms and pauses even in pediatric age.

  12. [THE DEVELOPMENT OF MEDICAL CARE OF POPULATION IN CONDITIONS OF SPECIALIZED DAY-TIME HOSPITALS OF NEUROLOGICAL PROFILE].

    Science.gov (United States)

    Grishina, N K; Solovieva, N B; Abdulsalamova, Z A

    2015-01-01

    The article considers issues concerning increasing of quality and accessibility of medical care in Moscow neurological profile included at the expense of wide-spread implementation of specialized day-time hospitals in health care practice. The analysis applied was based on average Moscow indicators of functioning of public health institutions and characteristics of clinical course of diseases of the mentioned profile.

  13. Climate Prediction Center (CPC)Ensemble Canonical Correlation Analysis 90-Day Seasonal Forecast of Precipitation

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Ensemble Canonical Correlation Analysis (ECCA) precipitation forecast is a 90-day (seasonal) outlook of US surface precipitation anomalies. The ECCA uses...

  14. A Survey of Primary Care Offices: Triage of Poisoning Calls without a Poison Control Center

    Directory of Open Access Journals (Sweden)

    Travis Austin

    2012-01-01

    Full Text Available Poison control centers hold great potential for saving health care resources particularly by preventing unnecessary medical utilization. We developed a four-question survey with three poisoning-related scenarios, based on common calls to our poison center, and one question regarding after-hours calls. We identified primary care provider offices in our poison center's region from an internet search. We contacted these offices via telephone and asked to speak to an office manager or someone responsible for triaging patient phone queries. Using a scripted form, trained investigators questioned 100 consecutive primary care provider offices on how they would handle these poisoning-related calls if there was no poison center to refer their patients to. Results of our survey suggest that 82.5% of poisoning-related calls to primary care offices would be referred to 911 or an emergency department if there was no poison center. These results further support the role that poison centers play in patient care and health care utilization.

  15. Patient centered primary care is associated with patient hypertension medication adherence.

    Science.gov (United States)

    Roumie, Christianne L; Greevy, Robert; Wallston, Kenneth A; Elasy, Tom A; Kaltenbach, Lisa; Kotter, Kristen; Dittus, Robert S; Speroff, Theodore

    2011-08-01

    There is increasing evidence that patient centered care, including communication skills, is an essential component to chronic illness care. Our aim was to evaluate patient centered primary care as a determinant of medication adherence. We mailed 1,341 veterans with hypertension the Short Form Primary Care Assessment Survey (PCAS) which measures elements of patient centered primary care. We prospectively collected each patient's antihypertensive medication adherence for 6 months. Patients were characterized as adherent if they had medication for >80%. 654 surveys were returned (50.7%); and 499 patients with complete data were analyzed. Antihypertensive adherence increased as scores in patient centered care increased [RR 3.18 (95% CI 1.44, 16.23) bootstrap 5000 resamples] for PCAS score of 4.5 (highest quartile) versus 1.5 (lowest quartile). Future research is needed to determine if improving patient centered care, particularly communication skills, could lead to improvements in health related behaviors such as medication adherence and health outcomes.

  16. IDENTIFICATION OF EXAMPLES OF GOOD PRACTICE IN ABSORPTION OF STRUCTURAL FUNDS, CASE STUDY PROJECT "CHRISTIAN DAY CENTER"

    Directory of Open Access Journals (Sweden)

    CEAUSESCU IONUT

    2016-08-01

    Full Text Available The main purpose of this study is to capture the practical point of view, the main issues in examples of best practices in the application for funding for the project "Christian Day Center- Support for young people and adults with disabilities" project benefited the City Council Târgu Jiu, is a project which was realized in the Regional Operational Programme, Priority Axis 3 DMI 3.2 - "Rehabilitation / modernization / development and equipping of social services", the total value of the project was 3,373,722.72 lei, of which non-repayable funding over was worth 2,592,251.08 lei. Through its general objective, the project "Day Center Christian - Support for young people and adults with disabilities" aims to contribute to improving the quality of infrastructure for social services by ensuring equal access of citizens of Tg-Jiu such services. Christian Day Center- support for young people and adults with physical disabilities, musculoskeletal, neuro, somatic and visual has already proposed to the idea of the project, to be a center which will ensure the social inclusion of these vulnerable and contribute to increasing the quality of life, improve communication and information on the rights and benefits of social services to improve the management and organization of the system of providing social services and facilitating the participation of all stakeholders in the development of social services.

  17. Human-centered environment design in intensive care unit

    NARCIS (Netherlands)

    Li, Y.; Albayrak, A.; Goossens, R.H.M.; Xiao, D.; Jakimowicz, J.J.

    2013-01-01

    Because of high risk and instability of the patients in Intensive care unit(ICU), the design of ICU is very difficult. ICU design, auxiliary building design, lighting design, noise control and other aspects can also enhance its management. In this paper, we compare ICU design in China and Holland ba

  18. The Hospice Concept of Care: A Family Centered Approach.

    Science.gov (United States)

    Story, Marilyn

    This description of the Cedar Valley Hospice program emphasizes palliative and supportive care for terminally ill patients and their families. The history of the hospice movement is outlined along with a description of the Cedar Valley program and the results of a 1980 program evaluation. The appendices contain a statement of the hospice goals and…

  19. Emergency care center turnaround time--an improvement story.

    Science.gov (United States)

    Gelrud, Joan; Burroughs, Helen; Koterwas, Joanne

    2008-01-01

    Emergency department overcrowding is a nationally recognized barrier to patient safety. Other obstacles to efficiency and adequate care in emergency rooms include lengthy patient waits and side-tracked ambulances. This article explores one community hospital's approach to significantly decreasing emergency visit turnaround times while increasing patient satisfaction.

  20. Using a patient-centered approach for health and social care integration.

    Science.gov (United States)

    Poulymenopoulou, Mikaela; Papakonstantinou, Despoina; Malamateniou, Flora; Vassilacopoulos, George

    2012-01-01

    The drive in using health and social care resources more effectively has resulted in undertaking various efforts towards better coordination in order to improve patient-centered and personalized care for the individuals. This requires horizontal integration in terms of processes among health and social care organizations existing information systems (ISs) and personal health records (PHRs) in order to enable integrated patient information sharing among all the health and social care staff and individuals involved. Service-oriented and business process management (BPM) technologies are considered most appropriate for achieving such integration especially when is required to change existing processes and to integrate diverse information systems. On these grounds, a patient-centered approach is proposed for redesigning health and social care processes and for integrating diverse ISs and PHRs with the objective to meet holistic care goals.

  1. Comparing the implementation of team approaches for improving diabetes care in community health centers

    NARCIS (Netherlands)

    Wees, P.J. van der; Friedberg, M.W.; Guzman, E.; Ayanian, J.Z.; Rodriguez, H.P.

    2014-01-01

    BackgroundPatient panel management and community-based care management may be viable strategies for community health centers to improve the quality of diabetes care for vulnerable patient populations. The objective of our study was to clarify implementation processes and experiences of integrating o

  2. 7 CFR 226.19 - Outside-school-hours care center provisions.

    Science.gov (United States)

    2010-01-01

    ... Section 226.19 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational... precondition for any outside-school-hours care center's eligibility for CACFP nutrition benefits. In...

  3. Family Centered Health Care--A Viable Reality? The Denver Experience.

    Science.gov (United States)

    Cowen, David L:; Sbarbaro, John A.

    In early 1966, the Denver Department of Health and Hospitals embarked on a city-wide, decentralized health program in an effort to provide family centered "team" health care to medically indigent patients. The program encompasses 28 different clinics and facilities. Factors hindering or influencing the final pattern of health care delivery…

  4. Eleven Years of Primary Health Care Delivery in an Academic Nursing Center.

    Science.gov (United States)

    Hildebrandt, Eugenie; Baisch, Mary Jo; Lundeen, Sally P.; Bell-Calvin, Jean; Kelber, Sheryl

    2003-01-01

    Client visits to an academic community nursing center (n=25,495) were coded and analyzed. Results show expansion of nursing practice and services, strong case management, and management of illness care. The usefulness of computerized clinical documentation system and of the Lundeen conceptional model of community nursing care was demonstrated.…

  5. An Instrument to Assess the Obesogenic Environment of Child Care Centers

    Science.gov (United States)

    Ward, Dianne; Hales, Derek; Haverly, Katie; Marks, Julie; Benjamin, Sara; Ball, Sarah; Trost, Stewart

    2008-01-01

    Objectives: To describe protocol and interobserver agreements of an instrument to evaluate nutrition and physical activity environments at child care. Methods: Interobserver data were collected from 9 child care centers, through direct observation and document review (17 observer pairs). Results: Mean agreement between observer pairs was 87.26%…

  6. Anemia em crianças menores de cinco anos que freqüentam creches públicas do município do Rio de Janeiro, Brasil Anemia in children under five years old attended at public day care centers from Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Isabela Escórcio Augusto da Matta

    2005-09-01

    Full Text Available OBJETIVOS: estimar a prevalência de anemia em crianças matriculadas em creches municipais do Rio de Janeiro e identificar os subgrupos de maior risco. MÉTODOS: foram avaliadas 865 crianças. A hemoglobina (Hb foi dosada em fotômetro portátil (HemoCue e a anemia foi definida quando Hb OBJECTIVES: to assess anemia prevalence in children enrolled in daycare centers in the city of Rio de Janeiro to determine the more at risk subgroups. METHODS: 865 children were assessed. Hemoglobin (Hb was measured in a portable photometer (HemoCue and anemia was defined with Hb<11g/dL and <9.5g/dL for children over and under six months old respectively. Biological, social and economic information was obtained by questionnaires responded by the mothers. RESULTS: anemic children had means of z weight score for their ages (-0.239 and height for age ( -0.548 lower than the non-anemic children. Anemia risk was higher for children under two years old (prevalence ratio of [PR]1.73; confidence interval [IC95%: 1.52-1.97, for the ones who had parents with less than four years of schooling (PR=1.57; IC95%: 1.24-1.99 and lived in homes with more than eight family members (PR=1.45; IC95%: 1.07-1.95. CONCLUSIONS: anemia prevalence was high. Children who were underweight and with short height for their age, under two years old, living in crowded homes and with low parental schooling were more vulnerable to anemia and should be the focus for control and prevention.

  7. 76 FR 66931 - Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center...

    Science.gov (United States)

    2011-10-28

    ... (76 FR 28988). This third and final ADLS will combine the third and fourth sessions called for in the... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center for Medicare and Medicaid Innovation November 17 and...

  8. Comparing the implementation of team approaches for improving diabetes care in community health centers

    OpenAIRE

    Wees, P.J. van der; Friedberg, M.W.; Guzman, E; Ayanian, J.Z.; Rodriguez, H.P.

    2014-01-01

    Background: Patient panel management and community-based care management may be viable strategies for community health centers to improve the quality of diabetes care for vulnerable patient populations. The objective of our study was to clarify implementation processes and experiences of integrating office-based medical assistant (MA) panel management and community health worker (CHW) community-based management into routine care for diabetic patients. Methods: Mixed methods study with intervi...

  9. Does occupational lifting and carrying among female health care workers contribute to an escalation of pain-day frequency?

    DEFF Research Database (Denmark)

    Holtermann, A; Clausen, T; Aust, B;

    2013-01-01

    The aim of the study was to investigate if different frequencies, loads and trunk postures of occupational lifting and carrying increases the risk of sub-chronic (1-30 days last 12 months) low back pain (LBP) to become persistent (>30 days last 12 months) among female health care workers....

  10. Fatores de risco para perda ponderal de crianças frequentadoras de berçários em creches do município de São Paulo Risk factors for ponderal loss of children attending the nurseries of day care centers in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Maysa Helena A. Toloni

    2009-03-01

    Full Text Available OBJETIVO: Identificar e quantificar os fatores de risco relacionados ao agravamento da condição nutricional entre o nascimento e a realização deste estudo. MÉTODOS: Estudo transversal com 270 crianças frequentadoras dos berçários de oito creches públicas e filantrópicas do município de São Paulo. Considerou-se com perda ponderal as crianças que apresentaram diferença negativa do escore Z para a relação peso para idade entre o nascimento e a ocasião da realização desse inquérito. No estudo das associações, utilizou-se o teste do qui-quadrado e consideraram-se as variáveis com nível de significância pOBJECTIVE: To identify and quantify risk factors related to the aggravation of nutritional condition from birth until the date of the study. METHODS: Cross-sectional study with 270 children attending nurseries of eight public and non-for-profit daycare centers in the city of São Paulo, Brazil. Ponderal loss was considered when children presented negative difference of Z score for weight-for-age (W/A from birth until the date of the present inquiry. Chi-square was used to test associations and considered significant if p<0.05. Multivariate logistic regression model adjusted Odds Ratio estimates for confounding variables and/or covariables. RESULTS: Anthropometric analysis showed 7.1% prevalence of malnutrition (W/A<-2 Z score at birth and 4.4% by the time of measurement. Ponderal evolution with unfavorable Z score was present in 50.7% of studied children (n=137. In the bivariate analyses, the variables: birth weight (OR=5.35; p<0.001, anemia (OR=1.81; p=0.019 and age less than 19 months (OR=1.67; p=0.036 were statistically significant. CONCLUSIONS: Ponderal loss in Z score during the first months of life has not been often used in epidemiological studies. However, future researches might identify weight loss as an indicator of risk for sociobiological vulnerability. Development of health programs in order to reduce the

  11. Human-centered environment design in intensive care unit

    OpenAIRE

    Li, Y.; Albayrak, A.; Goossens, R.H.M.; D. Xiao; Jakimowicz, J.J.

    2013-01-01

    Because of high risk and instability of the patients in Intensive care unit(ICU), the design of ICU is very difficult. ICU design, auxiliary building design, lighting design, noise control and other aspects can also enhance its management. In this paper, we compare ICU design in China and Holland based on related standards. We also premeditate the indoor environment from planning perspective, analyze patients, their families, medical staff and space requirement to conduct research in ICU desi...

