WorldWideScience

Sample records for public foster care

  1. Multidimension Treatment Foster Care

    DEFF Research Database (Denmark)

    Pontoppidan, Maiken; Hansen, Helle; Deding, Mette

    2014-01-01

    Dette notat er en kort opsamling af den nyeste forskning af effekterne af Multidimension Treatment Foster Care (herefter MTFC). SFI lavede i 2010 en oversigt over forskningen om effekterne af MTFC i forbindelse med udarbejdelsen af en projektbeskrivelse. Dette notat sammenfatter den nyeste...

  2. Kinship foster care and foster care in the Netherlands

    NARCIS (Netherlands)

    Strijker, J.; Zandberg, Tj.; Van der Meulen, B.F.

    2003-01-01

    This study examines the similarities and differences between foster parents and kinship foster parents in the Netherlands. Both parents and caseworkers have filled out questionnaires for the purpose of this study. No evidence has been found to support the argument that kinship foster care holds

  3. Homelessness: The Foster Care Connection.

    Science.gov (United States)

    Institute for Children and Poverty, New York, NY.

    Roughly 600,000 families are homeless today in America, while over 2.7 million children are in foster care or out-of-home placements. Few policymakers have examined these issues together, or understood that they are interrelated and must be addressed jointly to break the cycle of family disintegration, violence, and poverty. A recent survey by the…

  4. Antipsychotic treatment among youth in foster care.

    Science.gov (United States)

    Dosreis, Susan; Yoon, Yesel; Rubin, David M; Riddle, Mark A; Noll, Elizabeth; Rothbard, Aileen

    2011-12-01

    Despite national concerns over high rates of antipsychotic medication use among youth in foster care, concomitant antipsychotic use has not been examined. In this study, concomitant antipsychotic use among Medicaid-enrolled youth in foster care was compared with disabled or low-income Medicaid-enrolled youth. The sample included 16 969 youths younger than 20 years who were continuously enrolled in a Mid-Atlantic state Medicaid program and had ≥1 claim with a psychiatric diagnosis and ≥1 antipsychotic claim in 2003. Antipsychotic treatment was characterized by days of any use and concomitant use with ≥2 overlapping antipsychotics for >30 days. Medicaid program categories were foster care, disabled (Supplemental Security Income), and Temporary Assistance for Needy Families (TANF). Multicategory involvement for youths in foster care was classified as foster care/Supplemental Security Income, foster care/TANF, and foster care/adoption. We used multivariate analyses, adjusting for demographics, psychiatric comorbidities, and other psychotropic use, to assess associations between Medicaid program category and concomitant antipsychotic use. Average antipsychotic use ranged from 222 ± 110 days in foster care to only 135 ± 101 days in TANF (P foster care only and 24% in foster care/adoption compared with youths in the foster care system.

  5. Posttraumatic Stress Disorder among Foster Care Alumni: The Role of Race, Gender, and Foster Care Context

    Science.gov (United States)

    Jackson, Lovie J.; O'Brien, Kirk; Pecora, Peter J.

    2011-01-01

    Little is known about the prevalence of posttraumatic stress disorder (PTSD) in adult alumni of foster care and its demographic and contextual correlates. This is one of the first studies to report on racial/ethnic and gender differences and the influence of foster care experiences (i.e., revictimization during foster care, placement change rate,…

  6. Laboratory Screening for Children Entering Foster Care.

    Science.gov (United States)

    Greiner, Mary V; Beal, Sarah J; Nause, Katie; Staat, Mary Allen; Dexheimer, Judith W; Scribano, Philip V

    2017-12-01

    To determine the prevalence of medical illness detected by laboratory screening in children entering foster care in a single, urban county. All children entering foster care in a single county in Ohio were seen at a consultation foster care clinic and had laboratory screening, including testing for infectious diseases such as HIV, hepatitis B, hepatitis C, syphilis, and tuberculosis as well as for hemoglobin and lead levels. Over a 3-year period (2012-2015), laboratory screening was performed on 1977 subjects entering foster care in a consultative foster care clinic. The prevalence of hepatitis B, hepatitis C, syphilis, and tuberculosis were all found to be <1%. There were no cases of HIV. Seven percent of teenagers entering foster care tested positive for Chlamydia . A secondary finding was that 54% of subjects were hepatitis B surface antibody-negative, indicating an absence of detected immunity to the hepatitis B virus. Routine laboratory screening for children entering foster care resulted in a low yield. Targeted, rather than routine, laboratory screening may be a more clinically meaningful approach for children entering foster care. Copyright © 2017 by the American Academy of Pediatrics.

  7. Identifying Divergent Foster Care Careers for Danish Children

    DEFF Research Database (Denmark)

    Fallesen, Peter

    2014-01-01

    Foster care children who experience placement disruption and foster care instability are at elevated risk for a host of poor outcomes, yet little work considers what these unstable foster care careers look like or what causes them. In this article, I start by using previous studies on foster care...

  8. 45 CFR 1356.30 - Safety requirements for foster care and adoptive home providers.

    Science.gov (United States)

    2010-10-01

    ... licensing file for that foster or adoptive family must contain documentation which verifies that safety... 45 Public Welfare 4 2010-10-01 2010-10-01 false Safety requirements for foster care and adoptive... ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND...

  9. Foster Care and College: The Educational Aspirations and Expectations of Youth in the Foster Care System

    Science.gov (United States)

    Kirk, Chris M.; Lewis, Rhonda K.; Nilsen, Corinne; Colvin, Deltha Q.

    2013-01-01

    Despite an overall increase in college attendance, low-income youth and particularly those in the foster care system are less likely to attend college (Wolanin, 2005). Although youth in foster care report high educational aspirations, as little as 4% obtain a 4-year college degree (Nixon & Jones, 2007). The purpose of this study is to explore…

  10. Health care of youth aging out of foster care.

    Science.gov (United States)

    2012-12-01

    Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.

  11. Parenting the Poorly Attached Teenager. Fostering Families. A Specialized Training Program Designed for Foster Care Workers & Foster Care Parents.

    Science.gov (United States)

    Schatz, Mona Struhsaker; Faust, Timothy Philip

    This module is part of a training program for foster parents and foster care workers offered at Colorado State University. The module explores the attachment process and the long-term effects of attachment difficulties in the first years of a child's life. The module's learning objectives address: (1) ways of identifying the basic concepts…

  12. Supporting Youth Aging Out of Foster Care.

    Science.gov (United States)

    Ahmann, Elizabeth

    2017-01-01

    Over 400,000 children are in foster care in the United States, and more than 100,000 of them are waiting to be adopted. Yet many will age out of foster care into adulthood without an adoptive family. Teens and young adults aging out of foster care, even those with preparation and training for the transition, often do not fare well in young adulthood. Many face challenges in areas of education, employment, homelessness, finances, the criminal justice system, and meeting health and mental healthcare needs. Research demonstrates what only makes sense: teens with tangible support from meaningful adult relationships fare better than those without. This article describes an innovative program that connects teens in foster care with supportive adults through social events that can lead to meaningful long-term teen-adult connections - including friendships, mentoring, and even, in some cases, adoption. Pediatric nurses, aware of the challenges these teens face adjusting to adulthood, can begin to explore referral and support options for such teens in their own locales using the resources herein.

  13. 75 FR 23557 - National Foster Care Month, 2010

    Science.gov (United States)

    2010-05-04

    ... America A Proclamation Nearly a half-million children and youth are in foster care in America, all... promise of children and youth in foster care, as well as former foster youth. We also celebrate the professionals and foster parents who demonstrate the depth and kindness of the human heart. Children and youth...

  14. We Care for Kids: A Handbook for Foster Parents.

    Science.gov (United States)

    Illinois State Dept. of Children and Family Services, Springfield.

    This handbook outlines essential information for foster parents under these basic headings: (1) legal rights and responsibilities of children, parents and foster parents; (2) recruitment, licensing, training, and evaluation of foster homes; (3) placement and removal of foster children; (4) payments and expenses; (5) medical care; (6)…

  15. Depression among Alumni of Foster Care: Decreasing Rates through Improvement of Experiences in Care

    Science.gov (United States)

    White, Catherine Roller; O'Brien, Kirk; Pecora, Peter J.; English, Diana; Williams, Jason R.; Phillips, Chereese M.

    2009-01-01

    The Northwest Foster Care Alumni Study examined the relation between experiences in foster care and depression among young adults who spent at least a year in foster care as adolescents. Results indicate that preparation for leaving foster care, nurturing supports from the foster family, school stability, access to tutoring, access to therapeutic…

  16. 76 FR 25519 - National Foster Care Month, 2011

    Science.gov (United States)

    2011-05-05

    ... people in foster care. Through the American Recovery and Reinvestment Act, we have significantly... Agriculture child nutrition programs. Additionally, beginning in 2014, the Affordable Care Act will require...

  17. From Famine to Feast. A Review of the Foster Care Research Literature

    Science.gov (United States)

    Sellick, Clive

    2006-01-01

    Foster care has become the principal placement of choice for children and young people in public care in the United Kingdom (UK). This has been accompanied by a significant growth in its research scrutiny connected to a busy policy agenda, especially since 1997. With its increased usage, fostering has encountered both difficulties and…

  18. Re-Imagining Language, Culture, and Family in Foster Care

    Science.gov (United States)

    Puig, Victoria I.

    2013-01-01

    Nearly half a million children in the United States are currently being served by the foster care system. Infants and toddlers represent the largest single group entering foster care. While these very young children are at the greatest peril for physical, mental health, and developmental issues and tend to spend the longest time in the foster care…

  19. 45 CFR 1356.71 - Federal review of the eligibility of children in foster care and the eligibility of foster care...

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE... foster care and the eligibility of foster care providers in title IV-E programs. 1356.71 Section 1356.71... § 1356.71 Federal review of the eligibility of children in foster care and the eligibility of foster care...

  20. Mental and Physical Health of Children in Foster Care.

    Science.gov (United States)

    Turney, Kristin; Wildeman, Christopher

    2016-11-01

    Each year, nearly 1% of US children spend time in foster care, with 6% of US children placed in foster care at least once between their birth and 18th birthday. Although a large literature considers the consequences of foster care placement for children's wellbeing, no study has used a nationally representative sample of US children to compare the mental and physical health of children placed in foster care to the health of children not placed in foster care. We used data from the 2011-2012 National Survey of Children's Health, a nationally representative sample of noninstitutionalized children in the United States, and logistic regression models to compare parent-reported mental and physical health outcomes of children placed in foster care to outcomes of children not placed in foster care, children adopted from foster care, children across specific family types (eg, single-mother households), and children in economically disadvantaged families. We find that children in foster care are in poor mental and physical health relative to children in the general population, children across specific family types, and children in economically disadvantaged families. Some differences are explained by adjusting for children's demographic characteristics, and nearly all differences are explained by also adjusting for the current home environment. Additionally, children adopted from foster care, compared with children in foster care, have significantly higher odds of having some health problems. Children in foster care are a vulnerable population in poor health, partially as a result of their early life circumstances. Copyright © 2016 by the American Academy of Pediatrics.

  1. Supportive Housing in Foster Care: The Views of Young People

    Science.gov (United States)

    Sinkkonen, Hanna-Maija; Kyttälä, Minna

    2015-01-01

    This study investigated Finnish young people's experiences of supportive housing. Supportive housing is an after-care programme that should support the transition from foster care to independent adulthood. It is directed mainly at young people who have been taken into foster care by social workers. The sample consisted of 39 young people (23…

  2. Resiliency in Children and Youth in Kinship Care and Family Foster Care

    Science.gov (United States)

    Metzger, Jed

    2008-01-01

    This study examined self-concept, resiliency and social support in 107 children and youth placed in foster care in New York City. Of the children and youth, 55 were placed in family foster care, while the remaining 52 children and youth were placed in a kinship foster home. Significantly more of mothers of the kinship foster care children and…

  3. Trauma-Informed Care for Youth in Foster Care.

    Science.gov (United States)

    Fratto, Carolyn M

    2016-06-01

    violence, specifically abuse and/or neglect (Burns et al., 2004). It is estimated that approximately 90-percent of children in foster care have experienced a traumatic event, with nearly half reporting exposure to four or more types of traumatic events (Stein et al., 2001). Given the widespread prevalence of traumatic exposures, it is important for the mental health professionals working with foster care youth, to be aware of the prevalence and various types of trauma that are most common. Focus in treatment is typically on behavioral and emotional reactions rather than addressing the context of these symptoms, including trauma exposure histories and trauma-specific reactions. Clinicians must maintain awareness of the frequency and impact of childhood traumatic experiences on subsequent behaviors and overall functioning. Clinicians should appreciate the link between how traumatized children understand the world and interact with others differently from other children and how to provide appropriate treatment for children with a history of traumatic exposures. Practitioners must remain alert to symptoms that may suggest a history of trauma and must have an understanding of the difficulties adolescents may face regulating their emotions and behavior, as a symptom of a past traumatic experience. The failure to address trauma through screening, assessment, and treatment has major implications for long-term public health costs and services. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Children in foster care: what forensic nurses need to know.

    Science.gov (United States)

    Hornor, Gail

    2014-01-01

    Children living in foster care are a unique population with specialized healthcare needs. This article will assist forensic nurses and advanced practice forensic nurses, particularly those working in pediatrics, in understanding the needs of children in foster care and implementing a practice plan to better meet their healthcare needs. To that end, a basic understanding of the foster care system is crucial and involves an appreciation of the interface between the legal system and the child welfare system. Most important to providing care to children in foster care is a true understanding of trauma exposure and its potential effects on the lives of children: physically, developmentally, emotionally, and psychologically. This article will assist forensic nurses working with pediatric populations to more fully understand the needs of children in foster care and to develop innovative interventions to appropriately meet their unique needs.

  5. Engaging Adolescent Youth in Foster Care through Photography

    Science.gov (United States)

    Rice, Karen; Girvin, Heather; Primak, Sarah

    2014-01-01

    Older youth in foster care are particularly vulnerable because they are poorly prepared for the transition from foster care to independent adulthood. Interventions designed to assist in this transition rarely engage youth directly; plans are made for youth rather than with them. Photographs can serve as an externalised medium for the expression of…

  6. Emancipated Foster Youth's Transition from Care to Virginia Community Colleges

    Science.gov (United States)

    Scott, Shylan E.

    2012-01-01

    The focus of this study was the experience of students who had successfully achieved the transition from foster care to enrollment in Virginia Community Colleges. The following questions guided the inquiry: How do students who are emancipating from foster care describe their transition to enrollment at one of the Virginia Community Colleges? What…

  7. Improving the Postsecondary Educational Attainment of Youth in Foster Care

    Science.gov (United States)

    Dworsky, Amy

    2018-01-01

    This chapter examines what we know about the disparity in postsecondary educational attainment between youth in foster care and their non-foster care peers, the reasons for it, and the policies and programs that have been developed to address that disparity. It also discusses the unique role that community colleges can play in reducing this…

  8. Foster Care Involvement among Medicaid-Enrolled Children with Autism

    Science.gov (United States)

    Cidav, Zuleyha; Xie, Ming; Mandell, David S.

    2018-01-01

    The prevalence and risk of foster care involvement among children with autism spectrum disorder (ASD) relative to children with intellectual disability (ID), children with ASD and ID, and typically developing children were examined using 2001-2007 Medicaid data. Children were followed up to the first foster care placement or until the end of 2007;…

  9. Trajectories of Depression Symptoms among Older Youths Exiting Foster Care

    Science.gov (United States)

    Munson, Michelle R.; McMillen, Curtis

    2010-01-01

    The purpose of this study was to determine the trajectories of depressive symptoms as older youths from the foster care system mature while also examining the correlates of these trajectories. Data came from a longitudinal study of 404 youths from the foster care system in Missouri, who were interviewed nine times between their 17th and 19th…

  10. Factors associated with family reunification for children in foster care

    NARCIS (Netherlands)

    López, Mónica; del Valle, Jorge F.; Montserrat, Carme; Bravo, Amaia

    In this paper, we analyse reunification processes from family foster care, both kinship and non-kinship, and the variables associated with them in a Spanish sample. Data collection was carried out after a review of child protection and foster care files, and those responsible for the cases were also

  11. The value of a college degree for foster care alumni: comparisons with general population samples.

    Science.gov (United States)

    Salazar, Amy M

    2013-04-01

    Higher education is associated with substantial adult life benefits, including higher income and improved quality of life, among others. The current study compared adult outcomes of 250 foster care alumni college graduates with two samples of general population graduates to explore the role higher education plays in these young adults' lives. Outcomes compared include employment, income, housing, public assistance, physical and mental health, happiness, and other outcomes that are often found to be related to educational attainment. Foster care alumni college graduates were very similar to general population college graduates for individual income and rate of employment. However, foster care alumni graduates were behind general population graduates on factors such as self-reported job security, household earnings, health, mental health, financial satisfaction, home ownership, happiness, and public assistance usage. Results have implications for policy and practice regarding the most effective means of supporting postcollege stability of youths with foster care experience.