  12. Reality TV positions heart center as cardiac care leader.

    Science.gov (United States)

    Rees, T

    2001-01-01

    Saint Thomas Heart Institute, Nashville, Tenn., has a long history of successful cardiac care. More than 200,000 patients have been treated at Saint Thomas. Earlier this year the hospital launched a new branding campaign that features former patients who have bonded with the institution. These former patients were provided MiniDV video cameras to record their stories. The campaign has attracted considerable attention, including newspaper and TV news coverage. PMID:11374127

  13. CenteringParenting: an innovative dyad model for group mother-infant care.

    Science.gov (United States)

    Bloomfield, Joanna; Rising, Sharon Schindler

    2013-01-01

    CenteringParenting is a group model that brings a cohort of 6 to 7 mothers and infants together for care during the first year of life. During 9 group sessions the clinician provides well-baby care and also attends to the health, development, and safety issues of the mother. Ideally, CenteringParenting provides continuity of care for a cohort of women who have received care in CenteringPregnancy, group prenatal care that is 10 sessions throughout the entire pregnancy and that leads to community building, better health outcomes, and increased satisfaction with prenatal care. The postpartum year affects the entire family, but especially the mother, who is redefining herself and her own personal goals. Issues of weight/body image, breastfeeding, depression, contraception, and relationship issues all may surface. In traditional care, health resources for support and intervention are frequently lacking or unavailable. Women's health clinicians also note the loss of contact with women they have followed during the prenatal period, often not seeing a woman again until she returns for another pregnancy. CenteringParenting recognizes that the health of the mother is tied to the health of the infant and that assessment and interventions are more appropriate and efficient when done in a dyad context. Facilitative leadership, rather than didactic education, encourages women to fully engage in their care, to raise issues of importance to them, and to discuss concerns within an atmosphere that allows for the surfacing of culturally appropriate values and beliefs. Implementing the model calls for system changes that are often significant. It also requires the building of a substantial team relationship among care providers. This overview describes the CenteringParenting mother-infant dyad care model with special focus on the mother and reviews the perspectives and experiences of staff from several practice sites.

  14. Physical activity in child-care centers: do teachers hold the key to the playground?

    OpenAIRE

    COPELAND, KRISTEN A.; Kendeigh, Cassandra A; Saelens, Brian E; Kalkwarf, Heidi J.; Sherman, Susan N.

    2011-01-01

    Many (56%) US children aged 3–5 years are in center-based childcare and are not obtaining recommended levels of physical activity. In order to determine what child-care teachers/providers perceived as benefits and barriers to children’s physical activity in child-care centers, we conducted nine focus groups and 13 one-on-one interviews with 49 child-care teachers/providers in Cincinnati, OH. Participants noted physical and socio-emotional benefits of physical activity particular to preschoole...

  15. Preventing intensive care unit delirium: a patient-centered approach to reducing sleep disruption.

    Science.gov (United States)

    Stuck, Amy; Clark, Mary Jo; Connelly, Cynthia D

    2011-01-01

    Delirium in the intensive care unit is a disorder with multifactorial causes and is associated with poor outcomes. Sleep-wake disturbance is a common experience for patients with delirium. Care processes that disrupt sleep can lead to sleep deprivation, contributing to delirium. Patient-centered care is a concept that considers what is best for each individual. How can clinicians use a patient-centered approach to alter processes to decrease patient disruptions and improve sleep and rest? Could timing of blood draws and soothing music work to promote sleep? PMID:21983504

  16. Connecting teens to caring adults in a school-based health center: a case study.

    Science.gov (United States)

    Blacksin, Beth A; Kelly, Patricia J

    2015-01-01

    The traditional medical care system is generally unable to provide the broad health and wellness services needed by many adolescents, especially those from low-income and racial/ethnic minority communities. Using a theoretical framework adapted from Bronfenbrenner's ecological model of multiple influencers, this case study examined how a school-based health center was able to provide a network of connections for adolescents to caring adults within the school and the local community. Contributors to this network were the creation of a student-centered community with access to adolescent-friendly services, providers acting as connectors, and care of the whole adolescent.

  17. [Certified prostate cancer centers and second opinion centers for testicular cancer: successful models of uro-oncology cancer care].

    Science.gov (United States)

    Gschwend, J E; Albers, P; Schrader, M

    2011-08-01

    Establishment of organ site-specific cancer centers by the German Cancer Society (GCS) is part of the basic politically driven reform of oncology care in Germany. Since 2007 an increasing number of prostate cancer centers have been guided toward certification by the OnkoZert GmbH of the GCS. Currently 68 centers are certified and together with ongoing certification proceedings will amount to 81 prostate cancer centers, which cover about one fourth of cases of primary prostate cancer. Urology is of particular importance in the management of these centers. For the most part, urologists belonging to a clinical unit are the initiators of the certification process, thus ensuring that uro-oncology is firmly entrenched in the specialty with involvement of outpatient service providers. Fears that authority will be lost are unfounded as long as responsibility for this task is taken seriously and active use is made of the possibilities for creativity. A similarly important function is fulfilled by the testicular cancer centers that offer second opinion services, which were initiated by urology conjointly with German Cancer Aid to pursue the goal of quality assurance for this tumor entity and therefore likewise secure the position of this tumor in the realm of urologists. By applying such strategic approaches, urologists will succeed in sustainably safeguarding their future importance in a very competitive environment and in counteracting the encroachments of other specialties by exhibiting clear orientation.

  18. Transforming care teams to provide the best possible patient-centered, collaborative care.

    Science.gov (United States)

    Sevin, Cory; Moore, Gordon; Shepherd, John; Jacobs, Tracy; Hupke, Cindy

    2009-01-01

    Patient experience of care is now a crucial parameter in assessing the quality of healthcare delivered in the United States. Continuity, patient-driven access to care, and being "known" by a provider or practice, particularly for patients with chronic diseases, have been shown to enhance patient satisfaction with care and health outcomes. Healthcare systems are challenged to effectively meet the wants and needs of patients by tailoring interventions based on each person's unique set factors-his or her strengths, preferences, and personal and social context. Creating care teams, a coordinated multidisciplinary group of healthcare professionals, enables a practice to take advantage of the skill sets represented and redesign care delivery with the patient and community as the focal point. This article describes the attributes of highly functioning care teams, how to measure them, and guidance on creating them. A case example illustrates how these ideas work in practice.

  19. Cultural health capital and the interactional dynamics of patient-centered care.

    Science.gov (United States)

    Dubbin, Leslie A; Chang, Jamie Suki; Shim, Janet K

    2013-09-01

    As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care. PMID:23906128

  20. Laryngomalacia: patient outcomes following aryepiglottoplasty at a tertiary care center.

    Science.gov (United States)

    Pamuk, A Erim; Süslü, Nilda; Günaydın, R Onder; Atay, Gamze; Akyol, Umut

    2013-01-01

    Laryngomalacia is the most common cause of stridor in neonates and infants. Most cases are mild and resolve spontaneously without treatment. Only severe cases with intolerable symptoms require surgical intervention; in such cases, supraglottoplasty is considered the treatment of choice. The aim of this study was to review and present the outcomes in patients with laryngomalacia who underwent aryepiglottoplasty-a type of supraglottoplasty. The medical records of children diagnosed as laryngomalacia who were followed up at Hacettepe University Hospital, Department of Otorhinolaryngology, between 2007 and 2012 were reviewed retrospectively. The study included 16 children who required surgical intervention. The mean age of the 16 children included in the study was 133 days (range: 7 days-48 months). Among the patients, 9 (56%) were male and 7 (44%) were female. In all, 7 patients (44%) had a comorbid condition. Laryngomalacia diagnoses were as follows: type I: n = 2, 13%; type II: n = 13, 81%; type III: n= 1, 6%. Stridor completely resolved in 10 of the children who underwent aryepiglottoplasty. Three patients required tracheotomy and 3 required revision supraglottoplasty; these six cases were considered as failed surgical treatment. The aryepiglottoplasty success rate was 63%. None of the patients had any intraoperative or postoperative complications. Despite the primarily benign nature of laryngomalacia, comorbid conditions can exacerbate symptoms and negatively affect the prognosis. Aryepiglottoplasty can be performed with high success and low complication rates in properly selected patients. PMID:24382534

  1. The Social Work Role in Reducing 30-Day Readmissions: The Effectiveness of the Bridge Model of Transitional Care.

    Science.gov (United States)

    Alvarez, Renae; Ginsburg, Jacob; Grabowski, Jessica; Post, Sharon; Rosenberg, Walter

    2016-04-01

    The hospital experience is taxing and confusing for patients and their families, particularly those with limited economic and social resources. This complexity often leads to disengagement, poor adherence to the plan of care, and high readmission rates. Novel approaches to addressing the complexities of transitional care are emerging as possible solutions. The Bridge Model is a person-centered, social work-led, interdisciplinary transitional care intervention that helps older adults safely transition from the hospital back to their homes and communities. The Bridge Model combines 3 key components-care coordination, case management, and patient engagement-which provide a seamless transition during this stressful time and improve the overall quality of transitional care for older adults, including reducing hospital readmissions. The post Affordable Care Act (ACA) and managed care environment's emphasis on value and quality support further development and expansion of transitional care strategies, such as the Bridge Model, which offer promising avenues to fulfil the triple aim by improving the quality of individual patient care while also impacting population health and controlling per capita costs.

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

    DEFF Research Database (Denmark)

    Jensen, Betina Hebbelstrup; Röser, Dennis; Andreassen, Bente Utoft;

    2016-01-01

    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...... and low birth weight. 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...... the risk of diarrhoea in Danish children in day care centres This article is protected by copyright. All rights reserved....

  3. Using the "customer service framework" to successfully implement patient- and family-centered care.

    Science.gov (United States)

    Rangachari, Pavani; Bhat, Anita; Seol, Yoon-Ho

    2011-01-01

    Despite the growing momentum toward patient- and family-centered care at the federal policy level, the organizational literature remains divided on its effectiveness, especially in regard to its key dimension of involving patients and families in treatment decisions and safety practices. Although some have argued for the universal adoption of patient involvement, others have questioned both the effectiveness and feasibility of patient involvement. In this article, we apply a well-established theoretical perspective, that is, the Service Quality Model (SQM) (also known as the "customer service framework") to the health care context, to reconcile the debate related to patient involvement. The application helps support the case for universal adoption of patient involvement and also question the arguments against it. A key contribution of the SQM lies in highlighting a set of fundamental service quality determinants emanating from basic consumer service needs. It also provides a simple framework for understanding how gaps between consumer expectations and management perceptions of those expectations can affect the gap between "expected" and "perceived" service quality from a consumer's perspective. Simultaneously, the SQM also outlines "management requirements" for the successful implementation of a customer service strategy. Applying the SQM to the health care context therefore, in addition to reconciling the debate on patient involvement, helps identify specific steps health care managers could take to successfully implement patient- and family-centered care. Correspondingly, the application also provides insights into strategies for the successful implementation of policy recommendations related to patient- and family-centered care in health care organizations.

  4. The Little Rascals Day Care Center Case: Commentary on Clinical Testimony on Prominent Public Trials.

    Science.gov (United States)

    Summit, Ronald C.

    1994-01-01

    Comments on some of the philosophical and moral problems inherent in prosecuting a child sexual abuse case. This particular case was complicated by the multiple victims and multiple perpetrators. Both medical and psychological clinical expert witnesses need to be aware of and respectful of the ground rules of the courtroom. (JPS)

  5. Reducing Food Waste at a Migrant Day Care Center through the Rearrangement of Existing Activities.

    Science.gov (United States)

    Montesinos, Luis; And Others

    1985-01-01

    An intervention in which second food helpings were made contingent upon consumption of at least half of all food groups and, children who ate half of each food category were the first to be allowed to brush their teeth resulted in a reduction of waste for all three categories (vegetables, meat, milk) in which waste was high. (Author/CL)

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

    NARCIS (Netherlands)

    Enserink, R.

    2014-01-01

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

  7. Nutrition Education Needs Assessment for Licensed Group Day Care Centers in the State of Utah

    OpenAIRE

    Barksdale, Almina

    1980-01-01

    In November 1977 Congress established the Nutrition Education and Training Program (NETP) with the passage of Public Law 95-166. Section 227.37 of the NETP Regulations (1978) mandates that each state establish a plan of action for the use of any federally appropriated funds earmarked for "nutrition education" , and further, the plan should contain a proposal to instruct all students in the state about the nutritional value of foods as well as the relationship between food , nutrition, and hea...

  8. The Family Care Center: Transitional Care for the Sick Infant and His Family.

    Science.gov (United States)

    Goldson, Edward

    1981-01-01

    A hospital-based transitional care medical program for infants discharged from a neonatal intensive care unit is described. Family involvement is emphasized, as is interdisciplinary teamwork. Concerns that the program would encourage unnecessary hospitalization and increase vulnerability to infection have been proven unjustified. (Author/DB)

  9. Point-of-Care Testing and Cardiac Biomarkers: The Standard of Care and Vision for Chest Pain Centers.

    Science.gov (United States)

    Kost, Gerald J; Tran, Nam K

    2005-11-01

    Point-of-care testing (POCT) is defined as testing at or near the site of patient care. POCTdecreases therapeutic turnaround time (TTAT), increases clinical efficiency, and improves medical and economic outcomes. TTAT represents the time from test ordering to patient treatment. POC technologies have become ubiquitous in the United States, and, therefore,so has the potential for speed, convenience, and satisfaction, strong advantages for physicians, nurses, and patients in chest pain centers. POCT is applied most beneficially through the collaborative teamwork of clinicians and laboratorians who use integrative strategies, performance maps, clinical algorithms, and care paths (critical pathways). For example, clinical investigators have shown that on-site integration of testing for cardiac injury markers (myoglobin, creatinine kinase myocardial band [CKMB],and cardiac troponin I [cTnI]) in accelerated diagnostic algorithms produces effective screening, less hospitalization, and substantial savings. Chest pain centers, which now total over 150 accredited in the United States, incorporate similar types of protocol-driven performance enhancements. This optimization allows chest pain centers to improve patient evaluation, treatment, survival, and discharge. This article focuses on cardiac biomarker POCT for chest pain centers and emergency medicine. PMID:16278118

  10. [Family-centered care: A model for approaching dementia care in the community].

    Science.gov (United States)

    Esandi, Nuria; Canga, Ana

    2016-04-01

    Along with ageing population, there has been an increase in the prevalence and incidence of chronic and debilitating conditions, such as dementia which, in turn, has increased the demands for long term care in the community. This is challenging current health care systems that wish to provide an appropriate response whilst intensify its efforts to contain costs. This paper, through a critical reflection, argues for an integrative, positive, and systemic care approach, focused not only on the person with dementia but also on the entire family unit. For this purpose, it approaches the impact that dementia has for the family, and therefore for Primary Health Care professional. In addition care strategies aimed at strengthening the whole family system are suggested. PMID:26968688

  11. The Centers for Disease Control and Prevention's Healthy Days Measures – Population tracking of perceived physical and mental health over time

    Directory of Open Access Journals (Sweden)

    Kobau Rosemarie

    2003-09-01

    Full Text Available Abstract To promote the health and quality of life of United States residents, the U.S. Department of Health and Human Services' Centers for Disease Control and Prevention (CDC – with 54 state and territorial health agencies – has supported population surveillance of health-related quality of life (HRQOL. HRQOL was defined as "perceived physical and mental health over time." Commonly-used measures of health status and activity limitation were identified and a set of "Healthy Days" HRQOL measures was developed and validated. A core set of these measures (the CDC HRQOL-4 asks about self-rated general health and the number of recent days when a person was physically unhealthy, mentally unhealthy, or limited in usual activities. A summary measure combines physically and mentally unhealthy days. From 1993 to 2001, more than 1.2 million adults responded to the CDC HRQOL-4 in each state-based Behavioral Risk Factor Surveillance System (BRFSS telephone interview. More than one fifth of all BRFSS respondents also responded to a set of related questions – including five items that assess the presence, main cause and duration of a current activity limitation, and the need for activity-related personal and routine care; as well as five items that ask about recent days of pain, depression, anxiety, sleeplessness, and vitality. The Healthy Days surveillance data are particularly useful for finding unmet health needs, identifying disparities among demographic and socioeconomic subpopulations, characterizing the symptom burden of disabilities and chronic diseases, and tracking population patterns and trends. The full set of 14 Healthy Days Measures (the CDC HRQOL-14 has shown good measurement properties in several populations, languages, and settings. The brief standard CDC HRQOL-4 is now often used in surveys, surveillance systems, prevention research, and population health report cards.

  12. Caring for people with dementia in residential aged care: successes with a composite person-centered care model featuring Montessori-based activities.

    Science.gov (United States)

    Roberts, Gail; Morley, Catherine; Walters, Wendy; Malta, Sue; Doyle, Colleen

    2015-01-01

    Person-centered models of dementia care commonly merge aspects of existing models with additional influences from published and unpublished evidence and existing government policy. This study reports on the development and evaluation of one such composite model of person-centered dementia care, the ABLE model. The model was based on building the capacity and ability of residents living with dementia, using environmental changes, staff education and organizational and community engagement. Montessori principles were also used. The evaluation of the model employed mixed methods. Significant behavior changes were evident among residents of the dementia care Unit after the model was introduced, as were reductions in anti-psychotic and sedative medication. Staff reported increased knowledge about meeting the needs of people with dementia, and experienced organizational culture change that supported the ABLE model of care. Families were very satisfied with the changes. PMID:25499658

  13. Health Care Preferences Among Nursing Home Residents: Perceived Barriers and Situational Dependencies to Person-Centered Care.

    Science.gov (United States)

    Bangerter, Lauren R; Abbott, Katherine; Heid, Allison R; Klumpp, Rachel E; Van Haitsma, Kimberly

    2016-02-01

    Although much research has examined end-of-life care preferences of nursing home (NH) residents, little work has examined resident preferences for everyday health care. The current study conducted interviews with 255 residents recruited from 35 NHs. Content analysis identified barriers (i.e., hindrances to the fulfillment of resident preferences) and situational dependencies (i.e., what would make residents change their mind about the importance of these preferences) associated with preferences for using mental health services, choosing a medical care provider, and choosing individuals involved in care discussions. Barriers and situational dependencies were embedded within the individual, facility environment, and social environment. Approximately one half of residents identified barriers to their preferences of choosing others involved in care and choosing a medical care provider. In contrast, the importance of mental health services was situationally dependent on needs of residents. Results highlight opportunities for improvement in practice and facility policies that promote person-centered care. [Journal of Gerontological Nursing, 42(2), 11-16.].

  14. Organizational culture and the implementation of person centered care: results from a change process in Swedish hospital care.

    Science.gov (United States)

    Alharbi, Tariq Saleem J; Ekman, Inger; Olsson, Lars-Eric; Dudas, Kerstin; Carlström, Eric

    2012-12-01

    Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding.

  15. Patient-Centered Care and Patient-Reported Measures: Let's Look Before We Leap.

    Science.gov (United States)

    Miller, Daniel; Steele Gray, Carolyn; Kuluski, Kerry; Cott, Cheryl

    2015-08-01

    This commentary focuses on patient-reported measures as tools to support patient-centered care for patients with multiple chronic conditions (MCCs). We argue that those using patient-reported measures in care management or evaluation of services for MCC patients should do so in recognition of the challenges involved in treating them. MCC patient care is challenging because (1) it is difficult to specify the causes of particular symptoms; (2) assessment of many important symptoms relies on subjective report; and (3) patients require care from a variety of providers. Due to the multiple domains of health affected in single individuals, and the large variation in needs, care that is holistic and individualized (i.e. patient-centered) is appropriate for MCC patients. However, due to the afore-mentioned challenges, it is important to carefully consider what this care entails and how practical contexts shape it. Patient-centered care for MCC patients implies continuous, dialogic patient-provider relationships, and the formulation of coherent and adaptive multi-disciplinary care protocols. We identify two broadly defined contextual influences on the nature and quality of these processes and their outputs: (1) busy practice settings and (2) fragmented information technology. We then identify several consequences that may result from inattention to these contextual influences upon introduction of patient-reported measure applications. To maximize the benefits, and minimize the harms of patient-reported measure use, we encourage policy makers and providers to attend carefully to these and other important contextual factors before, during and after the introduction of patient-reported measure initiatives.

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

    Directory of Open Access Journals (Sweden)

    M. SOTIROVSKA-SIRVINI

    1997-09-01

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

  17. Elder abuse and neglect in a population offering care by a primary health care center in Izmir, Turkey.

    Science.gov (United States)

    Kissal, Aygul; Beşer, Ayşe

    2011-01-01

    The objective of this study is to investigate the prevalence of abuse and neglect of the elderly aged 65 years and older, living with their relative in a primary health care center area and affecting factors. A descriptive study included 331 people aged 65 years. The most frequent type of abuse was psychological abuse and the least frequent was sexual abuse. Female gender, low education levels, living with spouses and children, and perception of familial relationships as average or below average significantly increased abuse. The nurses providing primary health care should be able to identify and observe the elderly at risk of abuse and conduct programs preventing abuse. PMID:21347984

  18. Compassion as the foundation of patient-centered care: the importance of compassion in action.

    Science.gov (United States)

    Frampton, Susan B; Guastello, Sara; Lepore, Michael

    2013-09-01

    The Institute of Medicine defines patient-centered care as "providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions." What is missing in this definition is an explicit emphasis on compassion. This perspective article draws on the experience of Planetree (CT, USA), a not-for-profit organization that partners with healthcare establishments to drive adoption of patient-centered care principles and practices by connecting healthcare professionals with the voices and perspectives of the patients and family members who utilize their services. Across hundreds of focus groups facilitated by Planetree, patients and their loved ones emphasize that paramount among their needs, preferences and values are compassionate human interactions. For care to be truly patient-centered, a foundation of compassion is essential. Reports from patients and the media, and research from healthcare systems around the world demonstrate the fallacy of assuming that compassion is a current or prevalent feature of the care experience. Concurrently, a growing evidence base highlights the supreme importance of compassion in driving high-quality, high-value care. However, good intentions are not sufficient for delivering compassionate care. Drawing on the experiences of exemplary patient-centered hospitals (recognized as such following a rigorous culture audit to determine fulfillment of the criteria for formal recognition as a Designated® Patient-Centered Hospital [Planetree]), this paper explores practical approaches for embedding compassion in healthcare delivery and organizational culture to meet patients' expressed desires for empathic and respectful human interactions. PMID:24236742

  19. An integrated model for inner-city health-care delivery: the Deaconess Center.

    Science.gov (United States)

    James, D M

    1998-01-01

    Under the auspices of the Buffalo General Hospital and the faculty of medicine of the State University of New York at Buffalo, a comprehensive delivery system for primary care has been established in a local inner-city neighborhood. At the Deaconess Family Medicine Center, located within an inner-city location of Buffalo, New York, several divisions have been integrated to provide comprehensive patient-oriented primary care. These divisions include a primary care clinic, an urgent care clinic, a substance abuse clinic, and a community pediatrics clinic. Professional services are provided by attending physicians and residents. The horizontal integration of these four divisions is in turn vertically integrated with the tertiary care teaching hospital inpatient and obstetrical services, providing a continuum of patient care. The horizontal integration serves as an entry point for patients to enter the hospital's health-care system, while the vertical integration capability serves to capture any specialized referrals or inpatient needs. This article discusses the structure of the center, with special reference to service integration, service delivery, and patient capture; medical education; and the place of integrated units in the strategic plan of a tertiary care hospital.

  20. A Three-Year Experience of Medical Thoracoscopy at A Tertiary Care Center of Himalayan Region

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    Rakhee Sodhi

    2016-03-01

    Full Text Available Introduction: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases. Despite its proven role in diagnostic and therapeutic purposes, it is infrequently used, which could be because of cost of equipment and lack of training. We analyzed our initial 3 years record of thoracoscopy at Himalayan Institute of Medical Sciences, a tertiary care center in Himalayan region of north India. Materials and Methods: This cross-sectional study was to analyze our experience of medical thoracoscopy which was started in Jan 2011 at our center. All patients who underwent thoracoscopy during the period between Jan 2011 to Dec 2013 were included in the study. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions. Clinical, radiological, cytological & histopathological data of the patients were collected prospectively and analysed. Results: The diagnostic yield for a pleuroscopic pleural biopsy in our study was 87.23% (41/47. Malignancy was diagnosed histopathologically in 70.2% (33/47 patients (both primary & metastatic pleural carcinoma and tuberculosis in 10.6% (5/47. There was no mortality related to procedure. Only three patients had minor complications like subcutaneous emphysema which was mild and resolved by second post-procedure day. Pain at intercostal drain site was observed in some patients. Conclusion: Thoracoscopy is an easy outpatient procedure and an excellent diagnostic tool for pleural effusion of uncertain etiology. It has low complication rate even in settings where the procedure is just started. It should be included in the armamentarium of tools for management of pleural effusion.

  1. On the Effectiveness of Child Care Centers in Promoting Child Development in Ecuador

    OpenAIRE

    Rosero, Jose

    2012-01-01

    Although the literature on the effectiveness of child care centers in developing countries is thin, most of the studies have concluded that the provision of these services are beneficial to enhance the development of poor children at early ages. Using different matching techniques, the results in this paper contrast with that conclusion as it finds no support of a positive effect of a large scale child care program in Ecuador on any of the dimensions considered of cognitive development. This ...

  2. Attitudes towards primary care career in community health centers among medical students in China

    OpenAIRE

    Zhang, Lingling; Bossert, Thomas; Mahal, Ajay; Hu, Guoqing; Guo, Qing; Liu, Yuanli

    2016-01-01

    Background Very few of the primary care doctors currently working in China’s community health centers have a college degree (issued by 5-year medical schools). How to attract college graduates to community services in the future, therefore, has major policy relevance in the government’s ongoing efforts to reform community health care and fill in the long-absent role of general physicians in China. This paper examined medical school students’ attitudes towards working in communities and the fa...

  3. Family-Centered Care in Juvenile Justice Institutions: A Mixed Methods Study Protocol

    Science.gov (United States)

    Mulder, Eva; Rigter, Henk; Breuk, René; van der Vaart, Wander; Vermeiren, Robert

    2016-01-01

    Background Treatment and rehabilitation interventions in juvenile justice institutions aim to prevent criminal reoffending by adolescents and to enhance their prospects of successful social reintegration. There is evidence that these goals are best achieved when the institution adopts a family-centered approach, involving the parents of the adolescents. The Academic Workplace Forensic Care for Youth has developed two programs for family-centered care for youth detained in groups for short-term and long-term stay, respectively. Objective The overall aim of our study is to evaluate the family-centered care program in the first two years after the first steps of its implementation in short-term stay groups of two juvenile justice institutions in the Netherlands. The current paper discusses our study design. Methods Based on a quantitative pilot study, we opted for a study with an explanatory sequential mixed methods design. This pilot is considered the first stage of our study. The second stage of our study includes concurrent quantitative and qualitative approaches. The quantitative part of our study is a pre-post quasi-experimental comparison of family-centered care with usual care in short-term stay groups. The qualitative part of our study involves in-depth interviews with adolescents, parents, and group workers to elaborate on the preceding quantitative pilot study and to help interpret the outcomes of the quasi-experimental quantitative part of the study. Results We believe that our study will result in the following findings. In the quantitative comparison of usual care with family-centered care, we assume that in the latter group, parents will be more involved with their child and with the institution, and that parents and adolescents will be more motivated to take part in therapy. In addition, we expect family-centered care to improve family interactions, to decrease parenting stress, and to reduce problem behavior among the adolescents. Finally, we assume

  4. Identity of care in a Psychosocial Care Center for Children and Adolescents who uses drugs

    Directory of Open Access Journals (Sweden)

    Isabella Teixeira Bastos

    2014-12-01

    Full Text Available Objective To associate the territory of identity with the production of care within a PCC focusing on children and adolescents with drug abuse and their institutional identity. Method We used the “ process tracing methodology” in four research categories: focus groups, characterization of professionals, observing the everyday and interviewing two members of emblematic cases of the service. Results territory of identity of the institution, which operates the production of care is crossed by the difficulty of dealing with the complexity brought by the users and the performance of the PCC network. This paper is also permeated by different conceptions of care and small problematization of these issues in collective spaces of service. Conclusion The discussion in focus groups and other devices can be powerful resources to reframe the meaning of care and identity of collective service.

  5. Does the Culture of Modern Day Palliative Care Social Work Leave Room for Leadership?

    OpenAIRE

    Davidson, Jason

    2016-01-01

    This paper describes research undertaken as part of an MA study in leadership. It draws on interviews with six high profile leaders at the fore front of end of life care sector in the UK. Its findings and emerging themes offer insights about the opportunities for social work leaders in palliative care in the future and how the profession and palliative care sector address current barriers to taking advantage of such opportunity. The main focus of this paper is leadership related to palliative...

  6. Integrating patient-centered care and clinical ethics into nutrition practice.

    Science.gov (United States)

    Schwartz, Denise Baird

    2013-10-01

    The purpose of this article is to present the application of patient-centered care and clinical ethics into nutrition practice, illustrate the process in a case study, and promote change in the current healthcare clinical ethics model. Nutrition support clinicians have an opportunity to add another dimension to their practice with the incorporation of patient-centered care and clinical ethics. This represents a culture change for healthcare professionals, including nutrition support clinicians, patients and their family. All of these individuals are stakeholders in the process and have the ability to modify the current healthcare system to improve communication and facilitate a change by humanizing nutrition support practice. Nutrition support is a medical, life-sustaining treatment, and the use of this therapy requires knowledge by the nutrition support clinician of patient-centered care concepts, preventive clinical ethics, religion/spirituality and cultural diversity, palliative care team role, and advance care planning. Integrating these into the practice of nutrition support is an innovative approach and results in new knowledge that requires a change in the culture of care and engagement and empowerment of the patient and their family in the process. This is more than a healthcare issue; it involves a social/family conversation movement that will be enhanced by the nutrition support clinician's participation.