  12. Health risk behavior of youth in foster care.

    Science.gov (United States)

    Gramkowski, Bridget; Kools, Susan; Paul, Steven; Boyer, Cherrie B; Monasterio, Erica; Robbins, Nancy

    2009-05-01

    Many adolescent health problems are predominantly caused by risk behavior. Foster adolescents have disproportionately poor health; therefore, identification of risk behavior is critical. Data from a larger study were analyzed to investigate the health risk behavior of 56 youth in foster care using the Child Health and Illness Profile-Adolescent Edition. Data indicated that youth in foster care had some increased risk behavior when compared with a normative adolescent population. Younger adolescents and those in relative placement had less risky behavior. Risk behavior was increased for youth in foster care when they were in group homes, had experienced a parental death, or had a history of physical or emotional abuse or attempted suicide. These results point to areas of strength and vulnerability for youth in foster care and suggest areas for clinicians and caregivers of these adolescents to focus interventions towards harm reduction and enhancement of resiliency.

  13. Washington state foster care: dental utilization and expenditures.

    Science.gov (United States)

    Melbye, Molly L R; Chi, Donald L; Milgrom, Peter; Huebner, Colleen E; Grembowski, David

    2014-01-01

    To identify factors associated with dental utilization and expenditures for children enrolled in Washington State (WA) foster care (FC). This cross-sectional study used 2008 Medicaid enrollment and claims files for children ages WA FC program for ≥11 months (N = 10,177). Regression models were used to examine associations between utilization and expenditures and sex, race, age group, Supplemental Security Income (SSI) (i.e., disability), substance abuse, behavior problems, placement setting (Foster Home Care, Kinship Care, Group Care, Other), and urbanicity. Only 43 percent of the children utilized any dental care; the adjusted mean expenditure was $198.35 [95% confidence interval (CI) $181.35, $215.36]. Fewer utilized diagnostic (41 percent), preventive (39 percent), restorative (11 percent), or complex (5 percent) services. Associated with utilization (P ≤ 0.01) were: female [ARR = 1.05, 95% CI(1.01, 1.10)]; 0-2 years [ARR = 0.18, 95% CI(0.15, 0.21)], [3-5 years ARR = 0.78, 95% CI(0.74, 0.83)]; Native American [ARR = 0.85, 95% CI(0.80, 0.91)]; SSI [ARR = 1.10, 95% CI(1.04, 1.17)]; Kinship Care [ARR = 0.94, 95% CI(0.90, 0.98)]; Group Care [ARR = 1.25 95% CI(1.15, 1.37)]; and urban/rural urbanicity with population WA FC for ≥11 months during 2008 did not receive dental care. Research is needed to determine the level of unmet need among children in FC and interventions to improve access to oral health of the children. Enforcement of existing federal legislation is needed. © 2013 American Association of Public Health Dentistry.

  14. Can Medicaid Claims Validly Ascertain Foster Care Status?

    Science.gov (United States)

    Raghavan, Ramesh; Brown, Derek S; Allaire, Benjamin T

    2017-08-01

    Medicaid claims have been used to identify populations of children in foster care in the current literature; however, the ability of such an approach to validly ascertain a foster care population is unknown. This study linked children in the National Survey of Child and Adolescent Well-Being-I to their Medicaid claims from 36 states using their Social Security numbers. Using this match, we examined discordance between caregiver report of foster care placement and the foster care eligibility code contained in the child's Medicaid claims. Only 73% of youth placed in foster care for at least a year displayed a Medicaid code for foster care eligibility. Half of all youth coming into contact with child welfare displayed discordance between caregiver report and Medicaid claims. Children with emergency department utilization, and those in primary care case management health insurance arrangements, had the highest odds of accurate ascertainment. The use of Medicaid claims to identify a cohort of children in foster care results in high rates of underascertainment. Supplementing administrative data with survey data is one way to enhance validity of ascertainment.

  15. Family reintegration of children and adolescents in foster care in Brazilian municipalities with different population sizes

    OpenAIRE

    Andrea M. Iannelli; Simone Gonçalves Assis; Liana Wernersbach Pinto

    2015-01-01

    The scope of this article is to present and analyze data from Brazilian foster care services for children / adolescents from the perspective of family reintegration. It also seeks to support the implementation of public policies in order to provide effective reintegration in accordance with the differing local contexts. It uses data from 1,157 municipalities that have foster care services. The methodology takes into account the data collection of 2,624 Brazilian centers and 36,929 children an...

  16. Food in Foster Families: Care, Communication and Conflict

    Science.gov (United States)

    Rees, Alyson; Holland, Sally; Pithouse, Andrew

    2012-01-01

    This study explores the significance of food and mealtimes in relation to the transition into foster care and the therapeutic settling of the child in a new family. In doing so, we draw upon an in-depth, qualitative case study of 10 experienced foster families in the UK focusing on what helped them to be successful. At the time of the study, there…

  17. Improving Educational Outcomes for Children in Foster Care

    Science.gov (United States)

    Watson, Christina; Kabler, Brenda

    2012-01-01

    Recent statistics estimate that there are 783,000 children living in foster care in the United States. This vulnerable population is at risk for academic failure as well as internalizing and externalizing behavioral problems. Compared to their peers, foster youth face significant educational difficulties, including lower levels of academic…

  18. How to Measure the Cost of Foster Family Care.

    Science.gov (United States)

    Settles, Barbara H.; And Others

    This report presents a method for measuring the cost of foster family care in local areas through use of governmental and other available data on costs relating to non-foster children. The cost measurement procedures used, for which 32 pages of tables and worksheet forms are provided, are designed to measure average costs in a particular area…

  19. 77 FR 26909 - National Foster Care Month, 2012

    Science.gov (United States)

    2012-05-07

    ..., childhood can be a time of sadness, pain, and separation. These children need and deserve safe, loving, and... commend the devotion and selflessness of the foster parents who step in to care for them. We also pay..., parent and advocacy groups--volunteer their time as mentors, tutors, and advocates for children in foster...

  20. Treatment Foster Care Pre-Service Trainings: Changes in Parenting Attitudes and Fostering Readiness

    Science.gov (United States)

    Strickler, Amy; Trunzo, Annette C.; Kaelin, Michael S.

    2018-01-01

    Background: Pre-service training of treatment parents is a requirement for all foster care models to ensure safety and well-being of children in care. Researchers theorize treatment parents benefit more from enhanced pre-service trainings; however, no rigorous studies exist indicating the effectiveness of these trainings for treatment parents.…

  1. The effect of foster care placement on paternal welfare dependency

    DEFF Research Database (Denmark)

    Fallesen, Peter

    The arrival of a child profoundly alters the life-course for men. Yet, children could change men's lives not only by arriving in them, but also by departing from them. In this article, I test how one such departure-foster care placement-affects men's labor market attachment, and in so doing I...... provide a novel parallel to existing research on how fatherhood affects men, which focuses almost exclusively on a child's arrival. Using population panel data from Denmark that include all first time fathers whose children were placed in foster care from 1995-2005, I find that having a child placed...... in foster care is associated with up to a 12 percentage point increase in welfare dependency. This result persists in analyses that control for individual and family level fixed effects, unobserved heterogeneity, and selection into having a child placed in foster care....

  2. Getting Foster Youth to and through College: Successes and Challenges of the New Jersey Foster Care Scholars Program

    Science.gov (United States)

    Davis, Maia; Losey, Elizabeth

    2008-01-01

    The popularity of the New Jersey Foster Care Scholars program is a testament to its importance. Typical college students rely on parents for financial assistance and emotional support. Youth aging out of foster care often are on their own. The scholarship program offers an opportunity for higher education that many foster youth thought they would…

  3. 25 CFR 20.507 - What requirements must foster care providers meet?

    Science.gov (United States)

    2010-04-01

    ... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.507 What requirements must foster care providers meet? If a child needs foster care, the social services worker must select care that... contain an approved current home study. (c) An off-reservation foster home, or residential care facility...

  4. Predictors of Early Childbirth Among Female Adolescents in Foster Care.

    Science.gov (United States)

    King, Bryn; Van Wert, Melissa

    2017-08-01

    Placement into foster care is driven by a number of factors, many of which are associated with adolescent childbirth. Yet, there are few studies that identify the experiences and characteristics that predict adolescent childbirth among girls who spend time in foster care. A longitudinal, population-based data set was constructed by probabilistically matching California child protective service records for female foster youth to maternal information available on vital birth records for children born between 2001 and 2010. Rates of childbirth among girls in foster care after their 10th birthday were generated. Chi-square tests assessed differences and survival models were specified to determine the rate of childbearing across key characteristics. Among the 30,339 girls who spent time in foster care as adolescents, 18.3% (5,567) gave birth for the first time before their 20th birthday. At a bivariate level, significant differences (p foster care placement experiences. In the fully adjusted survival model, the highest birth rates were observed among girls who entered care between ages 13 and 16 years; had been in care for relatively short periods of time; lived in congregate care at the estimated date of conception; had a history of running away; and were Latina, black, or Native American. The results suggest that there are identifiable risk factors associated with early childbirth among girls in foster care, which can help determine the timing and location of reproductive health services to minimize unintended pregnancy and maximize adolescent health and well-being. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  5. Public Policies that Help Foster Social Inclusion

    Science.gov (United States)

    Cheung, Chau-kiu

    2013-01-01

    Public policies can be effective in raising people's social inclusion as intended only reasonably through their implementation. With respect to the implementation perspective, this study examines the effectiveness of eight policies as perceived to implement in Hong Kong, China. The study employs data collected from 1,109 Chinese adults randomly…

  6. "Couch Surfing" of Latino Foster Care Alumni: Reliance on Peers as Social Capital

    Science.gov (United States)

    Perez, Beatrix F.; Romo, Harriett D.

    2011-01-01

    Youth exiting foster care often experience difficulties transitioning into adulthood. This paper focuses on Latino foster care youth in a major southwestern U.S. city and addresses the importance of peer networks as a crucial form of social capital as youth leave foster care. Case studies illustrate experiences of foster care alumni ranging in age…

  7. Psychotropic medication patterns among youth in foster care.

    Science.gov (United States)

    Zito, Julie M; Safer, Daniel J; Sai, Devadatta; Gardner, James F; Thomas, Diane; Coombes, Phyllis; Dubowski, Melissa; Mendez-Lewis, Maria

    2008-01-01

    Studies have revealed that youth in foster care covered by Medicaid insurance receive psychotropic medication at a rate > 3 times that of Medicaid-insured youth who qualify by low family income. Systematic data on patterns of medication treatment, particularly concomitant drugs, for youth in foster care are limited. The purpose of this work was to describe and quantify patterns of psychotropic monotherapy and concomitant therapy prescribed to a randomly selected, 1-month sample of youth in foster care who had been receiving psychotropic medication. METHODS. Medicaid data were accessed for a July 2004 random sample of 472 medicated youth in foster care aged 0 through 19 years from a southwestern US state. Psychotropic medication treatment data were identified by concomitant pattern, frequency, medication class, subclass, and drug entity and were analyzed in relation to age group; gender; race or ethnicity; International Classification of Diseases, Ninth Revision, psychiatric diagnosis; and physician specialty. Of the foster children who had been dispensed psychotropic medication, 41.3% received > or = 3 different classes of these drugs during July 2004, and 15.9% received > or = 4 different classes. The most frequently used medications were antidepressants (56.8%), attention-deficit/hyperactivity disorder drugs (55.9%), and antipsychotic agents (53.2%). The use of specific psychotropic medication classes varied little by diagnostic grouping. Psychiatrists prescribed 93% of the psychotropic medication dispensed to youth in foster care. The use of > or = 2 drugs within the same psychotropic medication class was noted in 22.2% of those who were given prescribed drugs concomitantly. Concomitant psychotropic medication treatment is frequent for youth in foster care and lacks substantive evidence as to its effectiveness and safety.

  8. Enhancing the Empowerment of Youth in Foster Care: Supportive Services

    Science.gov (United States)

    Kaplan, Sandra J.; Skolnik, Louise; Turnbull, Ayme

    2009-01-01

    This paper reviews the research on youth empowerment in seven child welfare programmatic areas. A lack of studies specifically focused on the empowerment of youth in foster care was found. Conceptual perspectives and existing data, however, suggest that the empowerment of youth in and transitioning out of care is essential and should be overtly…

  9. Pathways to Preventing Substance Use Among Youth in Foster Care.

    Science.gov (United States)

    Kim, Hyoun K; Buchanan, Rohanna; Price, Joseph M

    2017-07-01

    Substance use problems are highly prevalent among youth in foster care. Such problems in adolescence have long-lasting implications for subsequent adjustment throughout adulthood and even across generations. Although several programs have demonstrated positive results in reducing substance use in at-risk youth, few studies have systemically examined how such programs work for foster youth and whether they are effective for both genders. This study examined the efficacy of KEEP SAFE, a family-based and skill-focused program designed to prevent substance use and other related health risking behaviors among youth in foster care. We hypothesized that improving the caregiver-youth relationship would lead to later reductions in youths' involvement with deviant peers, which subsequently would lead to less substance use, and that this mechanism would work comparably for both genders. A sample of 259 youth (154 girls, ages 11-17 years) in foster care and their caregivers participated in a randomized controlled trial and was followed for 18 months post-baseline. Results indicated that the intervention significantly reduced substance use in foster youth at 18 months post-baseline and that the intervention influenced substance use through two processes: youths' improved quality of relationships with caregivers at 6 months post-baseline and fewer associations with deviant peers at 12 months post-baseline. This suggests that these two processes may be fruitful immediate targets in substance use prevention programs for foster youth. We also found little gender differences in direct and mediating effects of the intervention, suggesting KEEP SAFE may be effective for both genders in foster care.

  10. A Critical Reflection: Foster Care Youth Experiences at a Four Year Postsecondary Institution

    Science.gov (United States)

    Greer, Renada D.

    2016-01-01

    Foster care youth face significant challenges to postsecondary educational success, especially while enrolled at four-year institutions. Foster care youth are absent of family support that their non-foster peers receive throughout the college experience. Without family support, foster care youth encounter greater challenges to persevere through…

  11. Prior Trauma Exposure for Youth in Treatment Foster Care

    Science.gov (United States)

    Dorsey, Shannon; Burns, Barbara J.; Southerland, Dannia G.; Cox, Julia Revillion; Wagner, H. Ryan; Farmer, Elizabeth M. Z.

    2012-01-01

    Very little research has focused on rates of trauma exposure for youth in treatment foster care (TFC). Available research has utilized record review for assessing exposure, which presents limitations for the range of trauma types examined, as records are predominantly focused on abuse and neglect. The current study examines exposure rates and…

  12. Modern Family: Adoption and Foster Care in Children's Literature

    Science.gov (United States)

    Meese, Ruth Lyn

    2012-01-01

    Teachers often have no preparation for handling the questions and conversations that arise in the classroom when discussing literature having adoption or foster care themes. Instead of relying on personal experiences or stereotypes portrayed through the media, teachers are advised to understand the developmental tasks of children from families…

  13. Posttraumatic Stress Symptoms in Preschool Children in Foster Care: The Influence of Placement and Foster Family Environment.

    Science.gov (United States)

    Vasileva, Mira; Petermann, Franz

    2017-10-01

    Children in foster care often experience traumatic events which increase their risk for posttraumatic stress symptoms (PTSS). Until now, no research has investigated the developmentally sensitive PTSS criteria for preschoolers among children in foster care. The current study estimated the prevalence of potentially traumatic experiences and clinical PTSS in German foster care children aged 3 to 7 years. The foster parents of 324 children completed questionnaires about children's PTSS, foster parental stress, parenting, and family functioning. Linear regression models tested trauma-related variables, placement history, and foster family characteristics as predictors of PTSS. Approximately 45.4% of the foster children had experienced at least one traumatic event and 15.4% had clinical PTSS. Physical abuse, β = .34, p < .001; hospitalization, β = -.17, p = .026; witnessing someone being hurt, β = -.15, p = .047; and parental stress, β = .43, p < .001, were significantly associated with PTSS. Results demonstrate the impact the foster family has on children who are coping with trauma, and suggest the necessity of trauma-sensitive trainings for foster parents, with stress management as an important component. Copyright © 2017 International Society for Traumatic Stress Studies.

  14. Planned and unplanned terminations of foster care placements in the Netherlands: Relationships with characteristics of foster children and foster placements

    NARCIS (Netherlands)

    van Rooij, F.; Maaskant, A.; Weijers, I.; Weijers, D.; Hermanns, J.

    2015-01-01

    This study examined the role of placement and child characteristics in the unplanned termination of foster placements. Data were used from 169 foster children aged 0 to 20. Results showed that 35% of all foster placement terminations were unplanned. Outcomes of logistic regression analyses

  15. 'To talk or not to talk?' : Foster youth's experiences of sharing stories about their past and being in foster care

    NARCIS (Netherlands)

    Steenbakkers, Anne; van der Steen, Steffie; Grietens, Hans

    2016-01-01

    Sharing stories about the past and about being in care, can help adolescents placed in foster families to make meaning of their experiences and connect with their conversation partner. However, what obstacles and opportunities for sharing stories are experienced by foster youth has not been

  16. Foster care as a form of family support

    Directory of Open Access Journals (Sweden)

    Ewa Flaga

    2014-12-01

    Full Text Available The foster care system in Poland has recently undergone many changes on the basis of new legislation. It has been presented as a part of the work with the child and its family towards reintegration of the child’s family. However, in order for the aim of foster care to be achieved in this form, it is necessary to integrate work with the child and its family with all the elements of the local environment. Similar assumptions are the basis of the pedagogical concept of the environmental educational system by Stanisław Kowalski. The article presents how to implement pedagogical objectives through legal solutions, which emphasize the integration of the local environment.

  17. 45 CFR 1355.40 - Foster care and adoption data collection.

    Science.gov (United States)

    2010-10-01

    ... § 1355.40 Foster care and adoption data collection. (a) Scope of the data collection system. (1) Each... children who enter foster care prior to October 1, 1995 and who are still in the system, core data elements... of foster care data reports. (1) For each child, a computer generated transaction date must reflect...

  18. Sexual and Gender Minority Youth in Foster Care: Assessing Disproportionality and Disparities in Los Angeles

    OpenAIRE

    Wilson, Bianca DM; Cooper, Khush; Kastanis, Angeliki; Nezhad, Sheila

    2014-01-01

    LGBTQ foster youth are twice as likely to report poor treatment and more likely to live in group homes and to have more foster care placements. Approximately 1 in 5, or 1,400 foster youth in Los Angeles County, home to the nation’s largest population of foster youth, identify as LGBTQ. The finding is twice the estimated percentage of youth not in foster care who are LGBTQ. Generally, LGBTQ foster youth mirror the racial/ethnic demographic of all foster youth in Los Angeles County. The majorit...

  19. From Foster Care to College: The Seita Scholars Program at Western Michigan University

    Science.gov (United States)

    Unrau, Yvonne A.

    2011-01-01

    More than 32,000 young people in the United States exit the foster care system in a typical year by aging out to independence (Child Welfare Information Gateway, 2011). Despite available financial support for post-secondary education through the Foster Care Independence Act of 1999, only 20% of college-qualified foster youth attend college and…

  20. Family reintegration of children and adolescents in foster care in Brazilian municipalities with different population sizes.

    Science.gov (United States)

    Iannelli, Andrea M; Assis, Simone Gonçalves; Pinto, Liana Wernersbach; Pinto, Liana Wenersbach

    2015-01-01

    The scope of this article is to present and analyze data from Brazilian foster care services for children / adolescents from the perspective of family reintegration. It also seeks to support the implementation of public policies in order to provide effective reintegration in accordance with the differing local contexts. It uses data from 1,157 municipalities that have foster care services. The methodology takes into account the data collection of 2,624 Brazilian centers and 36,929 children and adolescents in care. The growing number of children/adolescents in care is in line with the increase in population size: 8.4 per small city; 60 per large city and 602.4 per metropolis. With respect to care residence in a different municipality there are varying indices: 12.4% in metropolises and 33.6% in small cities, revealing the absence of centers close to family units in the smaller communities. Regarding the activities promoted together with families, it was seen that there are still units that do not perform any activities, which runs contrary to Brazilian law. It is clear that policies for the child/adolescent in foster care centers need to consider the capacity of the municipality in accordance with population size to implement support actions for families to assist in family reintegration.

  1. Family reintegration of children and adolescents in foster care in Brazilian municipalities with different population sizes

    Directory of Open Access Journals (Sweden)

    Andrea M. Iannelli

    2015-01-01

    Full Text Available The scope of this article is to present and analyze data from Brazilian foster care services for children / adolescents from the perspective of family reintegration. It also seeks to support the implementation of public policies in order to provide effective reintegration in accordance with the differing local contexts. It uses data from 1,157 municipalities that have foster care services. The methodology takes into account the data collection of 2,624 Brazilian centers and 36,929 children and adolescents in care. The growing number of children/adolescents in care is in line with the increase in population size: 8.4 per small city; 60 per large city and 602.4 per metropolis. With respect to care residence in a different municipality there are varying indices: 12.4% in metropolises and 33.6% in small cities, revealing the absence of centers close to family units in the smaller communities. Regarding the activities promoted together with families, it was seen that there are still units that do not perform any activities, which runs contrary to Brazilian law. It is clear that policies for the child/adolescent in foster care centers need to consider the capacity of the municipality in accordance with population size to implement support actions for families to assist in family reintegration.

  2. Practising Political Care Ethics: Can Responsive Evaluation Foster Democratic Care?

    NARCIS (Netherlands)

    Visse, M.A.; Abma, T.; Widdershoven, G.

    2015-01-01

    This paper examines if and how responsive evaluation as a deliberative approach can serve as a guide for a politically oriented care ethics. A political care ethics puts the assignment of responsibilities and the inclusion of multiple perspectives of people at the centre of care. It honours the

  3. Parental Book Reading and Social-Emotional Outcomes for Head Start Children in Foster Care.

    Science.gov (United States)

    Lee, Kyunghee; Lee, Jung-Sook

    2016-01-01

    This study examines the associations between parental book reading and social-emotional outcomes for Head Start children in foster care. Despite no main Head Start impact on parental book reading, subgroup effects were found. Foster parents in Head Start provided more book reading for children with disabilities but less for children with low preacademic scores. Head Start enhanced social-emotional outcomes for children in foster care. The positive impacts of Head Start on children's social-emotional outcomes were greater when parents read books frequently. Head Start should include more foster families and provided parenting skills to enhance social-emotional outcomes for children in foster care.

  4. Health care quality measures for children and adolescents in Foster Care: feasibility testing in electronic records.

    Science.gov (United States)

    Deans, Katherine J; Minneci, Peter C; Nacion, Kristine M; Leonhart, Karen; Cooper, Jennifer N; Scholle, Sarah Hudson; Kelleher, Kelly J

    2018-02-22

    Preventive quality measures for the foster care population are largely untested. The objective of the study is to identify healthcare quality measures for young children and adolescents in foster care and to test whether the data required to calculate these measures can be feasibly extracted and interpreted within an electronic health records or within the Statewide Automated Child Welfare Information System. The AAP Recommendations for Preventive Pediatric Health Care served as the guideline for determining quality measures. Quality measures related to well child visits, developmental screenings, immunizations, trauma-related care, BMI measurements, sexually transmitted infections and depression were defined. Retrospective chart reviews were performed on a cohort of children in foster care from a single large pediatric institution and related county. Data available in the Ohio Statewide Automated Child Welfare Information System was compared to the same population studied in the electronic health record review. Quality measures were calculated as observed (received) to expected (recommended) ratios (O/E ratios) to describe the actual quantity of recommended health care that was received by individual children. Electronic health records and the Statewide Automated Child Welfare Information System data frequently lacked important information on foster care youth essential for calculating the measures. Although electronic health records were rich in encounter specific clinical data, they often lacked custodial information such as the dates of entry into and exit from foster care. In contrast, Statewide Automated Child Welfare Information System included robust data on custodial arrangements, but lacked detailed medical information. Despite these limitations, several quality measures were devised that attempted to accommodate these limitations. In this feasibility testing, neither the electronic health records at a single institution nor the county level Statewide

  5. Behavior problems of children in foster care: Associations with foster mothers' representations, commitment, and the quality of mother-child interaction.

    Science.gov (United States)

    Dubois-Comtois, Karine; Bernier, Annie; Tarabulsy, George M; Cyr, Chantal; St-Laurent, Diane; Lanctôt, Anne-Sophie; St-Onge, Janie; Moss, Ellen; Béliveau, Marie-Julie

    2015-10-01

    This study investigated different environmental and contextual factors associated with maltreated children's adjustment in foster care. Participants included 83 children (52 boys), ages 1-7 years, and their foster caregivers. Quality of interaction with the foster caregiver was assessed from direct observation of a free-play situation; foster caregiver attachment state of mind and commitment toward the child were assessed using two interviews; disruptive behavior symptoms were reported by foster caregivers. Results showed that quality of interaction between foster caregivers and children were associated with behavior problems, such that higher-quality interactions were related to fewer externalizing and internalizing problems. Foster caregivers' state of mind and commitment were interrelated but not directly associated with behavior problems of foster children. Type of placement moderated the association between foster caregiver commitment and foster child behavior problems. Whereas greater foster caregiver commitment was associated with higher levels of adjustment for children in foster families (kin and non-kin), this was not the case in foster-to-adopt families. Finally, the associations between foster child behavior problems and history of maltreatment and placement related-risk conditions fell below significance after considering child age and quality of interaction with the foster caregiver. Findings underscore the crucial contribution of the foster caregiver-child relationship to fostering child adjustment and, thereby, have important implications for clinical services offered to this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Delinquency and Crime Prevention: Overview of Research Comparing Treatment Foster Care and Group Care

    Science.gov (United States)

    Osei, Gershon K.; Gorey, Kevin M.; Jozefowicz, Debra M. Hernandez

    2016-01-01

    Background: Evidence of treatment foster care (TFC) and group care's (GC) potential to prevent delinquency and crime has been developing. Objectives: We clarified the state of comparative knowledge with a historical overview. Then we explored the hypothesis that smaller, probably better resourced group homes with smaller staff/resident ratios have…

  7. Placement breakdown in foster care: Reducing risks by a foster parent training program?

    NARCIS (Netherlands)

    Maaskant, A.M.

    2016-01-01

    This thesis started by focusing on Dutch foster children’s well-being, emotional and behavioral functioning and placement stability. Subsequently, we attempted to identify how foster families who are considered to be at a high risk of placement breakdown could be given effective support. The

  8. Reaching everyone: Promoting the inclusion of youth with disabilities in evaluating foster care outcomes

    OpenAIRE

    Blakeslee, Jennifer E.; Quest, A. Del; Powers, Jennifer; Powers, Laurie E.; Geenen, Sarah; Nelson, May; Dalton, Lawrence D.; McHugh, Elizabeth

    2013-01-01

    Efforts to evaluate foster care outcomes must avoid systematic exclusion of particular groups. Although often unrecognized as such, youth with disabilities are highly overrepresented in the U.S. foster care system, and yet youth with some disabilities, including those with intellectual, serious emotional, and physical impairments may be underrepresented in research and evaluation studies evaluating foster care outcomes. The recruitment and retention of youth with various disabilities in such ...

  9. Where do youth in foster care receive information about preventing unplanned pregnancy and sexually transmitted infections?

    Science.gov (United States)

    Hudson, Angela L

    2012-10-01

    Adolescents in foster care are at risk for unplanned pregnancy and sexually transmitted infections, including HIV infection. A study using a qualitative method was conducted to describe how and where foster youth receive reproductive health and risk reduction information to prevent pregnancy and sexually transmitted infections. Participants also were asked to describe their relationship with their primary health care provider while they were in foster care. Nineteen young adults, recently emancipated from foster care, participated in individual interviews. Using grounded theory as the method of analysis, three thematic categories were generated: discomfort visiting and disclosing, receiving and not receiving the bare essentials, and learning prevention from community others. Recommendations include primary health care providers providing a confidential space for foster youth to disclose sexual activity and more opportunities for foster youth to receive reproductive and risk prevention information in the school setting. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Associations Between Maltreatment History and Severity of Substance Use Behavior in Youth in Foster Care.

    Science.gov (United States)

    Gabrielli, Joy; Jackson, Yo; Brown, Shaquanna

    2016-09-22

    Substance use (SU) in youth remains a significant public health concern and a risk factor for morbidity and mortality in adolescents. The present study offers examination of the association between severity and chronicity of maltreatment history and SU in youth in foster care. Two hundred and ten (48% female) foster youth with a mean age of 12.71 years (SD = 2.95 years) completed surveys using an audio-computer-assisted self-interview program. Results revealed 31% of participants reported past-year SU, and substance users had a mean CRAFFT score of 3.43 (SD = 1.90). Reported age of SU onset was 11.08 years (SD = 2.21 years). The SU measurement model demonstrated excellent fit in this sample. Accounting for both youth age and youth placement type, the structural model with maltreatment predicting SU severity demonstrated strong model fit with a significant path between maltreatment and SU. Youth in residential facilities and older youth had higher rates of use than those residing in traditional foster home environments and younger youth. Findings provide additional support for the link between maltreatment experiences and SU severity in foster youth and suggest the need for screening and intervention services appropriate for this high-risk population. © The Author(s) 2016.

  11. Fostering change within organizational participants of multisectoral health care alliances.

    Science.gov (United States)

    Hearld, Larry R; Alexander, Jeffrey A; Mittler, Jessica N

    2012-01-01

    A touted advantage of multisectoral health care alliances is their ability to coordinate diverse constituencies and pursue community health goals in ways that allow them to make greater progress than each constituency could independently. However, participating organizations may have goals that do not entirely overlap or necessarily align with the alliance's goals, which can weaken or undermine an alliance's efforts. Fostering changes within participating organizations in ways that are consistent with the alliance's goals (i.e., alliance-oriented change) may be one mechanism by which alliances can coordinate diverse activities and improve care in their local communities. We examined whether alliance-oriented change within participating organizations is associated with alliance decision-making and conflict management style, level of participation, perceptions of alliance participation benefits and costs, and awareness of alliance activities within participating organizations. The study used two rounds of survey data collected from organizational participants of 14 alliances participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality program. Alliance participants generally reported low levels of alliance-oriented change within their organizations as a result of the alliance and its activities. However, participants reporting higher levels of internal change in response to alliance activities had more positive perceptions of alliance decision-making style, higher levels of participation in alliance activities, more positive perceptions of alliance participation benefits relative to costs, and greater awareness of alliance activities across multiple levels of their respective organizations. Despite relatively low levels of alliance-oriented change within participating organizations, alliances may still have the means to align the goal orientations of a diverse membership and foster change that may extend the reach of the alliance in the community.

  12. Fostering public cord blood banking and research in Canada.

    Science.gov (United States)

    Isasi, Rosario; Dalpe, Gratien; Knoppers, Bartha M

    2013-12-01

    In June 2013, Canadian Blood Services (CBS) established the National Public Cord Blood Bank (NPCBB) accessible to Canadian and international patients and researchers. The NPCBB promotes efforts that contribute to research and improved clinical care by making units not suitable for banking or transplantation available for research. In the context of the NPCBB of the CBS, this article will focus on the practical tools (e.g., consent protocols) developed to optimize umbilical cord blood (UCB) banking and research while enabling ethical provenance of UCB stem cells. The Canadian approach represents an ideal model for comparison as it is a country in which the national public bank (and other regional/provincial public banks) coexists with private companies.

  13. Fostering change in back pain beliefs and behaviors: when public education is not enough.

    Science.gov (United States)

    Gross, Douglas P; Deshpande, Sameer; Werner, Erik L; Reneman, Michiel F; Miciak, Maxi A; Buchbinder, Rachelle

    2012-11-01

    Mass media campaigns designed to alter societal views and individual behaviors about back pain have been undertaken and evaluated in multiple countries. In contrast to the original Australian campaign, subsequent campaigns have been less successful, with improvements observed in beliefs without the corresponding changes in related behaviors. This article summarizes the results of a literature review, expert panel, and workshop held at the Melbourne International Forum XI: Primary Care Research on Low Back Pain in March 2011 on the role and interplay of various social behavior change strategies, including public education, law and legislation, healthy public policy, and social marketing in achieving a sustained reduction in the societal burden of back pain. Given the complexities inherent to health-related behaviors change, the Rothschild framework is applied in which behavior change strategies are viewed on a continuum from public education at one end through law and health policy at the other. Educational endeavors should likely be augmented with social marketing endeavors and supportive laws and health policy to foster sustained change in outcomes such as work disability and health utilization. Practical suggestions are provided for future interventions aimed at changing back pain-related behaviors. Evaluation of previous back pain mass media campaigns reveals that education alone is unlikely to foster positive and persisting behavioral change without concomitant strategies. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Association between Childhood Sexual Abuse and Transactional Sex in Youth Aging out of Foster Care

    Science.gov (United States)

    Ahrens, Kym R.; Katon, Wayne; McCarty, Carolyn; Richardson, Laura P.; Courtney, Mark E.