  7. Building social participation with a support group users: challenges of care qualification in a Psychosocial Care Center (CAPS)

    OpenAIRE

    Vitor Corrêa Detomini; Renata Bellenzani

    2015-01-01

    The literature points out a lack of studies describing practical experiences approaching the role of social participation, even though, the subject Brazilian Health System (SUS) as a principle is valued by theoretical-conceptual works. The lack of studies is especially observed in mental health care services, where the existing studies focus on the users’ management engagement as part of psychosocial rehabilitation. Thus, this article introduces an experience developed in a Center for Psycho-...

  8. Caregiver Objective Burden and Assessments of Patient-Centered, Family-Focused Care for Frail Elderly Veterans

    Science.gov (United States)

    Rose, Julia Hannum; Bowman, Karen F.; O'Toole, Elizabeth E.; Abbott, Katherine; Love, Thomas E.; Thomas, Charles; Dawson, Neal V.

    2007-01-01

    Purpose: There is a growing consensus that quality of care for frail elders should include family and be evaluated in terms of patient-centered, family-focused care (PCFFC). Family caregivers are in a unique and sometimes sole position to evaluate such care. In the context of caring for physically frail elders, this study examined the extent to…

  9. Prognostic Patterns in Self-Report, Relative Report, and Professional Evaluation Measures for Hospitalized and Day-Care Patients

    Science.gov (United States)

    Sappington, A. A.; Michaux, Mary H.

    1975-01-01

    This study attempted to determine differences between patients who relapse and those who do not in both hospital and day-care settings. Subjects were 142 adult psychiatric patients. Three groups of measures were used: one based on professional evaluation, one based on self-report, and one based on relative report. (Author)

  10. Family Day Care Educators: An Exploration of Their Understanding and Experiences Promoting Children's Social and Emotional Wellbeing

    Science.gov (United States)

    Davis, Elise; Priest, Naomi; Davies, Belinda; Smyth, Lisa; Waters, Elizabeth; Herrman, Helen; Sims, Margaret; Harrison, Linda; Cook, Kay; Marshall, Bernie; Williamson, Lara

    2012-01-01

    This study aimed to explore family day care (FDC) educators' knowledge of child social and emotional wellbeing and mental health problems, the strategies used to promote children's wellbeing, and barriers and opportunities for promoting children's social and emotional wellbeing. Thirteen FDC educators participated in individual semi-structured…

  11. Does the Culture of Modern Day Palliative Care Social Work Leave Room for Leadership?

    Science.gov (United States)

    Davidson, Jason

    2016-01-01

    This paper describes research undertaken as part of an MA study in leadership. It draws on interviews with six high profile leaders at the fore front of end of life care sector in the UK. Its findings and emerging themes offer insights about the opportunities for social work leaders in palliative care in the future and how the profession and palliative care sector address current barriers to taking advantage of such opportunity. The main focus of this paper is leadership related to palliative care social work. However, it relates to much broader themes including the history, politics and culture of this profession and the requirements for leadership on the part of social work in the broader contexts of health and social care.

  12. Societal Values and Policies May Curtail Preschool Children’s Physical Activity in Child Care Centers

    Science.gov (United States)

    Sherman, Susan N.; Kendeigh, Cassandra A.; Kalkwarf, Heidi J.; Saelens, Brian E.

    2012-01-01

    BACKGROUND AND OBJECTIVES: Three-fourths of US preschool-age children are in child care centers. Children are primarily sedentary in these settings, and are not meeting recommended levels of physical activity. Our objective was to identify potential barriers to children’s physical activity in child care centers. METHODS: Nine focus groups with 49 child care providers (55% African American) were assembled from 34 centers (inner-city, suburban, Head Start, and Montessori) in Cincinnati, Ohio. Three coders independently analyzed verbatim transcripts for themes. Data analysis and interpretation of findings were verified through triangulation of methods. RESULTS: We identified 3 main barriers to children’s physical activity in child care: (1) injury concerns, (2) financial, and (3) a focus on “academics.” Stricter licensing codes intended to reduce children's injuries on playgrounds rendered playgrounds less physically challenging and interesting. In addition, some parents concerned about potential injury, requested staff to restrict playground participation for their children. Small operating margins of most child care centers limited their ability to install abundant playground equipment. Child care providers felt pressure from state mandates and parents to focus on academics at the expense of gross motor play. Because children spend long hours in care and many lack a safe place to play near their home, these barriers may limit children's only opportunity to engage in physical activity. CONCLUSIONS: Societal priorities for young children—safety and school readiness—may be hindering children’s physical development. In designing environments that optimally promote children’s health and development, child advocates should think holistically about potential unintended consequences of policies. PMID:22218842

  13. Increasing access--a qualitative study of homelessness and palliative care in a major urban center.

    Science.gov (United States)

    Krakowsky, Yonah; Gofine, Mirriam; Brown, Pnina; Danziger, Jana; Knowles, Holly

    2013-05-01

    Rates of morbidity and mortality are significantly higher in homeless populations. Homeless people experience many barriers to receive adequate palliative care. This qualitative study examines how a major urban city's palliative care resources can be improved to increase access and better serve the homeless. Audiotaped interviews were preformed with 7 homeless care providers in Toronto, Canada, and their transcripts were analyzed using thematic analysis. The findings of the study suggest that in order to increase access and to serve the city's terminally ill homeless better, the following 4 areas must be addressed: (1) increasing positive interaction between the health care system and the homeless, (2) training staff to deal with the unique issues confronting the homeless, (3) providing patient-centered care, and (4) diversifying the methods of delivery.

  14. Defining upper gastrointestinal bleeding from linked primary and secondary care data and the effect on occurrence and 28 day mortality

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    Crooks Colin

    2012-11-01

    Full Text Available Abstract Background Primary care records from the UK have frequently been used to identify episodes of upper gastrointestinal bleeding in studies of drug toxicity because of their comprehensive population coverage and longitudinal recording of prescriptions and diagnoses. Recent linkage within England of primary and secondary care data has augmented this data but the timing and coding of concurrent events, and how the definition of events in linked data effects occurrence and 28 day mortality is not known. Methods We used the recently linked English Hospital Episodes Statistics and General Practice Research Database, 1997–2010, to define events by; a specific upper gastrointestinal bleed code in either dataset, a specific bleed code in both datasets, or a less specific but plausible code from the linked dataset. Results This approach resulted in 81% of secondary care defined bleeds having a corresponding plausible code within 2 months in primary care. However only 62% of primary care defined bleeds had a corresponding plausible HES admission within 2 months. The more restrictive and specific case definitions excluded severe events and almost halved the 28 day case fatality when compared to broader and more sensitive definitions. Conclusions Restrictive definitions of gastrointestinal bleeding in linked datasets fail to capture the full heterogeneity in coding possible following complex clinical events. Conversely too broad a definition in primary care introduces events not severe enough to warrant hospital admission. Ignoring these issues may unwittingly introduce selection bias into a study’s results.

  15. SATISFACTION FROM HEALTH INSURANCE INSTITUTIONS AMONG PEOPLE ATTENDING THE PRIMARY HEALTH CARE CENTERS IN ANKARA

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    Fatma ILHAN

    2006-08-01

    Full Text Available The aim of this study was to determine the status of satisfaction from health insurance institutions among people at age 18 and over , attending the primary health care centers in Ankara city center. This study was conducted by applying a questionnaire to the persons attending to four primary health care center and two Mather-Child Health Care and Family Planning Centers in Ankara City Center between May 20-July 20, 2003. 3184 persons applied to six primary health care centers in Ankara city center were interviewed. The median age of the subjects was 38; 66.4 % were women; 30.9 % were primary school graduate and 48.8% were housewife. 100% of the subjects who own private health insurance were satisfied with their insurance status. This rate was 92.0% for the subjects who were under coverage of Emekli Sandigi, and 79% for those who were under coverage of Bag-Kur. The most common health insurance institution the subjects were not satisfied with, was SSK with 48.4 % unsatisfaction rate. “The capability of being physically emamined and treated in any health facility he/she want” was in the first rank among the satisfaction reasons (54.2%. “The absence of this capability” was the most common reason for unsatisfaction (44.0%. 51.6 of the subjects were satisfied with their own health insurance institution, Emekli Sandigi was the most preffered institution with a percentage of 22.3. [TAF Prev Med Bull 2006; 5(4.000: 244-253

  16. Pattern of Care Before Presentation Among the Psychiatric Emergency Cases at a Tertiary Health Care Center in Nigeria

    Science.gov (United States)

    Aina, Israel Odunmayowa; Otakpor, Alex Ndubisi; Israel-Aina, Yetunde Tinuola

    2016-01-01

    Objective: To determine the pattern of care sought in cases of psychiatric emergency before presentation to a tertiary health care center. Method: Consecutive recruitment of 180 emergency psychiatric cases, which comprised a total of 156 patients, presenting to the accident and emergency unit of the University of Benin Teaching Hospital (UBTH), Edo State, Nigeria, was conducted from June 2008 to January 2009. A structured instrument was used to gather the patients’ information including their sociodemographic characteristics, their care before presentation, and the relations accompanying them to the hospital. Results: The mean ± SD patient age was 33.82 ± 12.64 years, with an age range of 18–73 years and a modal age of 23 years. The male to female ratio was 1:1.05. Of the patients, 121 (77.6%) were not married, while 35 (22.4%) were married. Most identified as Christian (96.2%). The majority of the patients (70.0%) presented to the hospital through self-referral. Eighty (44.4%) of the patients had not sought any treatment before coming to UBTH. Forty-seven patients (26.1%) had sought care in churches, 39 (21.7%) had sought treatment in other hospitals, and 12 (6.7%) had sought traditional care before presenting to UBTH. Seventy-four patients (41.1%) were accompanied by parents and 44 (24.4%) were accompanied by siblings, while the spouse accompanied 23 (12.8%) patients. Conclusions: Most patients with psychiatric emergencies at UBTH prefer to present directly to the tertiary health care center in Benin City, and they are usually supported by their immediate family members. PMID:27486541

  17. Application of a marketing concept to patient-centered care: co-producing health with heart failure patients.

    Science.gov (United States)

    Leone, Robert P; Walker, Charles A; Curry, Linda Cox; Agee, Elizabeth J

    2012-05-01

    Increasing numbers of patients are being treated for heart failure each year. One out of four of the heart failure patients who receives care in a hospital is readmitted to the hospital within 30 days of discharge. Effective discharge instruction is critical to prevent these patient readmissions. Co-production is a marketing concept whereby the customer is a partner in the delivery of a good or service. For example, a patient and nurse may partner to co-produce a patient-centered health regimen to improve patient outcomes. In this article we review the cost of treating heart failure patients and current strategies to decrease hospital readmissions for these patients along with the role of the nurse and the concept of co-producing health as related to heart failure patients. Next we describe our study assessing the degree to which discharge processes were co-produced on two hospital units having a preponderance of heart failure patients, and present our findings indicating minimal evidence of co-production. A discussion of our findings, along with clinical implications of these findings, recommendations for change, and suggestions for future research are offered. We conclude that standardized discharge plans lead to a mindset of 'one size fits all,' a mindset inconsistent with the recent call for patient-centered care. We offer co-production as a patient-centered strategy for customizing discharge teaching and improving health outcomes for heart failure patients. PMID:22686115

  18. Adaptive practices in heart failure care teams: implications for patient-centered care in the context of complexity

    Directory of Open Access Journals (Sweden)

    Tait GR

    2015-08-01

    Full Text Available Glendon R Tait,1 Joanna Bates,2 Kori A LaDonna,3 Valerie N Schulz,4 Patricia H Strachan,5 Allan McDougall,3 Lorelei Lingard3 1Department of Psychiatry and Division of Medical Education, Dalhousie University, Halifax, NS, 2Centre for Health Education Scholarship, Vancouver General Hospital, Vancouver, BC, 3Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, 4Palliative Care, London Health Sciences Centre, University Hospital, London; 5School of Nursing, McMaster University, Hamilton, ON, Canada Background: Heart failure (HF, one of the three leading causes of death, is a chronic, progressive, incurable disease. There is growing support for integration of palliative care’s holistic approach to suffering, but insufficient understanding of how this would happen in the complex team context of HF care. This study examined how HF care teams, as defined by patients, work together to provide care to patients with advanced disease. Methods: Team members were identified by each participating patient, generating team sampling units (TSUs for each patient. Drawn from five study sites in three Canadian provinces, our dataset consists of 209 interviews from 50 TSUs. Drawing on a theoretical framing of HF teams as complex adaptive systems (CAS, interviews were analyzed using the constant comparative method associated with constructivist grounded theory. Results: This paper centers on the dominant theme of system practices, how HF care delivery is reported to work organizationally, socially, and practically, and describes two subthemes: “the way things work around here”, which were commonplace, routine ways of doing things, and “the way we make things work around here”, which were more conscious, effortful adaptations to usual practice in response to emergent needs. An adaptive practice, often a small alteration to routine, could have amplified effects beyond those intended by the innovating team

  19. Journey toward a Patient-Centered Medical Home: Readiness for Change in Primary Care Practices

    OpenAIRE

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

    2011-01-01

    Context: Information is limited regarding the readiness of primary care practices to make the transformational changes necessary to implement the patient-centered medical home (PCMH) model. Using comparative, qualitative data, we provide practical guidelines for assessing and increasing readiness for PCMH implementation.

  20. Towards a Predictive Model of Quality in Canadian Child Care Centers

    Science.gov (United States)

    Goelman, Hillel; Forer, Barry; Kershaw, Paul; Doherty, Gillian; Lero, Donna; LaGrange, Annette

    2006-01-01

    This paper reports on the design, methodology, and results of a study of quality in 326 classrooms in 239 Canadian child care centers. This study, the largest and most extensive ever undertaken in Canada, used the Caregiver Interaction Scale (CIS) to rate the adult-child interactions in the classrooms and the Infant-Toddler Environment Rating…

  1. Measuring Person-Centered Care: A Critical Comparative Review of Published Tools

    Science.gov (United States)

    Edvardsson, David; Innes, Anthea

    2010-01-01

    Purpose of the study: To present a critical comparative review of published tools measuring the person-centeredness of care for older people and people with dementia. Design and Methods: Included tools were identified by searches of PubMed, Cinahl, the Bradford Dementia Group database, and authors' files. The terms "Person-centered,"…

  2. Reenacted Case Scenarios for Undergraduate Healthcare Students to Illustrate Person-Centered Care in Dementia

    Science.gov (United States)

    Bradley, Sandra L.; De Bellis, Anita; Guerin, Pauline; Walters, Bonnie; Wotherspoon, Alison; Cecchin, Maggie; Paterson, Jan

    2010-01-01

    Healthcare practitioners have suggested that interpreting person-centered care for people who have dementia to undergraduate students requires guidance in practical application. This article describes the production of a written and digital interdisciplinary educational resource for tertiary students. It uses real-life case scenarios provided by…

  3. 7 CFR 226.17a - At-risk afterschool care center provisions.