    2012-01-01

    Purpose: To evaluate the association between history of childhood sexual abuse (CSA) and having transactional sex among adolescents who have been in foster care. Methods: We used an existing dataset of youth transitioning out of foster care. Independent CSA variables included self report of history of sexual molestation and rape when participants…

  15. Caregiver Involvement in the Education of Youth in Foster Care: An Exploratory Study

    Science.gov (United States)

    Beisse, Kay; Tyre, Ashli

    2013-01-01

    This study was an exploratory investigation of caregiver involvement in the education of youth in foster care. In this study, foster caregivers reported that they are involved in the education of children in their care and participate in at-home involvement activities more often than at-school involvement activities. Caregivers in this study…

  16. Postsecondary Strengths, Challenges, and Supports Experienced by Foster Care Alumni College Graduates

    Science.gov (United States)

    Salazar, Amy M.; Jones, Kevin R.; Emerson, John C.; Mucha, Lauren

    2016-01-01

    Young people transitioning from foster care to college experience unique identities and circumstances that make being successful in college especially challenging. We used qualitative survey data from 248 college graduates who were formerly in foster care to explore the strengths, challenges, and supports they experienced while in college that…

  17. Foster Care Placement, Poor Parenting, and Negative Outcomes among Homeless Young Adults

    Science.gov (United States)

    Tyler, Kimberly A.; Melander, Lisa A.

    2010-01-01

    Although homeless youth with and without foster care histories both face adverse life circumstances, little is known about how these two groups compare in terms of their early histories and whether they face similar outcomes. As such, we compared those with and without a history of foster care placement to determine if the associations between a…

  18. City Kids in the Wilderness: A Pilot-Test of Outward Bound for Foster Care Group Home Youth.

    Science.gov (United States)

    Fischer, Robert L.; Attah, E. B.

    2001-01-01

    A study examined perceptions of a 7-day Outward Bound program among 23 urban youths, foster parents, and foster care workers from group homes in Atlanta (Georgia). Foster parents reported improved self-esteem and behavior among the teens, but foster care workers reported worse behavior. Negative program impressions lessened among male youths but…

  19. A Foster Care Alumna’s Past and Present Technological Experience

    Directory of Open Access Journals (Sweden)

    Cesia Roche

    2015-04-01

    Full Text Available Research on technology use and access among youth raised in non-traditional family structures indicates that the youth’s experiences are different from individuals raised in traditional family structures. Foster care represents a non-traditional family structure that warrants research attention in terms of technology. Using a multicultural feminist framework, the present study explores the past and present technological experience of a woman (30 years old who was raised in the foster care system. The results are presented as a case study documenting her technological experience in foster care, as she transitioned out of the foster care system, and as she has taken on the roles of wife and mother. Results indicated that the participant had limited access to technology while in the foster care system, and this limited technology access related to her current use and perceptions of technology. Directions for future research are provided.

  20. Youth transitioning out of foster care: an evaluation of a Supplemental Security Income policy change.

    Science.gov (United States)

    King, Laura; Rukh-Kamaa, Aneer

    2013-01-01

    Youths with disabilities face numerous challenges when they transition to adulthood. Those who are aging out of foster care face the additional challenge of losing their foster care benefits, although some will be eligible for Supplemental Security Income (SSI) payments after foster care ceases. However, the time needed to process SSI applications exposes those youths to a potential gap in the receipt of benefits as they move between foster care and SSI. We evaluate the effects of a 2010 Social Security Administration policy change that allows such youths to apply for SSI payments 60 days earlier than the previous policy allowed. The change provides additional time for processing claims before the applicant ages out of the foster care system. We examine administrative records on SSI applications from before and after the policy change to determine if the change has decreased the gap between benefits for the target population.

  1. Adapting Parent-Child Interaction Therapy to Foster Care

    Science.gov (United States)

    Mersky, Joshua P.; Topitzes, James; Grant-Savela, Stacey D.; Brondino, Michael J.; McNeil, Cheryl B.

    2016-01-01

    Objective: This study presents outcomes from a randomized trial of a novel Parent-Child Interaction Therapy (PCIT) model for foster families. Differential effects of two intervention doses on child externalizing and internalizing symptoms are examined. Method: A sample of 102 foster children was assigned to one of three conditions--brief PCIT,…

  2. Allowing Family to be Family: End-of-Life Care in Veterans Affairs Medical Foster Homes.

    Science.gov (United States)

    Manheim, Chelsea E; Haverhals, Leah M; Jones, Jacqueline; Levy, Cari R

    2016-01-01

    The Medical Foster Home program is a unique long-term care program coordinated by the Veterans Health Administration. The program pairs Veterans with private, 24-hour a day community-based caregivers who often care for Veterans until the end of life. This qualitative study explored the experiences of care coordination for Medical Foster Home Veterans at the end of life with eight Veterans' family members, five Medical Foster Home caregivers, and seven Veterans Health Administration Home-Based Primary Care team members. A case study, qualitative content analysis identified these themes addressing care coordination and impact of the Medical Foster Home model on those involved: (a) Medical Foster Home program supports Veterans' families; (b) Medical Foster Home program supports the caregiver as family; (c) Veterans' needs are met socially and culturally at the end of life; and (d) the changing needs of Veterans, families, and caregivers at Veterans' end of life are addressed. Insights into how to best support Medical Foster Home caregivers caring for Veterans at the end of life were gained including the need for more and better respite options and how caregivers are compensated in the month of the Veteran's death, as well as suggestions to navigate end-of-life care coordination with multiple stakeholders involved.

  3. The Effect of Medical Treatment of Attention Deficit Hyperactivity Disorder (ADHD) on Foster Care Caseloads: Evidence from Danish Registry Data

    DEFF Research Database (Denmark)

    Fallesen, Peter; Wildeman, Christopher

    Since the early 2000s, foster care caseloads have decreased in many wealthy democracies, yet the causes of these declines remain, for the most part, a mystery. This paper uses administrative data from one country that experienced a sharp decline in foster care caseloads, Denmark, to show that inc...... rate all shape foster care caseloads, future research should be attentive to how medical treatment aimed at addressing children’s acute behavioral problems could also have a powerful effect on foster care caseloads....

  4. 25 CFR 20.508 - What must the social services agency do when a child is placed in foster care, residential care...

    Science.gov (United States)

    2010-04-01

    ... PROGRAMS Child Assistance Foster Care § 20.508 What must the social services agency do when a child is placed in foster care, residential care or guardianship home? The social services agency must make... placed in foster care, residential care or guardianship home? 20.508 Section 20.508 Indians BUREAU OF...

  5. The Socioemotional Development of Orphans in Orphanages and Traditional Foster Care in Iraqi Kurdistan.

    Science.gov (United States)

    Ahmad, Abdulbaghi; Mohamad, Kirmanj

    1996-01-01

    A one-year follow-up study of children who had lost both parents and were placed in orphanages (n=19) or foster homes (n=18) in Iraqi Kurdistan investigated the orphans' situation and development. The children in orphanages were found to have higher frequency of post-traumatic stress disorder than the foster care children. (Author/CR)

  6. Fostering elementary school children’s public speaking skills

    DEFF Research Database (Denmark)

    Herbein, Evelin; Golle, Jessika; Tibus, Maike

    2018-01-01

    Mastering public speaking is a competence which is already required in elementary school. Surprisingly, however, systematic research on the promotion of public speaking competence among elementary school children is scarce. In order to address this gap, we developed and evaluated a public speaking...... the training effects on public speaking skills and speech anxiety. The dependent variables were assessed via self-ratings (extent of public speaking skills, speech anxiety) and video ratings of a public speech (appropriateness of public speaking skills). Findings revealed positive training effects on public...... speaking skills overall: Participating in the training elicited more appropriate speeches in terms of nonverbal and organizational skills but did not influence speech anxiety....

  7. Protection of Children in Malaysia through Foster Care Legislation and Policy

    Directory of Open Access Journals (Sweden)

    Azizah Mohd

    2012-01-01

    Full Text Available Children are immature, naive and unable to care for themselves. Due to this verynature of children, they are in need of among others, care, attention andsupervision from adults. Care, attention and supervision are among the means ofcare and protection of children, which can only be acquired in a familyenvironment. One of the ways to achieve family environment is through FosterCare where a child who is in need of care and protection will be placed with afamily permanently or temporarily or until they are able to care for themselves.Foster care will at least provide for a family life experience especially for childrenwithout family or who have problems in their family life. This paper is to examinethe Concept of Foster care in Malaysia and the law relating to it as to provideprotection to children in need of care and protection. Examination will focus onrelevant legislations and policy relating to Foster Care. Discussion will extend toanalysis on whether the available laws and policies are adequate to sustainchildren protection in Malaysia through Foster Care.

  8. Career mentoring needs of youths in foster care: voices for change.

    Science.gov (United States)

    Hudson, Angela L

    2013-05-01

    Adolescents with a history of foster care placement are more likely to become homeless, have mental illness, become parents too early in life, or become incarcerated within the juvenile justice/prison system. In addition, a low percentage of young adults, who formerly were in foster care, complete vocational training or higher education. This was a qualitative study, using focus group methodology. Four focus group sessions were conducted with youth living in foster care. The purpose was to obtain their perceptions about mentoring. Focus groups comprised six to eight youths per group and were guided by a semi-structured interview guide. A total of 27 youth in foster care participated in focus group interviews. Mean age was 16.4 (SD = 0.68) years. Youth participants were very knowledgeable about mentoring programs for at-risk youth, along with negative psychosocial outcomes experienced by former foster youth. However, they remarked that they are given few opportunities for career mentoring. The overall themes that emerged from narrative data were needing and finding authority figures, hooking up with a career mentor, and deserving the good life. Career mentoring is an affordable and feasible intervention for child welfare agencies. This could lead to more motivated and prepared youth living in foster care for vocational training or higher education. Learning opportunities from a career mentor may be a lifeline for preventing negative psychosocial outcomes for foster youth, reward achievement goals, and improve overall quality of life in emerging adulthood. © 2013 Wiley Periodicals, Inc.

  9. 25 CFR 20.509 - What must the social services worker do when a child is placed in foster care or residential care...

    Science.gov (United States)

    2010-04-01

    ... home or residential care facility to law enforcement and protective services in accordance with tribal... Assistance Foster Care § 20.509 What must the social services worker do when a child is placed in foster care... tribal or state licensed foster home or residential care facility evaluating how the home has fulfilled...

  10. Good caring and vocabularies of motive among foster carers

    Directory of Open Access Journals (Sweden)

    Jennifer Doyle

    2013-12-01

    Full Text Available Employing C. Wright Mills’ concept of vocabulary of motives, this article examines the motives and attitudes of people who volunteer to foster children with high support needs. Data is drawn from a larger qualitative study involving indepth interviewing of 23 carers. When asked why they had become foster carers participants produced conventional accounts of child-centred altruistic motives–an acceptable vocabulary of motives which satisfied institutional and cultural expectations regarding caregiving. However, closer examination of participants’ experiences and attitudes revealed the likelihood that economic motives were also factors in decisions to foster. It is argued that participants chose to exclude economic motives from their accounts so as to avoid the risk of being seen to be ‘doing it for the money’.

  11. Fostering dignity in the care of nursing home residents through slow caring

    DEFF Research Database (Denmark)

    Lohne, Vibeke; Høy, Bente; Lillestø, Britt

    2017-01-01

    Background: Physical impairment and dependency on others may be a threat to dignity. Research questions: The purpose of this study was to explore dignity as a core concept in caring, and how healthcare personnel focus on and foster dignity in nursing home residents. Research design: This study has...... personnel, maintaining human dignity requires slow caring in nursing homes, as an essential approach....... a hermeneutic design. Participants and research context: In all, 40 healthcare personnel from six nursing homes in Scandinavia participated in focus group interviews in this study. Ethical considerations: This study has been evaluated and approved by the Regional Ethical Committees and the Social Science Data...

  12. Development and piloting of a treatment foster care program for older youth with psychiatric problems.

    Science.gov (United States)

    McMillen, J Curtis; Narendorf, Sarah Carter; Robinson, Debra; Havlicek, Judy; Fedoravicius, Nicole; Bertram, Julie; McNelly, David

    2015-01-01

    Older youth in out-of-home care often live in restrictive settings and face psychiatric issues without sufficient family support. This paper reports on the development and piloting of a manualized treatment foster care program designed to step down older youth with high psychiatric needs from residential programs to treatment foster care homes. A team of researchers and agency partners set out to develop a treatment foster care model for older youth based on Multi-dimensional Treatment Foster Care (MTFC). After matching youth by mental health condition and determining for whom randomization would be allowed, 14 youth were randomized to treatment as usual or a treatment foster home intervention. Stakeholders were interviewed qualitatively at multiple time points. Quantitative measures assessed mental health symptoms, days in locked facilities, employment and educational outcomes. Development efforts led to substantial variations from the MTFC model and a new model, Treatment Foster Care for Older Youth was piloted. Feasibility monitoring suggested that it was difficult, but possible to recruit and randomize youth from and out of residential homes and that foster parents could be recruited to serve them. Qualitative data pointed to some qualified clinical successes. Stakeholders viewed two team roles - that of psychiatric nurse and skills coaches - very highly. However, results also suggested that foster parents and some staff did not tolerate the intervention well and struggled to address the emotion dysregulation issues of the young people they served. Quantitative data demonstrated that the intervention was not keeping youth out of locked facilities. The intervention needed further refinement prior to a broader trial. Intervention development work continued until components were developed to help address emotion regulation problems among fostered youth. Psychiatric nurses and skills coaches who work with youth in community settings hold promise as important

  13. Social and Psychological Adjustment in Foster Care Alumni: Education and Employment

    OpenAIRE

    Archakova T.O.

    2015-01-01

    The article analyses issues in social and psychological adjustment of young adults, grown up in foster families. The psychological and socio-pedagogical factors facilitating professional education, successful employment and financial independence are emphasized. The methods and results of several large simple design researches of adjustment in foster care alumni, conducted in USA, are described. Recommendations for services and specialists working with young adults leaving state care are prov...

  14. What is work? Insights from the evolution of state foster care

    OpenAIRE

    Kirton, Derek

    2013-01-01

    This article focuses on state foster care as a case study in the (re)configuration and negotiation of boundaries between work and non-work. Foster care can be seen as occupying a liminal position between the domains of ‘work’ and ‘family’, requiring management of the tensions presumed to exist between competing value systems. Through a review of research and policy developments, the relevant boundary issues are contextualized and explored, drawing examples from areas such as remuneration, tax...

  15. Reaching everyone: Promoting the inclusion of youth with disabilities in evaluating foster care outcomes

    Science.gov (United States)

    Blakeslee, Jennifer E.; Quest, A. Del; Powers, Jennifer; Powers, Laurie E.; Geenen, Sarah; Nelson, May; Dalton, Lawrence D.; McHugh, Elizabeth

    2013-01-01

    Efforts to evaluate foster care outcomes must avoid systematic exclusion of particular groups. Although often unrecognized as such, youth with disabilities are highly overrepresented in the U.S. foster care system, and yet youth with some disabilities, including those with intellectual, serious emotional, and physical impairments may be underrepresented in research and evaluation studies evaluating foster care outcomes. The recruitment and retention of youth with various disabilities in such studies can be impeded by under-identification of disability and relatively high placement and school mobility. Furthermore, youth with various disabilities may experience more disappointing outcomes than foster youth overall, underscoring the importance of including these youth in outcome tracking efforts. This is especially relevant given the recent implementation of the National Youth in Transition Database (NYTD), which requires that state child welfare agencies gather baseline information about youth in foster care at age 17, and then survey outcomes at 19 and 21. To promote the full participation of foster youth with disabilities in such outcome evaluation, this paper describes successful strategies for identifying and retaining participants that were used in three separate longitudinal intervention studies. These strategies include the systematic recruitment of foster youth by special education status, and creative use of validated tracking and retention strategies incorporating minor accommodations as needed. PMID:24273364

  16. Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.

    Science.gov (United States)

    Vanderwerker, Lauren; Akincigil, Ayse; Olfson, Mark; Gerhard, Tobias; Neese-Todd, Sheree; Crystal, Stephen

    2014-10-01

    The authors investigated the extent to which clinical diagnoses of externalizing disorders explain higher rates of antipsychotic use by foster care youths. Medicaid claims data from 44 states for 2009 for youths in foster care (N=301,894) and those not in foster care (N=5,092,574) were analyzed, excluding those with schizophrenia, bipolar disorder, autism, and major depressive disorder. Logistic regressions assessed the relationship between foster care, externalizing disorders, and antipsychotic use. Foster care youths had higher rates of externalizing disorders than the comparison group (attention-deficit hyperactivity disorder, 17.3% versus 6.5%; disruptive behavior disorder, 7.2% versus 2.5%; conduct disorder, 2.3% versus .5%) and greater antipsychotic use (7.4% versus 1.4%). Foster care remained a significant predictor of antipsychotic use after control for demographic and diagnostic covariates, including externalizing disorders (adjusted odds ratio=2.59, 95% confidence interval=2.54-2.63). High rates of externalizing disorder diagnoses only partially explained elevated levels of antipsychotic use in this vulnerable population.

  17. Disruptions in foster care: A review and meta-analysis

    NARCIS (Netherlands)

    Oosterman, M.; Schuengel, C.; Slot, N.W.; Bullens, R.A.R.; Doreleijers, T.A.H.

    2007-01-01

    This review examined risk and protective factors associated with placement breakdown across k = 26 studies of 20,650 children in foster families. A series of meta-analyses were performed to assess the average effect sizes across multiple studies on the same factors. Older age at placement (k = 15),

  18. 78 FR 26219 - National Foster Care Month, 2013

    Science.gov (United States)

    2013-05-03

    ... love, protection, and stability of a permanent family. This month, we recommit to giving them that..., family members--individuals dedicated to making a difference. As they lend their strength to our most... be an adoptive or foster parent. And we will support programs that help increase permanency, reduce...

  19. Pregnancy Rates among Juvenile Justice Girls in Two Randomized Controlled Trials of Multidimensional Treatment Foster Care

    Science.gov (United States)

    Kerr, David C. R.; Leve, Leslie D.; Chamberlain, Patricia

    2009-01-01

    Preventing adolescent pregnancy is a national research priority that has had limited success. In the present study, the authors examined whether Multidimensional Treatment Foster Care (MTFC) relative to intervention services as usual (group care [GC]) decreased pregnancy rates among juvenile justice girls mandated to out-of-home care. Girls (13-17…

  20. Extended Foster Care for Transition-Age Youth: An Opportunity for Pregnancy Prevention and Parenting Support.

    Science.gov (United States)

    Putnam-Hornstein, Emily; Hammond, Ivy; Eastman, Andrea Lane; McCroskey, Jacquelyn; Webster, Daniel

    2016-04-01

    This analysis examined California county birth rate variations among girls in foster care. The objective was to generate data to assess potential intervention points tied to federal legislation extending foster care beyond age 18 years. Child protection records for all adolescent girls in foster care at age 17 years between 2003 and 2007 (N = 20,222) were linked to vital birth records through 2011. The cumulative percentage of girls who had given birth by age 21 years was calculated by county and race/ethnicity. One in three (35.2%) adolescent girls in foster care had given birth at least once before age 21 years. Although significant birth rate variations emerged, even at the low end of the county range, more than one in four girls had given birth by age 21 years. Child welfare systems are now charged with coordinating transitional services for foster youth beyond age 18 years. Extended foster care provides new opportunities for pregnancy prevention work and targeted parenting support. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. Family foster care: a protective alternative for children and adolescents / Acolhimento familiar: uma alternativa de proteção para crianças e adolescentes

    Directory of Open Access Journals (Sweden)

    Nina Rosa do Amaral Costa

    2009-01-01

    Full Text Available Foster care of children and adolescents who have had their rights violated is being discussed both in the scientific literature and in agencies involved in the development of public policies. Such discussions, which aim to define some guidelines to guarantee the right to family and community inclusion, expose a field under change. This paper focuses on foster care in the Brazilian context and presents it as one of the possible alternatives for children and adolescents in risk situations. The (misleading influences of some theoretical perspectives that deal with affective bonds in foster care are also discussed. It is argued that a new foster culture requires changes in the conceptions of infancy and youth, in the meanings of affectionate bonds, and in welfare policies for children and adolescents.

  2. Usage and Quality of Formal Child Care Services Experienced by Infants and Toddlers in Foster and Kinship Care: An Australian Study

    Science.gov (United States)

    Wise, Sarah

    2018-01-01

    This research uses data from the Early Childhood in Foster and Kinship Care (ECIFKC) study to identify the proportion of young children, under 2 years of age, in foster and kinship care who use formal child care; weekly hours of child care; predictors of weekly hours of child care; and quality of care experienced. The sample for these analyses…

  3. Children in family foster care have greater health risks and less involvement in Child Health Services.

    Science.gov (United States)

    Köhler, M; Emmelin, M; Hjern, A; Rosvall, M

    2015-05-01

    This study investigated the impact of being in family foster care on selected health determinants and participation in Child Health Services (CHS). Two groups of 100 children, born between 1992 and 2008, were studied using data from Swedish Child Health Services for the preschool period up to the age of six. The first group had been in family foster care, and the controls, matched for age, sex and geographic location, had not. Descriptive statistics were used to describe differences in health determinants and participation in Child Health Services between the two groups. The foster care group had higher health risks, with lower rates of breastfeeding and higher levels of parental smoking. They were less likely to have received immunisations and attended key nurse or physician visits and speech and vision screening. Missing data for the phenylketonuria test were more common in children in family foster care. Children in family foster care were exposed to more health risks than the control children and had lower participation in the universal child health programme during the preschool period. These results call for secure access to high-quality preventive health care for this particularly vulnerable group of children. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  4. Using a Deliberative Exercise to Foster Public Engagement in Nanotechnology

    Science.gov (United States)

    Jones, Angela R.; Anderson, Ashley A.; Yeo, Sara K.; Greenberg, Andrew E.; Brossard, Dominique; Moore, John W.

    2014-01-01

    Nanotechnology is an emerging technology poised to benefit society both technically and socially, but as with any new advance, there is potential risk. This paper describes a novel deliberative exercise involving nanotechnology that engages the public in debate regarding the funding of nanotechnology-related research while also discussing…

  5. Treatment Foster Care for Improving Outcomes in Children and Young People: A Systematic Review

    Science.gov (United States)

    Turner, William; Macdonald, Geraldine

    2011-01-01

    Objective: To assess the impact of treatment foster care (TFC) on psychosocial and behavioral outcomes, delinquency, placement stability, and discharge status for children and adolescents who, for reasons of severe medical, social, psychological and behavioural problems, were placed in out-of-home care in restrictive settings or at risk of…

  6. Temperament, disordered attachment and parental sensitivity in foster care: Differential findings on attachment security for shy children

    NARCIS (Netherlands)

    de Schipper, J.C.; Oosterman, M.; Schuengel, C.

    2012-01-01

    In a foster care sample, the moderating effect of temperamental shyness on the association between parental sensitivity and attachment quality was tested. The foster parents of 59 foster children (age M=57 months, SD=16.4) filled out the Child Behavior Questionnaire. To control for confounds,

  7. Using GIS to enhance programs serving emancipated youth leaving foster care.

    Science.gov (United States)

    Batsche, Catherine J; Reader, Steven

    2012-02-01

    This article describes a GIS prototype designed to assist with the identification and evaluation of housing that is affordable, safe, and effective in supporting the educational goals and parental status of youth transitioning from foster care following emancipation. Spatial analysis was used to identify rental properties based on three inclusion criteria (affordability, proximity to public transportation, and proximity to grocery stores), three exclusion criteria (areas of high crime, prostitution, and sexual predator residence), and three suitability criteria (proximity to health care, mental health care, and youth serving organizations). The results were applied to four different scenarios to test the utility of the model. Of the 145 affordable rental properties, 27 met the criteria for safe and effective housing. Of these, 19 were located near bus routes with direct service to post-secondary education or vocational training programs. Only 6 were considered appropriate to meet the needs of youth who had children of their own. These outcomes highlight the complexities faced by youth when they attempt to find affordable and suitable housing following emancipation. The LEASE prototype demonstrates that spatial analysis can be a useful tool to assist with planning services for youth making the transition to independent living. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Fostering development of nursing practices to support integrated care when implementing integrated care pathways: what levers to use?

    Science.gov (United States)

    Longpré, Caroline; Dubois, Carl-Ardy

    2017-11-29

    Care integration has been the focus of recent health system reforms. Given their functions at all levels of the care continuum, nurses have a substantial and primordial role to play in such integration processes. The aim of this study was to identify levers and strategies that organizations can use to support the development of a nursing practice aligned with the requirements of care integration in a health and social services centre (HSSC) in Quebec. The research design was a cross-sectional descriptive qualitative study based on a single case study with nested levels of analysis. The case was a public, multi-disciplinary HSSC in a semi-urban region of Quebec. Semi-structured interviews with 37 persons (nurses, professionals, managers, administrators) allowed for data saturation and ensured theoretical representation by covering four care pathways constituting different care integration contexts. Analysis involved four steps: preparing a predetermined list of codes based on the reference framework developed by Minkman (2011); coding transcript content; developing general and summary matrices to group observations for each care pathway; and creating a general model showing the overall results for the four pathways. The organization's capacity for response with regard to developing an integrated system of services resulted in two types of complementary interventions. The first involved investing in key resources and renewing organizational structures; the second involved deploying a series of organizational and clinical-administrative processes. In resource terms, integration efforts resulted in setting up new strategic services, re-arranging physical infrastructures, and deploying new technological resources. Organizational and clinical-administrative processes to promote integration involved renewing governance, improving the flow of care pathways, fostering continuous quality improvement, developing new roles, promoting clinician collaboration, and strengthening

  9. Perceived social environment and adolescents' well-being and adjustment: Comparing a foster care sample with a matched sample

    OpenAIRE

    Farruggia, SP; Greenberger, E; Chen, C; Heckhausen, J

    2006-01-01

    Previous research has demonstrated that former foster care youth are at risk for poor outcomes (e.g., more problem behaviors, more depression, lower self-esteem, and poor social relationships). It is not clear, however, whether these findings reflect preemancipation developmental deficits. This study used 163 preemancipation foster care youth and a matched sample of 163 comparison youth. Results showed that foster-care youth did not differ from the comparison sample on measures of well-being,...

  10. Providing a secure base: parenting children in long-term foster family care.

    Science.gov (United States)

    Schofield, Gillian; Beek, Mary

    2005-03-01

    This paper reports on a longitudinal study of children growing up in long-term foster family care. It focuses attention on the challenges for foster carers in providing a secure base for foster children in middle childhood and early adolescence, who have come predominantly from backgrounds of abuse, neglect, and psychosocial adversity. Separation and loss in the children's lives, often through multiple placements, increase the likelihood of difficulties across a range of development. These children tend to be wary, distrustful, and controlling when they enter foster placements, but need from their carers many of the caregiving qualities most commonly described as providing a secure base in infancy. This study describes a model of parenting which uses four caregiving dimensions that are consistent with attachment theory and research: promoting trust in availability, promoting reflective function, promoting self-esteem, and promoting autonomy. A fifth dimension, promoting family membership, is added, as it reflects the need for children in long-term foster family care to experience the security that comes from a sense of identity and belonging. Qualitative data from the study demonstrates the usefulness of this model as a framework for analysis, but also suggests the potential use of such a framework for working with and supporting foster carers.

  11. Effect of Foster Care on Language Learning at Eight Years: Findings from the Bucharest Early Intervention Project

    Science.gov (United States)

    Windsor, Jennifer; Moraru, Ana; Nelson, Charles A., III.; Fox, Nathan A.; Zeanah, Charles H.

    2013-01-01

    This study reports on language outcomes at eight years from the Bucharest Early Intervention Project, a randomized controlled study of foster care. We previously have shown that children placed in foster care by age two have substantially stronger preschool language outcomes than children placed later and children remaining in institutional care.…

  12. Validating office-based screening for psychosocial strengths and difficulties among youths in foster care.

    Science.gov (United States)

    Jee, Sandra H; Szilagyi, Moira; Conn, Anne-Marie; Nilsen, Wendy; Toth, Sheree; Baldwin, Constance D; Szilagyi, Peter G

    2011-05-01

    To assess the effectiveness of social-emotional screening in the primary care setting for youths in foster care. The setting was a primary care practice for all youth in home-based foster care in 1 county. Subjects were youths, aged 11 to 17 years, and their foster parents; both completed a Strengths and Difficulties Questionnaire at well-child visits. The Strengths and Difficulties Questionnaire is a previously validated 25-item tool that has 5 domains: emotional symptoms; conduct problems; hyperactivity/inattention; peer problems; and prosocial behaviors and an overall total difficulties score. We first compared youth versus parent Strengths and Difficulties Questionnaire scores and then assessed the accuracy of these Strengths and Difficulties Questionnaire scores by comparing them in a subsample of youths (n = 50) with results of home-based structured clinical interviews using the Children's Interview for Psychiatric Syndromes. Of 138 subjects with both youth and parent reports, 78% had prosocial behaviors (strengths), and 70% had 1 or more social-emotional problems. Parents reported significantly more conduct problems (38% vs 16%; P youth. The Strengths and Difficulties Questionnaire had better agreement with the Children's Interview for Psychiatric Syndromes (n = 50) for any Strengths and Difficulties Questionnaire-identified problem for combined youth and foster-parent reports (93%), compared with youth report alone (54%) or parent report alone (71%). Although most youths in foster care have social-emotional problems, most have strengths as well. Youth and foster-parent perspectives on these problems differ. Systematic social-emotional screening in primary care that includes both youth and parent reports can identify youths who may benefit from services.

  13. The effect of medical treatment of attention deficit hyperactivity disorder (ADHD) on foster care caseloads

    DEFF Research Database (Denmark)

    Fallesen, Peter; Wildeman, Christopher

    2015-01-01

    = 157,938) in the period from 1998 to 2010 to show that increasing medical treatment of attention deficit hyperactivity disorder (ADHD) accounts for a substantial share of the decrease in foster care caseloads. According to our estimates, the decline in foster care caseloads during this period would...... have been 45% smaller absent increases in medical treatment of ADHD. These findings are especially provocative in light of recent research showing ambiguous effects of medical treatment of ADHD. Future research should be attentive to how medical treatment aimed at addressing children’s acute behavioral...

  14. Characterizing and fostering charity care in the surgeon workforce.

    Science.gov (United States)

    Wright, D Brad; Scarborough, John E

    2011-07-01

    We sought to determine which demographic and practice characteristics are associated with both a surgeon's willingness to provide any charity care as well as the amount of charity care provided. Although it is known that surgeons tend to provide a greater amount of charity care than other physicians, no studies have attempted to look within the surgeon population to identify which factors lead some surgeons to provide more charity care than others. Using 4 rounds of data from the Community Tracking Study, we employ a 2-part multivariate regression model with fixed effects. A greater amount of charity care is provided by surgeons who are male, practice owners, employed in academic medical centers, or earn a greater proportion of their revenue from Medicaid. Surgeons who work in a group HMO are significantly less likely to provide any charity care. Personal resources (eg, time and money) had a minimal association with charity care provision. Surgeons whose characteristics are associated with a greater propensity for charity care provision as suggested by this study, should be considered as a potential source for building the volunteer workforce.

  15. Foster Care Dynamics and System Science: Implications for Research and Policy.

    Science.gov (United States)

    Wulczyn, Fred; Halloran, John

    2017-10-05

    Although system is a word frequently invoked in discussions of foster care policy and practice, there have been few if any attempts by child welfare researchers to understand the ways in which the foster care system is a system. As a consequence, insights from system science have yet to be applied in meaningful ways to the problem of making foster care systems more effective. In this study, we draw on population biology to organize a study of admissions and discharges to foster care over a 15-year period. We are interested specifically in whether resource constraints, which are conceptualized here as the number of beds, lead to a coupling of admissions and discharges within congregate care. The results, which are descriptive in nature, are consistent with theory that ties admissions and discharges together because of a resource constraint. From the data, it is clear that the underlying system exerts an important constraint on what are normally viewed as individual-level decisions. Our discussion calls on extending efforts to understand the role of system science in studies of child welfare systems, with a particular emphasis on the role of feedback as a causal influence.

  16. Safeguarding children and youth in residential and foster care: Supporting healthy sexual development

    DEFF Research Database (Denmark)

    Hansen, Gitte Riis; Grandal*, Niels

    (in 2012) to report on sexual and physical violence, that raised awareness on the subject. The investigations showed that professionals perceive very few of the cases of sexual abuse in residential and foster care and in many cases the perpetrators turn out to be peers. This drew attention......In The Netherlands, Denmark and Scotland special awareness on the subject of sexual abuse and sexual exploitation was raised by national investigations on the prevalence and content of sexual abuse in residential and foster care. In Flanders (Belgium) it was the start of the so called Helpline 1712...... to a central issue: the incapability of professionals to support a healthy sexual development and discuss sexual behaviour with children and young people, their (foster) parents and other professionals. Sex is a subject that is not easily talked about and most professionals feel insecure about. Moreover...