    Science.gov (United States)

    2010-01-01

    ... Section 226.17a Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational... standards will remain a precondition for any afterschool center's eligibility for CACFP nutrition...

  4. Role for a Labor-Management Partnership in Nursing Home Person-Centered Care

    Science.gov (United States)

    Leutz, Walter; Bishop, Christine E.; Dodson, Lisa

    2010-01-01

    Purpose: To investigate how a partnership between labor and management works to change the organization and focus of nursing home frontline work, supporting a transition toward person-centered care (PCC) in participating nursing homes. Design and Methods: Using a participatory research approach, we conducted case studies of 2 nursing homes…

  5. Care in a birth center according to the recommendations of the World Health Organization

    Directory of Open Access Journals (Sweden)

    Flora Maria Barbosa da Silva

    2013-10-01

    Full Text Available Birth centers are maternal care models that use appropriate technology when providing care to birthing women. This descriptive study aimed to characterize intrapartum care in a freestanding birth center, in light of the practices recommended by the World Health Organization (WHO, with 1,079 assisted births from 2006 to 2009 in the Sapopemba Birth Center, São Paulo, Brazil. Results included the use of intermittent auscultation (mean=7 controls; maternal positions during delivery: semi-sitting (82.3%, side-lying (16.0%, other positions (1.7%, oral intake (95.6%; companionship (93.3%; exposure to up to three vaginal examinations (85.4%, shower bathing (84.0%, walking (68.0%, massage (60.1%, exercising with a Swiss ball (51.7%; amniotomy (53.4%, oxytocin use during the first (31.0% and second stages of labor (25.8%, bath immersion (29.3% and episiotomy (14.1%. In this birth center, care providers used practices recommended by the WHO, although some practices might have been applied less frequently.

  6. Implementation of an Interdisciplinary, Team-Based Complex Care Support Health Care Model at an Academic Medical Center: Impact on Health Care Utilization and Quality of Life.

    Directory of Open Access Journals (Sweden)

    Christine Ritchie

    Full Text Available The Geriatric Resources for the Assessment and Care of Elders (GRACE program has been shown to decrease acute care utilization and increase patient self-rated health in low-income seniors at community-based health centers.To describe adaptation of the GRACE model to include adults of all ages (named Care Support and to evaluate the process and impact of Care Support implementation at an urban academic medical center.152 high-risk patients (≥5 ED visits or ≥2 hospitalizations in the past 12 months enrolled from four medical clinics from 4/29/2013 to 5/31/2014.Patients received a comprehensive in-home assessment by a nurse practitioner/social worker (NP/SW team, who then met with a larger interdisciplinary team to develop an individualized care plan. In consultation with the primary care team, standardized care protocols were activated to address relevant key issues as needed.A process evaluation based on the Consolidated Framework for Implementation Research identified key adaptations of the original model, which included streamlining of standardized protocols, augmenting mental health interventions and performing some assessments in the clinic. A summative evaluation found a significant decline in the median number of ED visits (5.5 to 0, p = 0.015 and hospitalizations (5.5 to 0, p<0.001 6 months before enrollment in Care Support compared to 6 months after enrollment. In addition, the percent of patients reporting better self-rated health increased from 31% at enrollment to 64% at 9 months (p = 0.002. Semi-structured interviews with Care Support team members identified patients with multiple, complex conditions; little community support; and mild anxiety as those who appeared to benefit the most from the program.It was feasible to implement GRACE/Care Support at an academic medical center by making adaptations based on local needs. Care Support patients experienced significant reductions in acute care utilization and significant improvements

  7. Patient Navigators: Agents of Creating Community-Nested Patient-Centered Medical Homes for Cancer Care.

    Science.gov (United States)

    Simon, Melissa A; Samaras, Athena T; Nonzee, Narissa J; Hajjar, Nadia; Frankovich, Carmi; Bularzik, Charito; Murphy, Kara; Endress, Richard; Tom, Laura S; Dong, XinQi

    2016-01-01

    Patient navigation is an internationally utilized, culturally grounded, and multifaceted strategy to optimize patients' interface with the health-care team and system. The DuPage County Patient Navigation Collaborative (DPNC) is a campus-community partnership designed to improve access to care among uninsured breast and cervical cancer patients in DuPage County, IL. Importantly, the DPNC connects community-based social service delivery with the patient-centered medical home to achieve a community-nested patient-centered medical home model for cancer care. While the patient navigator experience has been qualitatively documented, the literature pertaining to patient navigation has largely focused on efficacy outcomes and program cost effectiveness. Here, we uniquely highlight stories of women enrolled in the DPNC, told from the perspective of patient navigators, to shed light on the myriad barriers that DPNC patients faced and document the strategies DPNC patient navigators implemented. PMID:27594792

  8. Free-standing cancer centers: rationale for improving cancer care delivery.

    Science.gov (United States)

    Lokich, J J; Silvers, S; Brereton, H; Byfield, J; Bick, R

    1989-10-01

    Free-standing cancer centers (FSCC) represent a growing trend in cancer care delivery within community practice. The critical components to FSCC are multidisciplinary cancer care, a complete menu of direct care and support services, a commitment to clinical trials and clinical investigation, and a comprehensive program for quality assurance. The advantages of FSCC to the community, to hospital programs, to the practicing surgical, medical, and radiation oncologists, and to the third-party carriers, including health maintenance organizations, are detailed. The development of an FSCC depends on the resolution of issues of (a) competition (between hospitals, hospitals and physicians, therapeutic disciplines, regional comprehensive cancer centers and FSCCs) and (b) concerns about conflict of interest. The ideal model of FSCC may well be represented by the joint venture of community hospital(s) and the community oncologists.

  9. Significant Improvements in the Practice Patterns of Adult Related Donor Care in US Transplantation Centers.

    Science.gov (United States)

    Anthias, Chloe; Shaw, Bronwen E; Kiefer, Deidre M; Liesveld, Jane L; Yared, Jean; Kamble, Rammurti T; D'Souza, Anita; Hematti, Peiman; Seftel, Matthew D; Norkin, Maxim; DeFilipp, Zachariah; Kasow, Kimberly A; Abidi, Muneer H; Savani, Bipin N; Shah, Nirali N; Anderlini, Paolo; Diaz, Miguel A; Malone, Adriana K; Halter, Joerg P; Lazarus, Hillard M; Logan, Brent R; Switzer, Galen E; Pulsipher, Michael A; Confer, Dennis L; O'Donnell, Paul V

    2016-03-01

    Recent investigations have found a higher incidence of adverse events associated with hematopoietic cell donation in related donors (RDs) who have morbidities that if present in an unrelated donor (UD) would preclude donation. In the UD setting, regulatory standards ensure independent assessment of donors, one of several crucial measures to safeguard donor health and safety. A survey conducted by the Center for International Blood and Marrow Transplant Research (CIBMTR) Donor Health and Safety Working Committee in 2007 reported a potential conflict of interest in >70% of US centers, where physicians had simultaneous responsibility for RDs and their recipients. Consequently, several international organizations have endeavored to improve practice through regulations and consensus recommendations. We hypothesized that the changes in the 2012 Foundation for the Accreditation of Cellular Therapy and the Joint Accreditation Committee-International Society for Cellular Therapy and European Society for Blood and Marrow Transplantation standards resulting from the CIBMTR study would have significantly impacted practice. Accordingly, we conducted a follow-up survey of US transplantation centers to assess practice changes since 2007, and to investigate additional areas where RD care was predicted to differ from UD care. A total of 73 centers (53%), performing 79% of RD transplantations in the United States, responded. Significant improvements were observed since the earlier survey; 62% centers now ensure separation of RD and recipient care (P < .0001). This study identifies several areas where RD management does not meet international donor care standards, however. Particular concerns include counseling and assessment of donors before HLA typing, with 61% centers first disclosing donor HLA results to an individual other than the donor, the use of unlicensed mobilization agents, and the absence of long-term donor follow-up. Recommendations for improvement are made.

  10. Factors Affecting the Involvement of Day Centre Care Staff in the Delivery of Physiotherapy to Adults with Intellectual Disabilities: An Exploratory Study in One London Borough

    Science.gov (United States)

    Middleton, M. -J.; Kitchen, S. S.

    2008-01-01

    Background: Physiotherapists for adults with intellectual disabilities often work in day centres, relying on care staff to support programmes. This study investigates factors affecting physiotherapy delivery in 4 day centres in one London borough. Materials and Method: Semi-structured interviews were carried out with day centre care staff,…

  11. Using the "customer service framework" to successfully implement patient- and family-centered care.

    Science.gov (United States)

    Rangachari, Pavani; Bhat, Anita; Seol, Yoon-Ho

    2011-01-01

    Despite the growing momentum toward patient- and family-centered care at the federal policy level, the organizational literature remains divided on its effectiveness, especially in regard to its key dimension of involving patients and families in treatment decisions and safety practices. Although some have argued for the universal adoption of patient involvement, others have questioned both the effectiveness and feasibility of patient involvement. In this article, we apply a well-established theoretical perspective, that is, the Service Quality Model (SQM) (also known as the "customer service framework") to the health care context, to reconcile the debate related to patient involvement. The application helps support the case for universal adoption of patient involvement and also question the arguments against it. A key contribution of the SQM lies in highlighting a set of fundamental service quality determinants emanating from basic consumer service needs. It also provides a simple framework for understanding how gaps between consumer expectations and management perceptions of those expectations can affect the gap between "expected" and "perceived" service quality from a consumer's perspective. Simultaneously, the SQM also outlines "management requirements" for the successful implementation of a customer service strategy. Applying the SQM to the health care context therefore, in addition to reconciling the debate on patient involvement, helps identify specific steps health care managers could take to successfully implement patient- and family-centered care. Correspondingly, the application also provides insights into strategies for the successful implementation of policy recommendations related to patient- and family-centered care in health care organizations. PMID:21725217

  12. Elements of the patient-centered medical home associated with health outcomes among veterans: the role of primary care continuity, expanded access, and care coordination.

    Science.gov (United States)

    Nelson, Karin; Sun, Haili; Dolan, Emily; Maynard, Charles; Beste, Laruen; Bryson, Christopher; Schectman, Gordon; Fihn, Stephan D

    2014-01-01

    Care continuity, access, and coordination are important features of the patient-centered medical home model and have been emphasized in the Veterans Health Administration patient-centered medical home implementation, called the Patient Aligned Care Team. Data from more than 4.3 million Veterans were used to assess the relationship between these attributes of Patient Aligned Care Team and Veterans Health Administration hospitalization and mortality. Controlling for demographics and comorbidity, we found that continuity with a primary care provider was associated with a lower likelihood of hospitalization and mortality among a large population of Veterans receiving VA primary care. PMID:25180648

  13. Day-care, early common infections and childhood acute leukaemia: a multicentre French case–control study

    Science.gov (United States)

    Perrillat, F; Clavel, J; Auclerc, M F; Baruchel, A; Leverger, G; Nelken, B; Philippe, N; Schaison, G; Sommelet, D; Vilmer, E; Hémon, D

    2002-01-01

    We conducted a case–control study to investigate the role of early infections in the aetiology of childhood acute leukaemias. The study included 280 incident cases (240 acute lymphoblastic leukaemia and 40 acute non-lymphoblastic leukaemia) and 288 hospital controls, frequency matched by age, gender, hospital, catchment area of the hospital and ethnic origin. Data were obtained from standardised face-to-face interviews of the mothers. The interviews included questions on early common infections, day-care attendance, breast-feeding, birth order and infantile diseases. Odds ratios were estimated using an unconditional regression model including the stratification variables, parental socio-economic status and perinatal characteristics. Birth order was not associated with childhood leukaemia (acute lymphoblastic or acute non-lymphoblastic). A statistically-significant inverse association was observed between childhood leukaemia and day-care attendance (odds ratio=0.6, 95% Confidence Interval=(0.4–1.0)), repeated early common infections (⩾4 per year before age two, odds ratio=0.6 (0.4–1.0)), surgical procedures for ear–nose–throat infections before age two (odds ratio=0.5 (0.2–1.0)) and prolonged breast-feeding (⩾6 months, odds ratio=0.5 (0.2–1.0)). In the multivariate model including day-care attendance, early common infections and breast-feeding, results concerning breast-feeding remained unchanged. A statistically significant interaction between day-care attendance and repeated early common infections was observed. When the interaction was taken into account, the simple effects of day-care and early common infections disappeared (odds ratio=1.1 (0.5–2.3) and odds ratio=0.8 (0.5–1.3), respectively) while the joint effect of day-care attendance and early common infections was negatively associated with childhood leukaemia (odds ratio=0.3 (0.1–0.8)). All the above associations were observed both for acute lymphoblastic leukaemia and acute non

  14. Health care supervisors and employee relations success: three C's a day keep the union away.

    Science.gov (United States)

    Bolon, D S

    1995-09-01

    The health care industry is experiencing rapid change and uncertainty. Given the tremendous amount of instability in the industry, many observers are not surprised at the high level of militancy currently being displayed by many health care workers. However, it should not automatically follow that turbulent times will lead to uneasy management-labor relations. Maintaining nonunion status depends largely on the employee relations skills and capabilities of first-line supervisors. The article reviews and discusses three key attributes (communication, consideration, and commitment) that supervisors must display in order to promote employee satisfaction and remain union-free. Practical guidelines and suggestions are provided. PMID:10144616

  15. Cortisol levels of infants in center care across the first year of life: links with quality of care and infant temperament.

    Science.gov (United States)

    Albers, Esther M; Beijers, Roseriet; Riksen-Walraven, J Marianne; Sweep, Fred C G J; de Weerth, Carolina

    2016-01-01

    Cortisol concentrations of older children in childcare centers have been found to be higher than at home. This study focuses on infant cortisol in childcare centers throughout the first year of life, and aims to investigate whether inter-individual differences can be explained by temperament, the quality of maternal behavior, and the quality of center care. Sixty-four infants were followed for 9 months after entering care at 3 months of age. Salivary samples were taken at 10.00 h and 16.00 h in center care (in post-entry weeks 1, 2, 3, 4, 8, 12, 16, 24, and 36) and at home (in post-entry weeks 1, 24, and 36). Prior to entry, mothers completed a temperament questionnaire and the quality of maternal behavior (sensitivity and cooperation) was observed during routine bathing sessions. Subsequently, the infants were visited three times at center care to observe the quality of infant's interactive experiences with their professional caregiver. Longitudinal regression models showed that both morning and afternoon cortisol were higher in center care compared to home. Longitudinal regression models showed that infants receiving higher quality of maternal behavior displayed higher morning cortisol in center care, compared to infants receiving lower quality of maternal behavior. Higher quality of maternal behavior was also related to higher afternoon cortisol in center care, but only in infants high in negative emotionality. Center care quality was not related to cortisol. In sum, young infants show higher cortisol concentrations in center care that are related to infant temperament and quality of maternal behavior at home.