  17. [Mental health of preschool foster care children: How do foster families influence the way children cope with trauma?].

    Science.gov (United States)

    Vasileva, Mira; Petermann, Franz

    2017-08-15

    Parents and other significant persons have an important role when preschool children develop or cope with psychological symptoms following traumatic experiences. The underlying mechanisms of the interaction between traumatic experiences and influences of the foster family are still unclear. This study investigates foster parents’ stress levels and parenting styles as moderators or mediators in the context of traumatic experiences. Foster parents of 286 children between three and seven years participated in an online or paper-and-pencil survey. The results suggest a connection between the traumatic experiences of foster children and the stress levels as well as the parenting styles of their foster parents. While verbosity and laxness as parenting styles moderated the impact of traumatic experiences on externalising symptoms, stress levels mediated the impact of traumatic experiences on children’s internalising and externalising symptoms. The results underscore the necessity of standardized preparation of and support for foster parents in order to avoid deterioration of psychological symptoms following traumatic Events.

  18. Incremental Net Benefit of Early Intervention for Preschool-Aged Children with Emotional and Behavioral Problems in Foster Care.

    Science.gov (United States)

    Lynch, Frances L; Dickerson, John F; Saldana, Lisa; Fisher, Phillip A

    2014-01-01

    Of 1 million cases of child maltreatment identified every year in the United States, one-fifth result in foster care. Many of these children suffer from significant emotional and behavioral conditions. Decision-makers must allocate highly constrained budgets to serve these children. Recent evidence suggests that Multidimensional Treatment Foster Care for Preschoolers can reduce negative outcomes for these children, but the relative benefits and costs of the program have not been evaluated. The objective of this study was to assess net benefit, over 24 months, of Multidimensional Treatment Foster Care for Preschoolers compared to regular foster care. Data were from a randomized controlled trial of 117 young children entering a new foster placement. A subsample exhibited placement instability (n = 52). Intervention services including parent training, lasted 9-12 months. Multidimensional Treatment Foster Care for Preschoolers significantly increased permanent placements for the placement instability sample. Average total cost for the new intervention sample was significantly less than for regular foster care (full sample: $27,204 vs. $30,090; P = .004; placement instability sample: $29,595 vs. $36,061; P = .045). Incremental average net benefit was positive at all levels of willingness to pay of zero or greater, indicating that the value of benefits exceeded costs. Multidimensional Treatment Foster Care for Preschoolers has significant benefit for preschool children in foster care with emotional and behavioral disorders compared to regular foster care services. At even modest levels of willingness to pay, benefits exceed costs indicating a strong likeliness that this program is an efficient choice for improving outcomes for young children with emotional and behavioral disorders in foster care.

  19. Kinship and Nonrelative Foster Care: The Effect of Placement Type on Child Well-Being

    Science.gov (United States)

    Font, Sarah A.

    2014-01-01

    This study uses a national sample of 1,215 children, ages 6-17, who spent some time in formal kinship or nonrelative foster care to identify the effect of placement type on academic achievement, behavior, and health. Several identification strategies are used to reduce selection bias, including ordinary least squares, change score models,…

  20. You Can't Fight the System: Strategies of Family Justice in Foster Care Reintegration.

    Science.gov (United States)

    Crenshaw, Wes; Barnum, David

    2001-01-01

    Discusses the issue of justice in family therapy interventions and shares several strategies and ways of thinking about the therapy of foster care. Illustrates a case study and the interventions used to restore justice to a family caught up in the "system." (GCP)

  1. Maltreatment, Coping, and Substance Use in Youth in Foster Care: Examination of Moderation Models.

    Science.gov (United States)

    Gabrielli, Joy; Jackson, Yo; Huffhines, Lindsay; Stone, Katie

    2018-05-01

    Child maltreatment is associated with negative outcomes such as substance use (SU). This study tested relations among maltreatment history, coping behavior, and SU behavior in youth residing in foster care. Participants were 210 youth ( M age = 12.71 years; SD = 2.95) in foster care who completed self-report measures through an audio computer-assisted self-interview program. Using a structural equation modeling framework and latent measurement constructs, positive associations were identified between maltreatment at baseline and coping behavior outcomes as well as SU behavior outcome approximately 4.5 months later. Specifically, greater severity and chronicity of maltreatment was associated with greater SU behavior as well as indirect action, prosocial, and asocial coping behavior. Maltreatment was not significantly related to direct action coping behavior. In moderation tests, only asocial coping provided a significant interaction effect for SU behavior outcomes; SU behavior did not moderate pathways between maltreatment and coping behavior. For youth in foster care, the coping approach may be varied and relate differentially to SU behavior outcomes, with asocial approaches to coping acting as a buffer for the maltreatment/SU relation. Additionally, SU remains an important target for intervention and prevention in youth residing in foster care.

  2. Child Welfare-Involved Youth with Intellectual Disabilities: Pathways into and Placements in Foster Care

    Science.gov (United States)

    Slayter, Elspeth; Springer, Cheryl

    2011-01-01

    Existing literature suggests that youth with intellectual disabilities are at increased risk for child maltreatment. Little is known about youth with intellectual disabilities who are supervised by child welfare authorities or living in foster care. Reasons for child welfare system involvement and placement types are explored. In this…

  3. Creating Access to Opportunities for Youth in Transition from Foster Care. An AYPF Policy Brief

    Science.gov (United States)

    Russ, Erin; Fryar, Garet

    2014-01-01

    What happens to youth in foster care when they turn 18? Many face unprecedented challenges like homelessness, lack of financial resources, difficulty accessing educational opportunities, and unemployment. In this issue brief, The American Youth Policy Forum (AYPF) document these challenges and opportunities in three distinct yet overlapping areas…

  4. Educational Supports for Middle School Youths Involved in the Foster Care System

    Science.gov (United States)

    Tyre, Ashli D.

    2012-01-01

    Despite our knowledge of poor educational outcomes for youths in foster care, the literature on methods or models for addressing the needs of this vulnerable group of students remains extremely limited. Therefore, the purpose of the present study is to describe a school-based educational support model that provides advocacy, tutoring, and…

  5. Psychosocial Needs of Children in Foster Care and the Impact of Sexual Abuse

    NARCIS (Netherlands)

    Steenbakkers, Annemarie; Ellingsen, Ingunn; van der Steen, Stephanie; Grietens, Hans

    Children in family foster care, especially those who have experienced sexual abuse, require a safe and nurturing environment in which their psychosocial needs are met. However, there is limited knowledge on how youth prioritize various needs and what impact previous experiences have on these needs.

  6. Mentoring and Social Skills Training: Ensuring Better Outcomes for Youth in Foster Care

    Science.gov (United States)

    Williams, Charles A.

    2011-01-01

    Youth in foster care face significant life challenges that make it more likely that they will face negative outcomes (i.e., school failure, homelessness, and incarceration). While the reason(s) for out-of-home placement (i.e., family violence, abuse, neglect and/or abandonment) provide some context for negative outcomes, such negative outcomes…

  7. Child welfare services involvement among the children of young parents in foster care.

    Science.gov (United States)

    Dworsky, Amy

    2015-07-01

    Despite the high rate of early parenthood among youth in foster care as well as the increased risk of child maltreatment among children whose adolescent parents have been neglected or abused, very little is known about child welfare services involvement among children whose parents were in foster care when they were born. This study uses administrative data from the Illinois Department of Children and Family Services (DCFS) to examine the occurrence of child abuse and neglect investigations, indicated reports and out of home care placements among the children of youth in foster. Thirty-nine percent of the children were the subject of at least one CPS investigation, 17 percent had at least one indicated report and 11 percent were placed in out of home care at least once before their 5th birthday. Cox proportional hazard models are also estimated to identify characteristics of parenting foster youth and their placement histories associated with the risk of child welfare services involvement. Implications of the findings for policy and practice are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Using GIS Mapping to Assess Foster Care: A Picture Is Worth a Thousand Words

    Science.gov (United States)

    Rine, Christine M.; Morales, Jocelyn; Vanyukevych, Anastasiya B.; Durand, Emily G.; Schroeder, Kurt A.

    2012-01-01

    Geographic Information Systems (GIS) have become widely used outside of traditional mapping applications, expanding their reach to social service organizations. The purpose of this article is to describe and explore the benefits of GIS mapping in identifying strengths and needs of foster care systems in rural settings through graphically assessing…

  9. Supportive Housing for Homeless Families: Foster Care Outcomes and Best Practices. Summary

    Science.gov (United States)

    Lenz-Rashid, Sonja

    2013-01-01

    The "Supportive Housing for Homeless Families: Foster Care Outcomes and Best Practices" report describes the outcome evaluation of Cottage Housing Incorporated's Serna Village program in Sacramento, California. Serna Village is a supportive housing program serving homeless families. Outcomes from the program illustrate that it is…

  10. Mentoring for Young People Leaving Foster Care: Promise and Potential Pitfalls

    Science.gov (United States)

    Spencer, Renee; Collins, Mary Elizabeth; Ward, Rolanda; Smashnaya, Svetlana

    2010-01-01

    Mentoring for youths transitioning out of the foster care system has been growing in popularity as mentoring programs have enjoyed unprecedented growth in recent years. However, the existing empirical literature on the conditions associated with more effective youth mentoring relationships and the potential for harm in their absence should give us…

  11. Identification of Social-Emotional Problems among Young Children in Foster Care

    Science.gov (United States)

    Jee, Sandra H.; Conn, Anne-Marie; Szilagyi, Peter G.; Blumkin, Aaron; Baldwin, Constance D.; Szilagyi, Moira A.

    2010-01-01

    Background: Little is known about how best to implement behavioral screening recommendations in practice, especially for children in foster care, who are at risk for having social-emotional problems. Two validated screening tools are recommended for use with young children: the Ages and Stages Questionnaire: Social Emotional (ASQ-SE) identifies…

  12. The Value of a College Degree for Foster Care Alumni: Comparisons with General Population Samples

    Science.gov (United States)

    Salazar, Amy M.

    2013-01-01

    Higher education is associated with substantial adult life benefits, including higher income and improved quality of life, among others. The current study compared adult outcomes of 250 foster care alumni college graduates with two samples of general population graduates to explore the role higher education plays in these young adults' lives.…

  13. The Educational Professional: The Educational Experiences that Enhanced and Impeded the Academic Outcome of Youth in Foster Care

    Science.gov (United States)

    Chisholm, Gloria

    2010-01-01

    A child in foster care is often categorized as a student at risk for school failure. However, children in foster care face a unique challenge in that most have been involuntarily separated from their biological parent and/or family. The schools must work in collaboration with the child to provide the necessary supports to achieve better…

  14. Supporting Youth Transitioning out of Foster Care. Issue Brief 1: Education Programs. OPRE Report No. 2014-66

    Science.gov (United States)

    Dworsky, Amy; Smithgall, Cheryl; Courtney, Mark E.

    2014-01-01

    Youth transitioning out of foster care and into adulthood need many supports to navigate the challenges they face. Over the past three decades, federal child welfare policy has significantly increased the availability of those supports. In 1999, the Foster Care Independence Act amended Title IV-E of the Social Security Act to create the Chafee…

  15. The Impact of Student Services on First Year Persistence from Emancipated Foster Care Community College Students' Perceptions

    Science.gov (United States)

    Murphy, Ralph Frederick, II

    2016-01-01

    The abysmal persistence to completion rate for at-risk student populations is a concern for higher education leaders; especially, emancipated foster care community college students. Multiple data sources indicate foster care youth are more likely to enroll at community colleges than four-year universities. For this reason, the first-year…

  16. Substance Use and Mental Health Problems as Predictors of HIV Sexual Risk Behaviors among Adolescents in Foster Care

    Science.gov (United States)

    Thompson, Ronald G., Jr.; Auslander, Wendy F.

    2011-01-01

    This study examined the relationship between substance use, mental health problems, and HIV sexual risk behaviors among a sample of foster care adolescents. Data were collected through structured baseline interviews with 320 adolescents (ages 15 to 18 years) who resided in foster care placements and participated in a larger evaluation study of an…

  17. Understanding the Relationships between Attachment Styles, Locus of Control, School Maladaptation, and Depression Symptoms among Students in Foster Care

    Science.gov (United States)

    Jankowska, Anna M.; Lewandowska-Walter, A.; Chalupa, A. A.; Jonak, Jolanta; Duszynski, Ramzia; Mazurkiewicz, N.

    2015-01-01

    Altered family experiences place children in foster care at risk for school adjustment difficulties. This study focuses on exploring the differences in school adaptation, locus of control, depression symptoms, and attachment styles among children in foster care and children raised by their biological parents. Sixty children completed self-report…

  18. Mental health and associated risk factors of Dutch school aged foster children placed in long-term foster care

    NARCIS (Netherlands)

    Maaskant, A.M.; van Rooij, F.B.; Hermanns, J.M.A.

    2014-01-01

    More than 20,000 children in the Netherlands live in foster families. The majority are in long-term foster family placements, which are intended to provide a stable rearing environment until the children reach adulthood. International studies have shown, however, that compared to children in the

  19. ["Care" and public nutrition].

    Science.gov (United States)

    Martin-Prével, Yves

    2002-01-01

    In 1990, the Unicef conceptual framework for nutrition recognised the role of care, along with household food security and health services and environment, as one of the three underlying factors of child survival, growth, and development. This model has been adopted at a policy level at the International Conference on Nutrition (Rome, 1992) and over the past ten years the concept of care has been refined through literature reviews, consultative meetings and empirical works. "Care is the provision in the household and the community of time, attention, and support to meet the physical, mental, and social needs of the growing child and other household members". Basically, care refers to the actions of caregivers (mainly, but not only mothers) that translate food and health resources into positive outcomes for the child's nutrition. Even under circumstances of poverty, enhanced caregiving can optimise the use of resources to promote good nutrition. Care practices have been grouped into six categories: care for women, breastfeeding and child feeding practices, psychosocial care, food preparation, hygiene practices, household health practices. They cover a wide range of behaviours, are often culturally specific and are daily, repetitive, and time-consuming activities. It must be underlined that the way care practices are performed (i.e., quality of care) is as important as the practices themselves. It has also been emphasised that children play a significant role in determining the quality of care that they receive, through an interactive process: an active child elicits more care from the caregiver, who is in turn more responsive. Care resources at household level have been described according to three categories: human (knowledge, beliefs, education, physical and mental health of the caregiver), economic (control on income, workload and time), and organisational (alternate caregivers, community support). But the availability of care also depends on support at the

  20. Depressive symptom trajectories among girls in the juvenile justice system: 24-month outcomes of an RCT of Multidimensional Treatment Foster Care

    OpenAIRE

    Harold, Gordon T; Kerr, David C R; van Ryzin, Mark; DeGarmo, David S; Rhoades, Kimberly A; Leve, Leslie D

    2013-01-01

    Youth depression is a significant and growing international public health problem. Youth who engage in high levels of delinquency are at particularly high risk for developing problems with depression. The present study examined the impact of a behavioral intervention designed to reduce delinquency (Multidimensional Treatment Foster Care; MTFC) compared to a group care intervention (GC; i.e., services as usual) on trajectories of depressive symptoms among adolescent girls in the juvenile justi...

  1. Home or foster home care versus institutional long-term care for functionally dependent older people.

    Science.gov (United States)

    Young, Camilla; Hall, Amanda M; Gonçalves-Bradley, Daniela C; Quinn, Terry J; Hooft, Lotty; van Munster, Barbara C; Stott, David J

    2017-04-03

    Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this will reduce costs and improve the quality of care compared. To assess the effects of long-term home or foster home care versus institutional care for functionally dependent older people. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Library, MEDLINE, Embase, CINAHL, and two trials registers to November 2015. We included randomised and non-randomised trials, controlled before-after studies and interrupted time series studies complying with the EPOC study design criteria and comparing the effects of long-term home care versus institutional care for functionally dependent older people. Two reviewers independently extracted data and assessed the risk of bias of each included study. We reported the results narratively, as the substantial heterogeneity across studies meant that meta-analysis was not appropriate. We included 10 studies involving 16,377 participants, all of which were conducted in high income countries. Included studies compared community-based care with institutional care (care homes). The sample size ranged from 98 to 11,803 (median N = 204). There was substantial heterogeneity in the healthcare context, interventions studied, and outcomes assessed. One study was a randomised trial (N = 112); other included studies used designs that had potential for bias, particularly due lack of randomisation, baseline imbalances, and non-blinded outcome assessment. Most studies did not select (or exclude) participants for any specific disease state, with the exception of one study that only included patients if they had a stroke. All studies had methodological limitations, so readers should interpret results with caution.It is uncertain

  2. 'She was a foster mother who said she didn't give cuddles': The adverse early foster care experiences of children who later struggle with adoptive family life.