  16. 78 FR 22911 - Delta Air Lines, Inc., Reservation Sales and Customer Care Call Center, Seatac, WA; Delta Air...

    Science.gov (United States)

    2013-04-17

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF LABOR Employment and Training Administration Delta Air Lines, Inc., Reservation Sales and Customer Care Call Center, Seatac, WA; Delta Air Lines, Inc., Reservation Sales and Customer Care Call Center, Sioux City, IA; Notice of Revised Determination...

  17. Health professionals’ experiences of person-centered collaboration in mental health care

    Directory of Open Access Journals (Sweden)

    Rita Sommerseth

    2008-10-01

    Full Text Available Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semistructured in-depth interview to judge validity.Results: Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.Conclusion: Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.Keywords: multidisciplinary teams, person-centered collaboration, supportive systems, rehabilitation

  18. Same-Day CD4 Testing to Improve Uptake of HIV Care and Treatment in South Africa: Point-of-Care Is Not Enough

    Directory of Open Access Journals (Sweden)

    Bruce A. Larson

    2013-01-01

    Full Text Available Background. We evaluated whether a pilot program providing point-of-care (POC, but not rapid, CD4 testing (BD FACSCount immediately after testing HIV-positive improved retention in care. Methods. We conducted a retrospective record review at the Themba Lethu Clinic in Johannesburg, South Africa. We compared all walk-in patients testing HIV-positive during February, July 2010 (pilot POC period to patients testing positive during January 2008–February 2009 (baseline period. The outcome for those with a ≤250 cells/mm3 when testing HIV-positive was initiating ART <16 weeks after HIV testing. Results. 771 patients had CD4 results from the day of HIV testing (421 pilots, 350 baselines. ART initiation within 16 weeks was 49% in the pilot period and 46% in the baseline period. While all 421 patients during the pilot period should have been offered the POC test, patient records indicate that only 73% of them were actually offered it, and among these patients only 63% accepted the offer. Conclusions. Offering CD4 testing using a point-of-care, but not rapid, technology and without other health system changes had minor impacts on the uptake of HIV care and treatment. Point-of-care technologies alone may not be enough to improve linkage to care and treatment after HIV testing.

  19. Disruptive innovation in academic medical centers: balancing accountable and academic care.

    Science.gov (United States)

    Stein, Daniel; Chen, Christopher; Ackerly, D Clay

    2015-05-01

    Numerous academic medicine leaders have argued that academic referral centers must prepare for the growing importance of accountability-driven payment models by adopting population health initiatives. Although this shift has merit, execution of this strategy will prove significantly more problematic than most observers have appreciated. The authors describe how successful implementation of an accountable care health strategy within a referral academic medical center (AMC) requires navigating a critical tension: The academic referral business model, driven by tertiary-level care, is fundamentally in conflict with population health. Referral AMCs that create successful value-driven population health systems within their organizations will in effect disrupt their own existing tertiary care businesses. The theory of disruptive innovation suggests that balancing the push and pull of academic and accountable care within a single organization is achievable. However, it will require significant shifts in resource allocation and changes in management structure to enable AMCs to make the inherent difficult choices and trade-offs that will ensue. On the basis of the theories of disruptive innovation, the authors present recommendations for how academic health systems can successfully navigate these issues as they transition toward accountability-driven care.

  20. Integrating Adolescents and Young Adults into Adult-Centered Care for IBD.

    Science.gov (United States)

    Trivedi, Itishree; Holl, Jane L; Hanauer, Stephen; Keefer, Laurie

    2016-05-01

    Planned healthcare transition, initiated in pediatric care, is a gradual process aimed at fostering the adolescent patient's disease knowledge and skills with the ultimate objective of preparing patients and families for adult-centered care. The process is critical in inflammatory bowel diseases (IBD) where there is an increased risk of non-adherence, hospitalizations, and emergency department use as young adult patients graduate from pediatric to adult-centered care. While evidence for healthcare transition in IBD is mounting, important gaps remain in the understanding of this process from the perspective of the adult gastroenterologist. This paper summarizes what is known about healthcare transition in IBD and explores the unanswered questions-a conceptual and methodological framework for transition interventions, relevant outcomes that define successful transition, and key stakeholder perspectives. For the adult gastroenterologist managing the young adult patient population, this paper presents the paradigm of "care integration"-a process of ongoing, multi-modality support for the patient, initiated in the adult care setting, with the goal of improving self-management skills and active participation in medical decision-making.

  1. Disruptive innovation in academic medical centers: balancing accountable and academic care.

    Science.gov (United States)

    Stein, Daniel; Chen, Christopher; Ackerly, D Clay

    2015-05-01

    Numerous academic medicine leaders have argued that academic referral centers must prepare for the growing importance of accountability-driven payment models by adopting population health initiatives. Although this shift has merit, execution of this strategy will prove significantly more problematic than most observers have appreciated. The authors describe how successful implementation of an accountable care health strategy within a referral academic medical center (AMC) requires navigating a critical tension: The academic referral business model, driven by tertiary-level care, is fundamentally in conflict with population health. Referral AMCs that create successful value-driven population health systems within their organizations will in effect disrupt their own existing tertiary care businesses. The theory of disruptive innovation suggests that balancing the push and pull of academic and accountable care within a single organization is achievable. However, it will require significant shifts in resource allocation and changes in management structure to enable AMCs to make the inherent difficult choices and trade-offs that will ensue. On the basis of the theories of disruptive innovation, the authors present recommendations for how academic health systems can successfully navigate these issues as they transition toward accountability-driven care. PMID:25517702

  2. [The wound care center in surgery: an interdisciplinary concept for diagnostic and treatment of chronic wounds].

    Science.gov (United States)

    Coerper, S; Schäffer, M; Enderle, M; Schott, U; Köveker, G; Becker, H D

    1999-04-01

    In Germany there is no standardized wound care for patients with chronic wounds in specialized centers. We have established a wound care unit for the past 6 years. The principal concept of therapy was characterized by standardized local surgery, moist wound dressings and concomitant treatment of the underlying disease. We performed local therapy, coordinated the interdisciplinary treatment and developed a new wound documentation system for quality control. We established a close network, integrating general practitioners and home care organizations to realize a mainly outpatient treatment supported by short hospital therapy. Exclusive outpatient treatment was performed in 42% of all patients. According to our prospective data, we achieved an improvement in wound care: 69% of the wounds resistant to therapy for a mean of 30 months healed within 12 months after therapy according to our protocol. Our data strongly supported the importance of local surgery: neither wound depth nor wound infection had any influence on the healing rate, presumably due to radical excisional debridement of necrotic tissue. The presented data justify on medical and economic grounds the establishment of such wound care centers in Germany. PMID:10354850

  3. Individualised Colour Coded Any Day Neon atal Growth Monitoring Charts for Primary Health Care Workers: A New Approach

    Directory of Open Access Journals (Sweden)

    Asha K. Pratinidhi

    2015-01-01

    Full Text Available Research article Individualised Colour Coded Any Day Neon atal Growth Monitoring Charts for Primary Health Care Workers: A New Approach Asha K. Pratinidhi*, Satish V. Kakade** ,Satish D. Pawar***, Abhijit C. Bagade****, Chandrashekhar D. Aundhakar*****, Suryakant Y. Ingale****** *Director of Research, **Assoc. Professor (Sta tistics ,*****Professor and Head, Dept. of Pediatrics******,Assistant Professor, Dept. of Pe diatrics: Krishna Institute of Medical Sciences University, Karad Dist. Satara , Maharashtra; ***Director of Health Services, Govt. of Maharashtra; ****Consultant, Pediatrics and Public Health, Nashik, Maharastra Abstract: Background & Objectives There is a decline in infant mortality in developing countries but no significant reduction in neonatal mortality. Growth monitoring is the best objective method to know wellbeing of the baby. Existing growth monitoring charts are on the basis of weekly or monthly growth monitoring, hence cannot be used for any day growth monitoring. To bridge this gap ‘Individualised Colour Coded Any Day (ICCAD Neonatal Growth Monitoring Charts’ were prepared. Methods Growth of 430 normal neonates was studied by weighing apparently healthy babies daily from birth to 30 days of their life. The babies were weighed on a standard electronic weighing machine taking all the preca utions to avoid errors in weighments. Expected growth curve lines were drawn for four birth weight groups namely 1000gm to 1499gm, 1500 to 1999gm, 2000 to 2499gm and equal to or more than 2500gm by taking central value of the groups. A growth curve was drawn using actual daily mean values of duration and amount of weight loss, duration required to regain birth weight and weight gain thereafter. Results Four patterns of growth charts were prepared corresponding to the four birth weight groups. The growth curve has expected growth curve line and unsatisfactory growth curve line. The unsatisfactory growth curve line represents excessive

  4. Building social participation with a support group users: challenges of care qualification in a Psychosocial Care Center (CAPS

    Directory of Open Access Journals (Sweden)

    Vitor Corrêa Detomini

    2015-09-01

    Full Text Available The literature points out a lack of studies describing practical experiences approaching the role of social participation, even though, the subject Brazilian Health System (SUS as a principle is valued by theoretical-conceptual works. The lack of studies is especially observed in mental health care services, where the existing studies focus on the users’ management engagement as part of psychosocial rehabilitation. Thus, this article introduces an experience developed in a Center for Psycho-Social Attention (CAPS, in the state of Mato Grosso do Sul, aiming to address the issue of social participation in care qualification, in accordance to legislation and technical standards. Thisstudy focused on two types of sources. 1 Internship Final Report of a Psycology Student including 54 sessions of a support group, 2 technical and legal documents concerning the SUS and the National Mental Health Policy and Humanization. The service aspects were analyzed through technical and legislative foundations - focusing the needs and claims on group discussions, classified as structure and process, used to assess the health care quality. Most concerns were listed on normative Ordinances and Regulations. Achieving social participation was not an institutional premise and, among the main difficulties was the medical/outpatient centered model and the representation of “crazy”/”CAPS users” as incapable. It requires: i integration of “clinic” and “politics”; ii intensification of interdisciplinary and psychological care; iii respect the citizenship of mental health users, and, finally, iv that the collective participation spaces do not exhaust themselves. Therefore, the collective participation spaces need practical recommendations in order to improve the structures and work processes and meet the users’ needs.

  5. [Medicine on mission: The international health reform of Seventh-Day Adventists and their health care facilities in Sweden].

    Science.gov (United States)

    Eklöf, Motzi

    2008-01-01

    The international non-conformist denomination, Seventh-day Adventists, have since their foundation in 1863, had a distinctive health care model for their members. The life-style has included vegetarian diet, abstinence from alcohol, tobacco and other drugs and the observance of a day of rest once a week. The health policy has striven to care for God's creation in the hope of resurrection at the Day of Judgment and to reform the conventional medical practice. The Adventists have pursued an extensive international health care system--from the start based on dietary and physical treatment methods, such as hydrotherapy, massage and physiotherapy--in line with the Christian mission. Health care establishments have been inaugurated around the world as a vehicle for enabling the Christian health care message to reach the upper classes. With Adventist and Doctor, John Harvey Kellogg's Battle Creek Sanatorium in Michigan as both inspirational source and educational institution, the health care mission--including a vegetarian health food industry, following in the footsteps of cornflakes--spread to the Nordic countries by the turn of the century, 1900. Skodsborgs Badesanatorium near Copenhagen became the model institution for several health care establishments in Sweden during the 1900's, such as Hultafors Sanatorium. The American-Nordic link has manifested itself through co-publication of papers, exchange of health care personnel and reporting to the central Adventist church. The American non-conformist domain as well as a private sphere of activity, aiming mainly from the outset at society's upper classes, has encountered certain difficulties in maintaining this distinction in Sweden's officially increasing secularised society, and in relation to a state health insurance and a publicly financed health care system. With the passing of time, the socioeconomic composition of patients at Hultafors became more heterogeneous, and conventional medical procedures were increasingly

  6. Shortening day length as a previously unrecognized selective pressure for early breeding in a bird with long parental care

    OpenAIRE

    Podlaszczuk, Marcin; Wojciechowski, Zbigniew; Podlaszczuk, Patrycja; Minias, Piotr; Janiszewski, Tomasz; Wojciechowska, Agnieszka

    2014-01-01

    Several different selective pressures have been suggested to explain an intense competition for early return to breeding grounds in birds. In this study we hypothesized that shortening day length during summer months may constitute additional selective force acting towards early breeding in avian species with long parental care. To test this hypothesis, we studied time budget and foraging activities of early-nesting and late-nesting white storks Ciconia ciconia from th...

  7. The role of probiotics and prebiotics in the prevention of infections in child day-care centres.

    Science.gov (United States)

    Weizman, Z

    2015-01-01

    Infants and children attending day-care centres demonstrate a notably higher risk of gastrointestinal as well as of respiratory tract infections. The present short review evaluates various well-controlled clinical trials analysing the effect of probiotics and prebiotics in the prevention of such infections. In most of the 12 studies identified, probiotic supplementation was found to be a safe and effective therapeutic tool in preventing gastrointestinal and respiratory infection in this population.

  8. Duration of bed occupancy as calculated at a random chosen day in an acute care ward. Implications for the use of scarce resources in psychiatric care

    OpenAIRE

    Restan Asbjørn; Berg John E

    2005-01-01

    Abstract Background Psychiatric acute wards are obliged to admit patients without delay according to the Act on Compulsive Psychiatric Care. Residential long term treatment facilities and rehabilitation facilities may use a waiting list. Patients, who may not be discharged from the acute ward or should not wait there, then occupy acute ward beds. Materials and methods Bed occupancy in one acute ward at a random day in 2002 was registered (n = 23). Successively, the length of stay of all patie...

  9. Family centered maternity care: its relationship to perinatal regionalization and neonatal intensive care.

    Science.gov (United States)

    Swartz, W H; Swartz, J V

    1976-09-01

    For several months prior to birth a major portion of a family's attention, conversation, thought, and often worry, is directed toward the idea of a new child. This prolonged attention and anticipation contribute to making childbirth an emotionally charged experience. In psychological terms, it is therefore a critical period of peak motivation for learning, and a time to peak susceptibility to reinforcement. Theory, reason, and scientific evidence indicate thng with childbirth and early postpartum experiences, can significantly affect subsequent parental behaviors, the child's central environment influence. Evidence strongly suggests that these parental attitudes and behaviors so crucial to the child's ultimate well-being are learned rather than derived instinctually, and therefore they are malleable and can be taught, directed, and corrected. Through education and reinforcement it is possible to encourage parental behaviors and child interactions which are products of feelings of control, competence, accomplishment, understanding, and caring. Similarly we can recognize and work toward replacing attitudes, feelings, and behaviors that express fear, worry, and insecurity about the child. Over the past 50 years major changes have occurred in the practice of obstetrics and newborn pediatrics. Other major changes will necessarily occur as we move toward perinatal regionalization. Changes instigated solely on physiologic data can have unrecognized collateral effects on the psychological component of the childbirth experience. All concerned health care personnel, especially obstetricians and pediatricians, can insist that the importance of desirable mother-father-child interactions be recognized and that practices fostering them be afforded a high priority. I would like to endorse a comment from a recent article by Richmond concerning the advent of behavioral pediatrics by adding that behavioral obstetrics is also "an idea whose time has arrived".

  10. Family centered maternity care: its relationship to perinatal regionalization and neonatal intensive care.

    Science.gov (United States)

    Swartz, W H; Swartz, J V

    1976-09-01

    For several months prior to birth a major portion of a family's attention, conversation, thought, and often worry, is directed toward the idea of a new child. This prolonged attention and anticipation contribute to making childbirth an emotionally charged experience. In psychological terms, it is therefore a critical period of peak motivation for learning, and a time to peak susceptibility to reinforcement. Theory, reason, and scientific evidence indicate thng with childbirth and early postpartum experiences, can significantly affect subsequent parental behaviors, the child's central environment influence. Evidence strongly suggests that these parental attitudes and behaviors so crucial to the child's ultimate well-being are learned rather than derived instinctually, and therefore they are malleable and can be taught, directed, and corrected. Through education and reinforcement it is possible to encourage parental behaviors and child interactions which are products of feelings of control, competence, accomplishment, understanding, and caring. Similarly we can recognize and work toward replacing attitudes, feelings, and behaviors that express fear, worry, and insecurity about the child. Over the past 50 years major changes have occurred in the practice of obstetrics and newborn pediatrics. Other major changes will necessarily occur as we move toward perinatal regionalization. Changes instigated solely on physiologic data can have unrecognized collateral effects on the psychological component of the childbirth experience. All concerned health care personnel, especially obstetricians and pediatricians, can insist that the importance of desirable mother-father-child interactions be recognized and that practices fostering them be afforded a high priority. I would like to endorse a comment from a recent article by Richmond concerning the advent of behavioral pediatrics by adding that behavioral obstetrics is also "an idea whose time has arrived". PMID:963936

  11. What is patient-centered care really? Voices of Hispanic prenatal patients.

    Science.gov (United States)

    Bergman, Alicia A; Connaughton, Stacey L

    2013-01-01

    Variations in patient-centered care (PCC) models and approaches contribute to ambiguity in how PCC is understood and defined, especially with regard to meeting the needs of diverse patient populations. One of the biggest challenges of putting PCC into practice is knowing what elements are the most important to patients. This qualitative study privileges patients' voices and adds a cultural dimension to existing health communication research on PCC through an empirical investigation of 48 Hispanic prenatal care patients' understandings and expectations of PCC. Semistructured interviews with 48 patients revealed five key themes in order of frequency: (a) una relación amable (a friendly relationship), (b) la atencion médica efectiva (effective medical care), (c) Español hablado (the Spanish language spoken), (d) comprensión de la información (understanding of information), and (e) eliminación del racismo (elimination of racism). The themes reflected several different assumptions and expectations with regard to PCC as compared to those espoused in many of the existing models and frameworks, such as the extent to which friendly interpersonal behaviors (e.g., smiling, making eye contact, displaying patience, and engaging in formal greetings, introductions, and farewells) were critical to patient satisfaction with the health care experience. Not only did patients feel better understood, but accompanied by friendly behaviors, information was viewed as more believable and accurate, and thus more patient-centered. The findings suggest that implementing culturally sensitive PCC approaches to caring for Hispanic prenatal care patients can include training health care staff on the importance of displaying friendly communicative behaviors such as smiling.

  12. What is patient-centered care really? Voices of Hispanic prenatal patients.

    Science.gov (United States)

    Bergman, Alicia A; Connaughton, Stacey L

    2013-01-01

    Variations in patient-centered care (PCC) models and approaches contribute to ambiguity in how PCC is understood and defined, especially with regard to meeting the needs of diverse patient populations. One of the biggest challenges of putting PCC into practice is knowing what elements are the most important to patients. This qualitative study privileges patients' voices and adds a cultural dimension to existing health communication research on PCC through an empirical investigation of 48 Hispanic prenatal care patients' understandings and expectations of PCC. Semistructured interviews with 48 patients revealed five key themes in order of frequency: (a) una relación amable (a friendly relationship), (b) la atencion médica efectiva (effective medical care), (c) Español hablado (the Spanish language spoken), (d) comprensión de la información (understanding of information), and (e) eliminación del racismo (elimination of racism). The themes reflected several different assumptions and expectations with regard to PCC as compared to those espoused in many of the existing models and frameworks, such as the extent to which friendly interpersonal behaviors (e.g., smiling, making eye contact, displaying patience, and engaging in formal greetings, introductions, and farewells) were critical to patient satisfaction with the health care experience. Not only did patients feel better understood, but accompanied by friendly behaviors, information was viewed as more believable and accurate, and thus more patient-centered. The findings suggest that implementing culturally sensitive PCC approaches to caring for Hispanic prenatal care patients can include training health care staff on the importance of displaying friendly communicative behaviors such as smiling. PMID:23421385

  13. Energy saving options in health care centers; Grote mogelijkheden voor energiebesparing in zorgcentra

    Energy Technology Data Exchange (ETDEWEB)

    Traversari, R.; Hendriksen, L.; Van Heumen, S. [TNO, Delft (Netherlands)

    2012-01-15

    Research by TNO has shown that there is much room for improvement in nursing homes and health care centers with regard to climate installations. There is still a lack of knowledge and clarity about the functioning of these installations in the examined buildings. Health care centers lack the knowledge and ability to take on the role of professional client, both in daily operation and in renovation and building of new buildings. [Dutch] Onderzoek van TNO heeft aangetoond dat in verpleeghuizen en zorgcentra veel verbeteringen mogelijk zijn wat betreft klimaatinstallaties. In de onderzochte panden heerst nog veel onbekendheid en onduidelijkheid over het functioneren van deze installaties. Zorginstellingen missen de kennis en kunde om de rol van professioneel opdrachtgever op zich te nemen bij zowel de dagelijkse bedrijfsvoering, als ook bij renovatie en nieuwbouw.

  14. 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

    2014-01-01

    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. PMID:25321635

  15. Provider perceptions of the value of same-day, electronic patient-reported measures for use in clinical HIV care.

    Science.gov (United States)

    Fredericksen, R J; Tufano, J; Ralston, J; McReynolds, J; Stewart, M; Lober, W B; Mayer, K H; Mathews, W C; Mugavero, M J; Crane, P K; Crane, H M

    2016-11-01

    Strong evidence suggests that patient-reported outcomes (PROs) aid in managing chronic conditions, reduce omissions in care, and improve patient-provider communication. However, provider acceptability of PROs and their use in clinical HIV care is not well known. We interviewed providers (n = 27) from four geographically diverse HIV and community care clinics in the US that have integrated PROs into routine HIV care, querying perceived value, challenges, and use of PRO data. Perceived benefits included the ability of PROs to identify less-observable behaviors and conditions, particularly suicidal ideation, depression, and substance use; usefulness in agenda setting prior to a visit; and reduction of social desirability bias in patient-provider communication. Challenges included initial flow integration issues and ease of interpretation of PRO feedback. Providers value same-day, electronic patient-reported measures for use in clinical HIV care with the condition that PROs are (1) tailored to be the most clinically relevant to their population; (2) well integrated into clinic flow; and (3) easy to interpret, highlighting chief patient concerns and changes over time. PMID:27237187

  16. Oral health in institucionalizated elderly patients in two care centers in Passo Fundo - RS

    OpenAIRE

    Nicolau Silveira Neto; João Paulo de Carli; Maria Salete Sandini Linden; Micheline Sandini Trentin; Soluete Oliveira da Silva; Luciele Raquel Luft

    2008-01-01

    Objective: Considering that oral health, as well as general health are fundamental for maintaining the quality of life, the objective of this study was to investigate the oral health of the elderly population in the São José and Nossa Senhora da Luz Care Centers in Passo Fundo/ RS, Brazil. Methods: a clinical examination was performed in 107 elderly patients, to evaluate the oral health status as regards periodontal disease, edentulism, physiological alterations, and mucosa infection by the C...

  17. Cyberknife fractionated radiotherapy for adrenal metastases: Preliminary report from a multispecialty Indian cancer care center

    OpenAIRE

    Trinanjan Basu; Tejinder Kataria; Ashu Abhishek; Deepak Gupta; Shikha Goyal; Shyam S. Bisht; Karthick K Payaliappan; Vikraman Subhramani

    2015-01-01

    Purpose: Metastasis to adrenal gland from lung, breast, and kidney malignancies are quite common. Historically radiotherapy was intended for pain palliation. Recent studies with stereotactic body radiotherapy (SBRT) including Cyberknife robotic radiosurgery aiming at disease control brings about encouraging results. Here we represent the early clinical experience with Cyberknife stereotactic system from an Indian cancer care center. The main purpose of this retrospective review is to serve as...

  18. Impact of Low Procalcitonin Results on Antibiotic Administration in Hospitalized Patients at a Tertiary Care Center

    OpenAIRE

    Brennan, Meghan B.; Osterby, Kurt; Schulz, Lucas; Lepak, Alexander J.

    2016-01-01

    Procalcitonin is a sensitive and specific marker of bacterial infection; low results allow clinicians to safely de-escalate antibiotics. This retrospective cohort study aimed to determine the effect of low procalcitonin results on withholding, discontinuing, or de-escalating antibiotics in hospitalized patients at a tertiary care center. Antibiotics were initiated or continued without de-escalation in 55% of patients with low procalcitonin results. Among patients with low procalcitonin result...

  19. Feminist health care in a hostile environment: a case study of the Womancare Health Center.

    Science.gov (United States)

    Hyde, Cheryl A

    2008-01-01

    This article presents a case study of the Womancare Health Center in order to illustrate the development of and challenges to the feminist health movement in the United States. Specific attention is placed on the legislative, fiscal, and direct actions by the New Right against this organization. Analysis focuses on the means through which Womancare survived. The repercussions of constant intimidation and harassment for women's health programs and for health care policy overall are discussed.

  20. Predictors of sleep quality and successful weaning from mechanical ventilation among patients in respiratory care centers

    OpenAIRE

    Chen, C-J; Hsu, L-N; McHugh, G.; Campbell, M.; Tzeng, Y-L

    2015-01-01

    Background: Poor quality of sleep may result in more problems for patients who undergo weaning from mechanical ventilation because it could result in disabled muscle relaxation and affect the function of the respiratory muscles. Few studies have specifically investigated what factors contributed to quality of sleep and weaning outcomes. Purpose: This study investigates the predictors of quality of sleep and successful weaning from mechanical ventilation in patients at respiratory care centers...

  1. Readiness for Change: Evidence from a Study of Early Childhood Care and Education Centers

    OpenAIRE

    Doyle, Orla; Logue, Caitriona; McNamara, Kelly

    2009-01-01

    This study examines factors that influence staff members’ readiness for change in early childhood settings in Ireland. The introduction of a new national framework, designed to improve the quality of Early Childhood Care and Education Centers (ECCECs), has been piloted in several communities. This study measures support for this change in organizational practices using the Organizational Change Recipients’ Belief Scale and uses correlation analysis to determine how readiness for change is lin...

  2. Viral meningitis in child care center staff and parents: an outbreak of echovirus 30 infections.

    OpenAIRE

    Mohle-Boetani, J C; Matkin, C; Pallansch, M; Helfand, R.; Fenstersheib, M; Blanding, J A; Solomon, S. L.

    1999-01-01

    OBJECTIVE: A report of five cases of viral meningitis among adults with children enrolled in a child care center prompted an investigation of risk factors for viral transmission from children to adult household members. METHODS: To determine recent echovirus 30 (E30) infections, the authors conducted a serologic survey. To determine risk factors for infection among adult household members, they conducted a retrospective cohort study using written questionnaires. RESULTS: Recent E30 infections...

  3. Burn Teams and Burn Centers: The Importance of a Comprehensive Team Approach to Burn Care

    OpenAIRE

    Al-Mousawi, Ahmed M.; Mecott-Rivera, Gabriel A.; Jeschke, Marc G.; Herndon, David N

    2009-01-01

    Advances in burn care have been colossal, but while extra work is needed, it is clear that the organized effort of burn teams can continue making improvements in survival rates and quality of life possible for patients. Burn patients are unique, representing the most severe model of trauma,33 and hence this necessitates treatment in the best facilities available for that endeavor. Burn centers have developed to meet these intricate needs but can only function productively and most efficiently...

  4. Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi

    OpenAIRE

    Aysha Almas; Ayaz Ghouse; Ahmed Raza Iftikhar; Munawwar Khursheed

    2014-01-01

    Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi. Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included. Results. Out of 1336 patients, 28.6% (387) had un...

  5. Patient-centered collaborative care: employer-led business coalition vision for action.

    Science.gov (United States)

    Webber, Andrew; Mercure, Suzanne

    2006-01-01

    Employers influence healthcare delivery. Two spheres of influence include (i) what is done at each worksite and by each employer (plan design and communications as well as health plan contracting) and (ii) what is done collectively in both private and public sectors to address performance and to encourage the physicians to adopt practice changes. The need for change toward patient-centered care is the subject of this article.