    Science.gov (United States)

    Meakings, Sarah; Selwyn, Julie

    2016-10-01

    Foster care remains a valuable and safe intervention for many children unable to live with their birth family. When birth family reunification is not considered possible, a small proportion of children in foster care will go on to achieve permanency by way of adoption. This article reports on some unexpected findings to emerge from two national adoption studies of previously looked after children in England and Wales. Focussing on a subset of families who had experienced or were at risk of an adoption disruption, the findings revealed that not only did children carry elevated risks for disruption due to their older age at entry to care, multiple foster care placements and traumatic early histories, but once in care, many of the children whose placements had disrupted were considered by their adoptive parents to have had very poor, even harmful fostering experiences before being placed for adoption. Possible explanations for these findings are discussed, together with the implications for social work practice. © The Author(s) 2016.

  3. A shifting paradigm: Teachers' beliefs and methods for fostering ecological literacy in two public charter schools

    Science.gov (United States)

    Sterling, Evan P.

    Ecological literacy is measured by a person's ability to understand the natural systems that make life on earth possible and how to live in accordance with those systems. The emergence of the pedagogies of place- and community-based education during the past two decades provides a possible avenue for fostering ecological literacy in schools. This thesis explores the following research questions: 1) How is ecological literacy fostered in two Alaskan public charter schools? 2) What are teachers' beliefs in these two schools about the way children and youth develop ecological literacy? 3) What are effective teaching methods and what are the challenges in engaging students in ecological literacy? Semi-structured interviews were conducted with six K--12 teachers in two public charter schools in Alaska in order to investigate these questions, and relevant examples of student work were collected for study as well. Qualitative data analysis revealed several emergent themes: the need for real-world connections to curriculum; the necessity of time spent outdoors at a young age; the long-term and holistic nature of ecological literacy development; and the importance of family and community role models in developing connections with the natural world. Based upon the research findings, several recommendations are made to support the efforts of teachers in these schools and elsewhere for fostering ecological literacy in children and youth.

  4. Measurement of Behavioral and Emotional Outcomes of Youth in Foster Care: Investigation of the Roles of Age and Placement Type.

    Science.gov (United States)

    Gabrielli, Joy; Jackson, Yo; Brown, Shaquanna

    2015-09-01

    The Behavioral Assessment System for Children-2 (BASC-2) is used to assess behavioral and emotional outcomes for youth. Research providing evidence for use of the BASC-2 parent-report form historically has included biological parents reporting on their children (Reynolds and Kamphaus 2004). For youth residing in out-of-home placements through enrollment in foster care, caregivers reporting on their functioning may include foster parents or residential staff. Given the significant adverse mental health outcomes for youth in foster care and the need to adequately assess adjustment in foster care, the purpose of the study was to evaluate the measurement properties of caregivers' report on the parent report form (PRS) of the BASC-2 in foster care youth. Using 479 respondents, a measurement model was fit to the data demonstrating adequate fit across Internalizing Problems, Externalizing Problems, and Adaptive Skills. Further, a comparison of measurement properties across child and adolescent groups and groups of youth residing in residential facilities versus foster homes was conducted. Factorial invariance and latent means also were assessed. The BASC-2 PRS was found to be an adequate assessment of psychological outcomes for youth in foster care when completed by foster parents or residential facility staff.

  5. Kinship foster care among African American youth: Interaction effects at multiple contextual levels

    Science.gov (United States)

    Rufa, Anne K.; Fowler, Patrick J.

    2016-01-01

    This study investigated the effects of kinship foster care on mental health outcomes among African American youth. Longitudinal data were used from a nationally representative sample of children and adolescents who were the subject of child protective services investigation from 1999 to 2000 (n=5,501). The secondary analyses focused on African American youth (n=225) placed into foster care. In structured interviews, current caregivers reported on youth internalizing and externalizing behaviors immediately following placement into out-of-home care and 18-months later. Path analysis tested a theoretical model that compared placements with kin to other formal out-of-home arrangements in context of setting characteristics, including aspects of caregiver and neighborhood disorder. Results suggested significant increases in internalizing symptoms over time for youth with more baseline mental health problems, as well as those placed in more distressed neighborhoods. Increased externalizing symptoms occurred among youth with greater baseline behavior problems, those placed in more problematic neighborhoods, and youth who experienced a placement change between assessments. Additionally, a combination of placement characteristics predicted increases in externalizing problems; youth placed in kinship foster care with older caregivers in poorer health exhibited greater increases in externalizing problems. Findings highlighted important contextual considerations for out-of-home placement among African American youth. PMID:26924865

  6. Social and occupational justice barriers in the transition from foster care to independent adulthood.

    Science.gov (United States)

    Paul-Ward, Amy

    2009-01-01

    The professional discourse on social justice suggests that more critical work is needed to sufficiently address the societal issues that affect occupational therapy practitioners' ability to advocate for and with clients. Occupational therapy offers unique opportunities for the scholarly discussion of social justice and for clinical practice to address these issues. This article discusses the importance of incorporating a social justice perspective into occupational therapy by using an example from the author's research program. The experiences of adolescents in foster care were documented in an ongoing qualitative participatory study. An overview of adolescents' (N = 40) perceived independent living and vocational service needs is provided, and several barriers that affect adolescents' ability to develop the skills needed to achieve independent adulthood are described. The article concludes with a discussion of social justice implications as they relate to the myriad issues in the foster care system, occupational therapy research, and practice.

  7. Mental Health, Behavioral and Developmental Issues for Youth in Foster Care.

    Science.gov (United States)

    Deutsch, Stephanie A; Lynch, Amy; Zlotnik, Sarah; Matone, Meredith; Kreider, Amanda; Noonan, Kathleen

    2015-10-01

    Youth in foster care represent a unique population with complex mental and behavioral health, social-emotional, and developmental needs. For this population with special healthcare needs, the risk for adverse long-term outcomes great if needs go unaddressed or inadequately addressed while in placement. Although outcomes are malleable and effective interventions exist, there are barriers to optimal healthcare delivery. The general pediatrician as advocate is paramount to improve long-term outcomes. Copyright © 2015 Mosby, Inc. All rights reserved.

  8. Age-related trends in psychotropic medication use among very young children in foster care.

    Science.gov (United States)

    dosReis, Susan; Tai, Ming-Hui; Goffman, David; Lynch, Sean E; Reeves, Gloria; Shaw, Terry

    2014-12-01

    The specific objectives were to investigate changes in the prevalence of psychotropic medication use for each year increase in age from three to six years old among children in foster care and to examine time-varying odds of longer duration of use by each year of age. A retrospective analysis of data on mental health and pharmacy services was conducted for 1,491 children age six and younger who were in foster care in 2010 and had at least 365 days in foster care during 2009-2011. A total of 178 children received at least one psychotropic medication from 2009 through 2011. Psychotropic prevalence and average days of use were calculated for each therapeutic class. Longitudinal regression models assessed the time-varying relationship between year of age and duration of use, controlling for demographic and clinical covariates. Approximately 12% of children age six and younger in foster care for 365 days or more received at least one psychotropic medication over the three-year study period. Prevalence of ADHD medication and antipsychotic medication and duration increased with each year of age (p<.001). In adjusted longitudinal models, each year increase in age was associated with a nearly twofold higher likelihood of longer duration of antipsychotic and ADHD medication use. Young children who initiated antipsychotic and ADHD medications before the age of six continued to receive them for longer periods of time. There is a critical need for long-term studies to evaluate the effect of chronic exposure on children's health and well-being.

  9. Extending Foster Care to Age 21: Weighing the Costs to Government against the Benefits to Youth. Chapin Hall Issue Brief

    Science.gov (United States)

    Peters, Clark M.; Dworsky, Amy; Courtney, Mark E.; Pollack, Harold

    2009-01-01

    The Fostering Connections to Success and Increasing Adoptions Act of 2008 allows states to claim federal reimbursement for the costs of caring for and supervising Title IV-E eligible foster youth until their 21st birthday. This issue brief provides preliminary estimates of what the potential costs to government and the benefits to young people…

  10. The sexuality of young women with intellectual and developmental disabilities: A neglected focus in the American foster care system.

    Science.gov (United States)

    Ballan, Michelle S; Freyer, Molly Burke

    2017-07-01

    Youths with intellectual and developmental disabilities (ID/DD) are overrepresented in the American foster care system and experience heightened rates of pregnancy compared to their nondisabled peers. Yet limited information is known about sexually active or pregnant young women with ID/DD in foster care. Consequently, important healthcare needs of this population are not adequately addressed. This article explores sexuality education and sexual healthcare for female adolescents in foster care with ID/DD and recommends practice guidelines to support and prepare their emergent sexual development. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Child welfare caseworkers as service brokers for youth in foster care: findings from project focus.

    Science.gov (United States)

    Dorsey, Shannon; Kerns, Suzanne E U; Trupin, Eric W; Conover, Kate L; Berliner, Lucy

    2012-02-01

    Youth in the foster care system have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Increasingly emerging in the literature on mental health services is the importance of "brokers" or "gateway providers" of services. For youth in foster care, child welfare caseworkers often play this role. This study examines caseworker-level outcomes of Project Focus, a caseworker training and consultation model designed to improve emotional and behavioral outcomes for youth in foster care through increased linkages with EBPs. Project Focus was tested through a small, randomized trial involving four child welfare offices. Caseworkers in the Project Focus intervention group demonstrated an increased awareness of EBPs and a trend toward increased ability to identify appropriate EBP referrals for particular mental health problems but did not have significantly different rates of actual referral to EBPs. Dose of consultation was associated with general awareness of EBPs. Implications for practice and outcomes for youth are discussed.

  12. Quality of life of patients with schizophrenia treated in foster home care and in outpatient treatment

    Directory of Open Access Journals (Sweden)

    Mihanović M

    2015-03-01

    Full Text Available Mate Mihanović,1,2 Branka Restek-Petrović,1,2 Anamarija Bogović,1 Ena Ivezić,1 Davor Bodor,1 Ivan Požgain3 1Psychiatric Hospital “Sveti Ivan”, Zagreb, 2Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 3Department of Psychiatry, University Hospital Center Osijek, Osijek, Croatia Background: The Sveti Ivan Psychiatric Hospital in Zagreb, Croatia, offers foster home care treatment that includes pharmacotherapy, group psychodynamic psychotherapy, family therapy, and work and occupational therapy. The aim of this study is to compare the health-related quality of life of patients with schizophrenia treated in foster home care with that of patients in standard outpatient treatment. Methods: The sample consisted of 44 patients with schizophrenia who, upon discharge from the hospital, were included in foster home care treatment and a comparative group of 50 patients who returned to their families and continued receiving outpatient treatment. All patients completed the Short Form 36 Health Survey Questionnaire on the day they completed hospital treatment, 6 months later, and 1 year after they participated in the study. The research also included data on the number of hospitalizations for both groups of patients. Results: Though directly upon discharge from the hospital, patients who entered foster home care treatment assessed their health-related quality of life as poorer than patients who returned to their families, their assessments significantly improved over time. After 6 months of treatment, these patients even achieved better results in several dimensions than did patients in the outpatient program, and they also had fewer hospitalizations. These effects remained the same at the follow-up 1 year after the inclusion in the study. Conclusion: Notwithstanding the limitations of this study, it can be concluded that treatment in foster home care is associated with an improvement in the quality of life of patients

  13. Association between childhood sexual abuse and transactional sex in youth aging out of foster care.

    Science.gov (United States)

    Ahrens, Kym R; Katon, Wayne; McCarty, Carolyn; Richardson, Laura P; Courtney, Mark E

    2012-01-01

    To evaluate the association between history of childhood sexual abuse (CSA) and having transactional sex among adolescents who have been in foster care. We used an existing dataset of youth transitioning out of foster care. Independent CSA variables included self report of history of sexual molestation and rape when participants were, on average, 17 years of age. Our outcome variables were self-report of having transactional sex ever and in the past year, when participants were an average age of 19 years. Separate multiple logistic regression analyses were conducted to assess the associations between CSA variables and transactional sex variables. Initial analyses were performed on both genders; exploratory analyses were then performed evaluating each gender separately. Total N=732; 574 were included in the main analyses. History of sexual molestation was significantly associated with increased odds of having transactional sex, both ever and in the past year (OR [95% CI]: 3.21 [1.26-8.18] and 4.07 [1.33, 12.52], respectively). History of rape was also significantly associated with increased odds of having had transactional sex ever and in the past year (ORs [95% CI]: 3.62 [1.38-9.52] and 3.78 [1.19, 12.01], respectively). Odds ratios in female-only analyses remained significant and were larger in magnitude compared with the main, non-stratified analyses; odds ratios in male-only analyses were non-significant and smaller in magnitude when compared with the main analyses. Both CSA variables were associated with increased likelihood of transactional sex. This association appears to vary by gender. Our results suggest that policymakers for youth in foster care should consider the unique needs of young women with histories of CSA when developing programs to support healthy relationships. Health care providers should also consider adapting screening and counseling practices to reflect the increased risk of transactional sex for female youth in foster care with a history

  14. Smoking Behaviors Among Adolescents in Foster Care: A Gender-Based Analysis.

    Science.gov (United States)

    Shpiegel, Svetlana; Sussman, Steve; Sherman, Scott E; El Shahawy, Omar

    2017-09-19

    Adolescents in foster care are at high risk for cigarette smoking. However, it is not clear how their smoking behaviors vary by gender. The present study examined lifetime and current smoking among males and females, and explored gender-specific risk factors for engagement in smoking behaviors. Data from the Multi Site Evaluation of Foster Youth Programs was used to evaluate patterns of smoking among adolescents aged 12-18 years (N = 1121; 489 males, 632 females). Males and females did not differ significantly in rates of lifetime and current smoking, or in the age of smoking initiation and number of cigarettes smoked on a typical day. Gender-based analyses revealed that older age and placement in group homes or residential treatment facilities were associated with heightened risk of smoking among males. In contrast, sexual minority status (i.e., nonheterosexual orientation) and increased childhood victimization were associated with heightened risk of smoking among females. A history of running away was linked to smoking in both genders. Gender should be considered when designing intervention programs to address cigarette smoking among foster youth, as the stressors associated with smoking may differ for males and females.

  15. Attachment, Development, and Mental Health in Abused and Neglected Preschool Children in Foster Care: A Meta-Analysis.

    Science.gov (United States)

    Vasileva, Mira; Petermann, Franz

    2016-09-22

    A proper preparation for foster parents to care for abused and neglected children includes effective training and initial diagnostics in order to plan individual treatment. Hence, a basic knowledge about the main psychosocial and developmental problems associated with abuse and neglect and their prevalence in foster children is needed. For this purpose, a systematical literature review and a series of meta-analyses were conducted. A total of 25 studies reporting data on development (n = 4,033), mental health (n = 726), and attachment (n = 255) of foster children in preschool age met the inclusion criteria. The meta-analyses indicated prevalence rates of approximately 40% for developmental, mental health problems, and insecure attachment. Rates of disorganized attachment were estimated to 22%. These findings outline the necessity of an initial trauma-oriented diagnostics and trainings for foster parents that address foster children's development, mental health, and disorganized attachment. © The Author(s) 2016.

  16. Youth with Behavioral Health Disorders Aging Out of Foster Care: a Systematic Review and Implications for Policy, Research, and Practice.

    Science.gov (United States)

    Kang-Yi, Christina D; Adams, Danielle R

    2017-01-01

    This systematic review aimed to (1) identify and summarize empirical studies on youth with behavioral health disorders aging out of foster care and (2) address implications for behavioral health policy, research, and practice. We identified previous studies by searching PubMed, PsycINFO, EBSCO, and ISI Citation Indexes and obtaining references from key experts in the child welfare field. A total of 28 full articles published between 1991 and 2014 were reviewed and summarized into the key areas including systems of care, disability type, transition practice area, study methods, study sample, transition outcome measures, study analysis, and study findings. Considering how fast youth who have behavioral health disorders fall through the crack as they exit foster care, one cannot understate the importance of incorporating timely and appropriate transition planning and care coordination for youth who have behavioral health disorders aging out of foster care into the usual case management performed by behavioral health systems and service providers.