  6. A Research on Patient Satisfaction with Primary Health Care in the Center of Afyonkarahisar

    Directory of Open Access Journals (Sweden)

    Nazli Sensoy

    2013-10-01

    Full Text Available Aim: Patient satisfaction is an important indicator to evaluate the quality of primary health care service. It is also significant to improve the quality of medical care, expectation from health staff, priority of patient needs, views and feedbacks about medical services in primary health care. Our objective in this study is to determine the patient satisfaction and the factors effecting this aspect in the evaluation of primary health care quality. Material and Method: This research was carried out in one Mother and Child Health and Family Planning Centre and nine Health Centers in January 2009 at Afyonkarahisar center. The questionnaire was performed to investigate the degree of satisfaction about health services, and socio-demographic characteristics of patients admitted to primary health care by face to face interview method. The data was evaluated by SPSS 15.00.Results: 1227 patients participating in the study, 809 women and 418 were male, married 878, 290 were single.Their education level was 408 graduated from primary school. At the same time, their job distributions were 596 housewives, 133 retired. When the patients had health problems, the most preferable institutione was health center, the choice of the reasons they were satisfied with the services in general, determined as to obtain quick results and confidence in solving problems.75% of the patients waiting time for admission and registration procedures were 0-5minutes. The admission reasons were mostly physical examination and prescription. Patients who are male, aged above 50 years and low educated had much higher satisfaction levels. Discussion: As a result, decreased satisfaction with higher education level, satisfaction increased with increasing age and a short waiting period for the application-registration and examination procedures were being influenced patient satisfaction.

  7. Use of mortality within 30 days of a COPD hospitalisation as a measure of COPD care in UK hospitals.

    Science.gov (United States)

    Walker, P P; Thompson, E; Crone, H; Flatt, G; Holton, K; Hill, S L; Pearson, M G

    2013-10-01

    Mortality rate has been proposed as a metric of hospital chronic obstructive pulmonary disease (COPD) care in light of variation seen in national COPD audits. Using Hospital Episode Statistics (hospital 'coding') we examined 30-day mortality after COPD hospitalisation in 150 UK hospitals during 2006-2007 and 2007-2008. Mean and median 30-day mortalities were similar each year but the coefficient of variation was >20% and hospitals could change from a low or high quartile to the median by chance. We could not detect any reasons for hospitals being at the extremes. 30-day mortality after COPD hospitalisation is a complex variable and unlikely to be useful as a primary annual COPD metric.

  8. 7 CFR 226.11 - Program payments for centers.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Payment Provisions § 226.11 Program... approved child care centers, at-risk afterschool care centers, adult day care centers, emergency...

  9. [A reflection upon an organizational system model for nursing care centered on best practices].

    Science.gov (United States)

    Kempfer, Silvana Silveira; Birolo, Ioná Vieira Bez; Meirelles, Betina Homer Schlindwein; Erdmann, Alacoque Lorenzini

    2010-09-01

    This article aims at reflecting on nursing best practices and these practices as a perspective of systemizing care. Quality of nursing becomes evident from management practices instituted as a result of its development throughout time. Thinkers of the management area have really influenced nursing both at professional acting and theoretical basis levels. It is imperative that nursing comes closer to best practices, which are considered as a non linear manner of perceiving the world, where structuring of its actions is centered on complex perspective; the use of registers as a way for planning organization and care to take effect, as well as professional identification with issues that transcend personal care and are closer to universal ethics. Best practices are linked to social responsibility, sustainability and ecology as an essence of human actions to conduct management practices. PMID:21574344

  10. Using an Informed Advocacy Framework to Advance the Practice of Family-Centered Care.

    Science.gov (United States)

    Marcellus, Lenora; MacKinnon, Karen

    2016-01-01

    The philosophical framework of family-centered care (FCC) has been promoted consistently since the 1980s in perinatal and neonatal settings as a gold standard approach for developing programs and providing care that supports the meaningful involvement of parents in the care of their infants and children. Recent literature suggests that despite years of promotion, FCC remains an elusive practice. Sources frequently state that FCC is based on principles of communication and empowerment, but the literature overall does not suggest substantial underlying philosophical or theoretical underpinnings. There have been theoretical advances in nursing and other disciplines that hold potential for moving our practice of FCC forward. In this article, we describe the informed advocacy framework and apply the framework to FCC. PMID:27465458

  11. Prenatal care in a primary healthcare center for imprisoned pregnant women

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Silva Fochi

    2014-06-01

    Full Text Available This experience report aimed to describe the prenatal care undertaken in a primary care center in the non-metropolitan area of the State of São Paulo, offered to the female prison population. The data and related information refer to the period June 2010 – June 2012. The article describes the construction of the work process by the local team, the dynamics of providing the attendance, the human resources involved and the consultations undertaken. The prenatal care provided to the pregnant women made it possible to investigate the pluralized universe of imprisoned women and their needs resulting from the condition of being pregnant in the prison environment. Thus, decent attendance to the prison population’s health - a human and constitutional right - is considered important, so as to avoid physical, emotional and social problems, which in the pregnant woman may be passed on to her child.

  12. Characterization of the clientele attended in a Psychosocial Care Center - alcohol and drugs

    Directory of Open Access Journals (Sweden)

    Eliany Nazaré Oliveira

    2013-09-01

    Full Text Available This documentary and retrospective study aimed to analyze the profile of the clientele attended in the Psychosocial Care Center Alcohol and Other Drugs from Sobral, Ceará, Brazil in 2010, based on 300 records. Males predominated with 75% (n=225, with age ranging from 11 to 29 years old with 44.3% (n=133, single with 49% (n=147, and with elementary school 45.7% (n=137. The most commonly used drug among men was crack, 31.3% (n=94, and among women, tobacco, 12% (n=36. The losses associated with dependence, are mostly related to the family, with 31.3% (n=94. The highlight to crack requires changes in the care process implemented in institutions. One should remain alert to these new profiles related to chemical dependency, so that quality and integral care can be offered to this clientele.

  13. Developing patient-centered teams: The role of sharing stories about patients and patient care.

    Science.gov (United States)

    Bennett, Ariana H; Hassinger, Jane A; Martin, Lisa A; Harris, Lisa H; Gold, Marji

    2015-09-01

    Research indicates that health care teams are good for staff, patients, and organizations. The characteristics that make teams effective include shared objectives, mutual respect, clarity of roles, communication, trust, and collaboration. We were interested in examining how teams develop these positive characteristics. This paper explores the role of sharing stories about patients in developing patient-centered teams. Data for this paper came from 1 primary care clinic as part of a larger Providers Share Workshop study conducted by the University of Michigan. Each workshop included 5 facilitated group sessions in which staff met to talk about their work. This paper analyzes qualitative data from the workshops. Through an iterative process, research team members identified major themes, developed a coding scheme, and coded transcripts for qualitative data analysis. One of the most powerful ways group members connected was through sharing stories about their patients. Sharing clinical cases and stories helped participants bond around their shared mission of patient-centered care, build supportive relationships, enhance compassion for patients, communicate and resolve conflict, better understand workflows and job roles, develop trust, and increase morale. These attributes highlighted by participants correspond to those documented in the literature as important elements of teambuilding and key indicators of team effectiveness. The sharing of stories about patients seems to be a promising tool for positive team development in a primary care clinical setting and should be investigated further. PMID:26348238

  14. Identifying elements of patient-centered care in underserved populations: a qualitative study of patient perspectives.

    Directory of Open Access Journals (Sweden)

    Sheela Raja

    Full Text Available Patient-centered care is an important goal in the delivery of healthcare. However, many patients do not engage in preventive medical care. In this pilot study, we conducted twenty in depth, semi-structured qualitative interviews at the University of Illinois at Chicago Health Sciences campus in a four month time frame. Many patients were underserved and underinsured, and we wanted to understand their experiences in the healthcare system. Using content analysis, several themes emerged from the interview data. Participants discussed the need for empathy and rapport with their providers. They identified provider behaviors that fostered a positive clinical relationship, including step-by step explanations of procedures, attention to body language and clinic atmosphere, and appropriate time management. Participants identified cost as the most common barrier to engaging in preventive care and discussed children and social support as motivating factors. A long-term relationship with a provider was an important motivator for preventive care, suggesting that the therapeutic alliance was essential to many patients. Conversely, many participants discussed a sense of dehumanization in the healthcare system, reporting that their life circumstances were overlooked, or that they were judged based on insurance status or ethnicity. We discuss implications for provider training and healthcare delivery, including the importance of patient-centered medical homes.

  15. Identifying elements of patient-centered care in underserved populations: a qualitative study of patient perspectives.

    Science.gov (United States)

    Raja, Sheela; Hasnain, Memoona; Vadakumchery, Tracy; Hamad, Judy; Shah, Raveena; Hoersch, Michelle

    2015-01-01

    Patient-centered care is an important goal in the delivery of healthcare. However, many patients do not engage in preventive medical care. In this pilot study, we conducted twenty in depth, semi-structured qualitative interviews at the University of Illinois at Chicago Health Sciences campus in a four month time frame. Many patients were underserved and underinsured, and we wanted to understand their experiences in the healthcare system. Using content analysis, several themes emerged from the interview data. Participants discussed the need for empathy and rapport with their providers. They identified provider behaviors that fostered a positive clinical relationship, including step-by step explanations of procedures, attention to body language and clinic atmosphere, and appropriate time management. Participants identified cost as the most common barrier to engaging in preventive care and discussed children and social support as motivating factors. A long-term relationship with a provider was an important motivator for preventive care, suggesting that the therapeutic alliance was essential to many patients. Conversely, many participants discussed a sense of dehumanization in the healthcare system, reporting that their life circumstances were overlooked, or that they were judged based on insurance status or ethnicity. We discuss implications for provider training and healthcare delivery, including the importance of patient-centered medical homes. PMID:25993110

  16. Relationships between Young Children in Full-Time Day Care and Their Caregivers: A Qualitative Study of Parental and Caregiver Perspectives

    Science.gov (United States)

    Drugli, May Britt; Mari Undheim, Anne

    2012-01-01

    We studied the quality of caregiver-child relationships from the perspectives of parents and caregivers of young children in full-time day care. The sample consisted of 41 parents of children aged two years or younger (22 boys and 19 girls) in day care, and 35 of their caregivers. Parents and caregivers were interviewed. Parents and caregivers…

  17. 30-day hospital readmission of older adults using care transitions after hospitalization: a pilot prospective cohort study

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2013-06-01

    Full Text Available Paul Y Takahashi,1 Lindsey R Haas,2 Stephanie M Quigg,1 Ivana T Croghan,1 James M Naessens,2 Nilay D Shah,2 Gregory J Hanson11Division of Primary Care Internal Medicine, Department of Medicine, 2Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USAPurpose: Patients leaving the hospital are at increased risk of functional decline and hospital readmission. The Employee and Community Health service at Mayo Clinic in Rochester developed a care transition program (CTP to provide home-based care services for medically complex patients. The study objective was to determine the relationship between CTP use, 30-day hospital readmission, and Emergency Room (ER visits for adults over 60 years with high Elder Risk Assessment scores.Patients and methods: This was a pilot prospective cohort study that included 20 patients that used the CTP and 20 patients discharged from the hospital without using the CTP. The medically complex study patients were drawn from the department of Employee and Community Health population between October 14, 2011 and September 27, 2012. The primary outcomes were 30-day hospital readmission or ER visit after discharge from the hospital. The secondary outcomes were within-group changes in grip strength, gait speed, and quality of life (QOL. Patients underwent two study visits, one at baseline and one at 30 days postbaseline. The primary analysis included time-to-event from baseline to rehospitalization or ER visit. Paired t-tests were used for secondary outcomes, with continuous scores.Results: Of the 40 patients enrolled, 36 completed all study visits. The 30-day hospital readmission rates for usual care patients were 10.5% compared with no readmissions for CTP patients. There were 31.6% ER visits in the UC group and 11.8% in the CTP group (P = 0.37. The secondary analysis showed some improvement in physical QOL scores (pre: 32.7; post: 39.4 for the CTP participants (P < 0.01 and no differences in gait speed or

  18. Impact of Information Technology, Clinical Resource Constraints, and Patient-Centered Practice Characteristics on Quality of Care

    Directory of Open Access Journals (Sweden)

    JongDeuk Baek

    2015-02-01

    Full Text Available Objective: Factors in the practice environment, such as health information technology (IT infrastructure, availability of other clinical resources, and financial incentives, may influence whether practices are able to successfully implement the patient-centered medical home (PCMH model and realize its benefits. This study investigates the impacts of those PCMH-related elements on primary care physicians’ perception of quality of care. Methods: A multiple logistic regression model was estimated using the 2004 to 2005 CTS Physician Survey, a national sample of salaried primary care physicians (n = 1733. Results: The patient-centered practice environment and availability of clinical resources increased physicians’ perceived quality of care. Although IT use for clinical information access did enhance physicians’ ability to provide high quality of care, a similar positive impact of IT use was not found for e-prescribing or the exchange of clinical patient information. Lack of resources was negatively associated with physician perception of quality of care. Conclusion: Since health IT is an important foundation of PCMH, patient-centered practices are more likely to have health IT in place to support care delivery. However, despite its potential to enhance delivery of primary care, simply making health IT available does not necessarily translate into physicians’ perceptions that it enhances the quality of care they provide. It is critical for health-care managers and policy makers to ensure that primary care physicians fully recognize and embrace the use of new technology to improve both the quality of care provided and the patient outcomes.

  19. STUDY ON SOLID WASTE COLLECTION AND DISPOSAL IN HOSPITALS AND HEALTA CARE CENTERS OF TEHRAN PROVINCE

    OpenAIRE

    Omrani, A.; K. Imandel; H Karimzadegan

    1998-01-01

    The main objective of this investigation was to achieve a clear pattern of solid waste collection and disposal in selected hospital and health care establishments in certain cities of Tehran province. This study was done in more than 82 percent of all hospitals with 3017 beds during the year 1996. Solid waste produced per bed was evaluated to be 2.87 kg per day which was 8670 kg per day, for all beds, comprising less than 1% of the total solid waste generated in the same cities during the sam...

  20. [The Day Service as a tool to reduce inappropriateness of care: the experience of a research hospital in Rome (Italy)].

    Science.gov (United States)

    Cadeddu, Chiara; Specchia, Maria Lucia; Principi, Francesca; Marchini, Raffaele; Cerimele, Marina; Ricciardi, Walter; Cavuto, Costanza

    2015-01-01

    The Day Service was established in Italy to promote appropriateness of care and consists in the delivery of packages of complex outpatient services. A Working Group for the continuous improvement of pre-hospitalization activities of the Regina Elena Scientific Institute in Rome, Italy, established that the outpatient management of surgical patients in the hospital would occur in a Day Service, through a package of services identified at the regional level or appropriate diagnostic and therapeutic pathways. This article describes the experience of the hospital's Day Service and compares results from the last four months of 2013 with those of the first four months of 2014. The introduction of a Day Service has led to a reduction in the number of inappropriate pre-admission tests (mainly computerized tomography, magnetic resonance and Positron emission scans and scintigraphy) and this has had a positive impact not only in terms of organization, reduction of hospital stay and overall hospitalization-related activities, but also from an economic standpoint. The implementation of a Day Service has also improved the overall patient experience, from an organizational point of view, and this is an important aspect, considering that patients at the Regina Elena Scientific Institute are oncological patients, they are often elderly and most reside in other Italian regions.