  17. Intervening to Improve Outcomes for Siblings in Foster Care: Conceptual, Substantive, and Methodological Dimensions of a Prevention Science Framework

    Science.gov (United States)

    Kothari, Brianne H.; Blakeslee, Jennifer; Lamson-Siu, Emilie; Bank, Lew; Linares, L. Oriana; Waid, Jeffrey; Sorenson, Paul; Jimenez, Jessica; Pearson, Eva; Shlonsky, Aron

    2014-01-01

    In recent years, the child welfare field has devoted significant attention to siblings in foster care. Policymakers and practitioners have supported efforts to connect siblings via shared foster placements and visitation while researchers have focused on illuminating the empirical foundations of sibling placement and sibling intervention in child welfare. The current paper synthesizes literature on sibling relationship development and sibling issues in child welfare in the service of presenting a typology of sibling-focused interventions for use with foster youth. The paper provides two examples of current intervention research studies focused on enhancing sibling developmental processes and understanding their connection to child welfare outcomes. The paper concludes by presenting an emerging agenda informing policy, practice, and research on siblings in foster care. PMID:24634558

  18. Multidimensional Treatment Foster Care: An Alternative to Residential Treatment for High Risk Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Philip A. Fisher

    2012-07-01

    Full Text Available This paper describes the Multidimensional Treatment Foster Care program (MTFC, an evidence based approach for providing psychotherapeutic treatment for very troubled children and adolescents that is an alternative to residential care. Versions of the MTFC program have been developed and validated for young children with a history of maltreatment as well as for older children and adolescents who are involved with the youth justice system. In the paper we describe the development of the MTFC program and its foundations in the social learning model that originated at the Oregon Social Learning Center in the 1960's and 70's. We present information about program elements. We then review the research that has been conducted on MTFC.

  19. Adverse childhood experiences among children placed in and adopted from foster care: Evidence from a nationally representative survey.

    Science.gov (United States)

    Turney, Kristin; Wildeman, Christopher

    2017-02-01

    Despite good reason to believe that children in foster care are disproportionately exposed to adverse childhood experiences (ACEs), relatively little research considers exposure to ACEs among this group of vulnerable children. In this article, we use data from the 2011-2012 National Survey of Children's Health (NSCH), a nationally representative sample of non-institutionalized children ages 0-17 in the United States, to estimate the association between foster care placement and exposure to an array of ACEs. In adjusted logistic regression models, we find that children placed in foster care or adopted from foster care, compared to their counterparts, were more likely to experience parental divorce or separation, parental death, parental incarceration, parental abuse, violence exposure, household member mental illness, and household member substance abuse. These children were also more likely to experience ACEs than children across different thresholds of socioeconomic disadvantage (e.g., children in households with incomes below the poverty line) and across different family structures (e.g., children in single-mother families). These results advance our understanding of how children in foster care, an already vulnerable population, are disproportionately exposed to ACEs. This exposure, given the link between ACEs and health, may have implications for children's health and wellbeing throughout the life course. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. The profile and progress of neglected and abused children in long-term foster care.

    Science.gov (United States)

    Barber, James G; Delfabbro, Paul H

    2009-07-01

    This study compared the profile of neglected and abused children in the Australian foster care system as well as differences between maltreatment types in relation to parental contact, reunification and psychosocial progress in care. The case files of 235 children entering foster care were examined and their social workers were administered standardised questionnaires at the point of intake. All measures were repeated for those remaining in care 1 year and then again 2 years later. Neglected children were younger than non-neglected children, more likely to have a physical or mental disability, more likely to experience multiple forms of maltreatment and less likely to pose conduct problems for carers. Neglected children were more likely than non-neglected children to experience a decline in parental contact over time, and were less likely to be reunified with their families of origin. There was minimal difference between neglected and non-neglected in their psychosocial progress while in care. Aboriginal children were more likely to be reunified than non-Aboriginal children when neglect was attributable to transient factors (parental incapacity) but the reverse was true for non-neglected children. The fact that neglected children more often require a second form of maltreatment before being removed from home suggests that children's services workers are less inclined to remove children for neglect than for other forms of maltreatment. As a consequence, those neglected children who are in care tend to come from more dysfunctional families than non-neglected children do, as evidenced by the relatively poorer parental contact and reunification results of neglected children. Neglected children differ systematically from non-neglected children and suffer relative disadvantage in relation to multiple forms of maltreatment, parental contact, and reunification. The fact that declines in parental contact among neglected children in care occurred only when indirect contact

  1. Girls in Foster Care: Risk and Promotive Factors for School Adjustment Across the Transition to Middle School.

    Science.gov (United States)

    Pears, Katherine C; Kim, Hyoun K; Leve, Leslie D

    2012-01-01

    Girls in foster care may face difficulties across the transition to middle school. Latent growth curve modeling was employed to examine trajectories and predictors of academic competence and aggression from and against peers for 75 girls in foster care from the end of elementary school to the 2(nd) year of middle school. Across the transition to middle school, academic competence increased. Poor self-regulation was associated with decreased academic competence, and higher caregiver support was associated with increased academic competence. Frequency of aggression from peers decreased across the transition, with perceived school competence predicting smaller decreases. Aggression against peers dropped initially and then increased to pretransition levels by the end of the 2(nd) year of middle school. Lower caregiver support was associated with higher rates of aggression against peers at the end of the 1(st) year of middle school. The results are discussed in terms of implications for interventions for girls in foster care.

  2. Explaining variations in state foster care maintenance rates and the implications for implementing new evidence-based programs

    Science.gov (United States)

    Goldhaber-Fiebert, Jeremy D.; Babiarz, Kimberly S.; Garfield, Rachel L.; Wulczyn, Fred; Landsverk, John; Horwitz, Sarah M.

    2013-01-01

    Background U.S. Child Welfare systems are involved in the lives of millions of children, and total spending exceeds $26 billion annually. Out-of-home foster care is a critical and expensive Child Welfare service, a major component of which is the maintenance rate paid to support housing and caring for a foster child. Maintenance rates vary widely across states and over time, but reasons for this variation are not well understood. As evidence-based programs are disseminated to state Child Welfare systems, it is important to understand what may be the important drivers in the uptake of these practices including state spending on core system areas. Data and methods We assembled a unique, longitudinal, state-level panel dataset (1990–2008) for all 50 states with annual data on foster care maintenance rates and measures of child population in need, poverty, employment, urbanicity, proportion minority, political party control of the state legislature and governorship, federal funding, and lawsuits involving state foster care systems. All monetary values were expressed in per-capita terms and inflation adjusted to 2008 dollars. We used longitudinal panel regressions with robust standard errors and state and year fixed effects to estimate the relationship between state foster care maintenance rates and the other factors in our dataset, lagging all factors by one year to mitigate the possibility that maintenance rates influenced their predictors. Exploratory analyses related maintenance rates to Child Welfare outcomes. Findings State foster care maintenance rates have increased in nominal terms, but in many states, have not kept pace with inflation, leading to lower real rates in 2008 compared to those in 1991 for 54% of states for 2 year-olds, 58% for 9 year-olds, and 65% for 16 year-olds. In multivariate analyses including socioeconomic, demographic, and political factors, monthly foster care maintenance rates declined $15 for each 1% increase in state unemployment and

  3. Development and feasibility of a sibling intervention for youth in foster care.

    Science.gov (United States)

    Kothari, Brianne H; McBeath, Bowen; Lamson-Siu, Emilie; Webb, Sara Jade; Sorenson, Paul; Bowen, Hannah; Waid, Jeff; Bank, Lew

    2014-12-01

    Due to their ubiquity and possible influence on youth mental health, academic, and other outcomes, sibling-focused intervention strategies may be important for the development and implementation of evidence-based practices (EBPs) in child welfare. However, there is no rigorous evidence as to either the best methods for, or feasibility of, incorporating the sibling link within existing clinical treatments for foster youth. This paper applies the literature on evidence-based practices (EBP) and implementation research in child welfare to sibling-focused intervention; and presents data concerning the development, delivery, cost, and feasibility of a novel sibling-focused intervention program, Supporting Siblings in Foster Care (SIBS-FC). Results suggest that despite the challenges and costs involved with delivering SIBS-FC, the program catered to the diverse needs of pre-adolescent and adolescent siblings living together and apart, was viewed positively by youth, and was implemented with a high degree of fidelity. These findings underscore the importance of attending to the early-stage development of psychosocial interventions in child welfare and highlight the role of interagency collaboration, program planning, staff training and supervision, and fidelity tracking for EBP development in child welfare. Implications for prevention research and sibling-focused intervention programming in child welfare are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Does subsequent criminal justice involvement predict foster care and termination of parental rights for children born to incarcerated women?

    Science.gov (United States)

    Kubiak, Sheryl Pimlott; Kasiborski, Natalie; Karim, Nidal; Schmittel, Emily

    2012-01-01

    This longitudinal study of 83 incarcerated women, who gave birth during incarceration and retained their parental rights through brief sentences, examines the intersection between subsequent criminal justice involvement postrelease and child welfare outcomes. Ten years of multiple state-level administrative data sets are used to determine if arrest or conviction predict foster care and/or termination of parental rights. Findings indicate that only felony arrest is a significant predictor of foster care involvement. Additionally, 69% of mothers retained legal custody, despite subsequent criminal involvement for many, suggesting supportive parenting programs and resources need to be available to these women throughout and after incarceration.

  5. Impact of a Supportive Housing Program on Housing Stability and Sexually Transmitted Infections Among Young Adults in New York City Who Were Aging Out of Foster Care.

    Science.gov (United States)

    Lim, Sungwoo; Singh, Tejinder P; Gwynn, R Charon

    2017-08-01

    Former foster youth are at increased risk of housing instability and sexually transmitted infections (STIs) during the transitional period following foster care. We measured housing stability using sequence analysis and assessed whether a supportive housing program in New York, New York, was effective in improving housing stability and reducing STIs among former foster youth. Matched administrative records identified 895 former foster youth who were eligible for the housing program during 2007-2010. The main outcomes included housing stability (as determined from episodes of homelessness, incarceration, hospitalization, and residence in supportive housing) and diagnosed STI case rates per 1,000 person-years during the 2 years after baseline. Marginal structural models were used to assess impacts of the program on these outcomes. Three housing stability patterns (unstable housing, stable housing, and rare institutional dwelling patterns) were identified. The housing program was positively associated with a pattern of stable housing (odds ratio = 4.4, 95% confidence interval: 2.9, 6.8), and negatively associated with diagnosed STI rates (relative risk = 0.3, 95% confidence interval: 0.2, 0.7). These positive impacts on housing stability and STIs highlight the importance of the supportive housing program for youths aging out of foster care and the need for such programs to continue. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. A pilot randomized trial teaching mindfulness-based stress reduction to traumatized youth in foster care.

    Science.gov (United States)

    Jee, Sandra H; Couderc, Jean-Philippe; Swanson, Dena; Gallegos, Autumn; Hilliard, Cammie; Blumkin, Aaron; Cunningham, Kendall; Heinert, Sara

    2015-08-01

    This article presents a pilot project implementing a mindfulness-based stress reduction program among traumatized youth in foster and kinship care over 10 weeks. Forty-two youth participated in this randomized controlled trial that used a mixed-methods (quantitative, qualitative, and physiologic) evaluation. Youth self-report measuring mental health problems, mindfulness, and stress were lower than anticipated, and the relatively short time-frame to teach these skills to traumatized youth may not have been sufficient to capture significant changes in stress as measured by electrocardiograms. Main themes from qualitative data included expressed competence in managing ongoing stress, enhanced self-awareness, and new strategies to manage stress. We share our experiences and recommendations for future research and practice, including focusing efforts on younger youth, and using community-based participatory research principles to promote engagement and co-learning. CLINICALTRIALS.GOV: Protocol Registration System ID NCT01708291. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Adverse Consequences of School Mobility for Children in Foster Care: A Prospective Longitudinal Study

    Science.gov (United States)

    Pears, Katherine C.; Kim, Hyoun K.; Buchanan, Rohanna; Fisher, Philip A.

    2015-01-01

    Few prospective studies have examined school mobility in children in foster care. This study described the school moves of 86 such children and 55 community comparison children (primarily Caucasian), living in a medium-sized metropolitan area in the Pacific Northwest who were approximately 3-6-years-old at the study start. Additionally, the effects of moves from kindergarten through Grade 2 on academic and social emotional competence in Grades 3 through 5 were examined. A greater number of early school moves was associated with poorer later social emotional competence and partially mediated the effects of maltreatment and out-of-home placement on social emotional competence. This was only the case for children with poorer early learning skills in kindergarten. Implications for preventive intervention are discussed. PMID:25906815

  8. Labeling and the effect of adolescent legal system involvement on adult outcomes for foster youth aging out of care.

    Science.gov (United States)

    Lee, JoAnn S; Courtney, Mark E; Harachi, Tracy W; Tajima, Emiko A

    2015-09-01

    This study uses labeling theory to examine the role that adolescent legal system involvement may play in initiating a process of social exclusion, leading to higher levels of adult criminal activities among foster youth who have aged out of care. We used data from the Midwest Evaluation of the Adult Functioning of Former Foster Youth (Midwest Study), a prospective study that sampled 732 youth from Illinois, Iowa, and Wisconsin as they were preparing to leave the foster care system at ages 17 or 18. The youth were interviewed again at ages 19, 21, and 23 or 24. We used structural equation modeling to examine pathways to self-reported adult criminal behaviors from juvenile legal system involvement. The path model indicated that legal system involvement as a juvenile was associated with a lower likelihood of having a high school diploma at age 19, which was associated with a reduced likelihood of employment and increased criminal activities at age 21. Legal system involvement is more common among foster youth aging out of care, and this legal system involvement appears to contribute to a process of social exclusion by excluding former foster youth from conventional opportunities. (c) 2015 APA, all rights reserved).

  9. Home or foster home care versus institutional long-term care for functionally dependent older people

    NARCIS (Netherlands)

    Young, Camilla; Hall, Amanda M.; Goncalves-Bradley, Daniela C.; Quinn, Terry J.; Hooft, Lotty; van Munster, Barbara C.; Stott, David J.

    2017-01-01

    Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this will reduce

  10. Home or foster home care versus institutional long-term care for functionally dependent older people

    NARCIS (Netherlands)

    Young, Camilla; Hall, Amanda M.; Gonçalves-Bradley, Daniela C.; Quinn, Terry J.; Hooft, Lotty; van Munster, Barbara C.; Stott, David J.

    2017-01-01

    Background: Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this

  11. Demographic and placement variables associated with overweight and obesity in children in long-term foster care.

    Science.gov (United States)

    Schneiderman, Janet U; Arnold-Clark, Janet S; Smith, Caitlin; Duan, Lei; Fuentes, Jorge

    2013-11-01

    Overweight and obesity is a growing problem for children in foster care. This study describes the prevalence of overweight and obesity in an urban, ethnic minority population of children ages 2-19 in long-term foster care (N = 312) in Los Angeles, California. It also investigates whether demographics or placement settings are related to high body mass index. The estimates of prevalence of overweight/obesity (≥85th percentile) and obesity (≥95th percentile) were presented for gender, age, ethnicity, and placement type. Multiple logistic regression was used to examine potential associations between demographic and placement variables and weight status. The prevalence of overweight/obesity was almost 40 % and obesity was 23 % for the study population. Children placed in a group home had the highest prevalence of overweight/obesity (60 %) and obesity (43 %) compared to other types of placement. Within this study, older children (ages 12-19) were more likely to be overweight/obese than normal weight compared to children between 2 and 5 years old when controlling for gender, ethnicity and placement (OR = 2.10, CI = 1.14-3.87). These findings suggest that older age and long-term foster care in general may be risk factors for obesity. Child welfare agencies and health care providers need to work together to train caregivers with children in long-term foster care in obesity treatment interventions and obesity prevention strategies.

  12. Private sector in public health care systems

    OpenAIRE

    Matějusová, Lenka

    2008-01-01

    This master thesis is trying to describe the situation of private sector in public health care systems. As a private sector we understand patients, private health insurance companies and private health care providers. The focus is placed on private health care providers, especially in ambulatory treatment. At first there is a definition of health as a main determinant of a health care systems, definition of public and private sectors in health care systems and the difficulties at the market o...

  13. The Association between Foster Care and Substance Abuse Risk Factors and Treatment Outcomes: An Exploratory Secondary Analysis

    Science.gov (United States)

    Blome, Wendy Whiting; Shields, Joseph; Verdieck, Mary Jeanne

    2009-01-01

    The child welfare and substance abuse systems are integrally linked through the children and families they both serve. There is a dearth of knowledge, however, on how children who have experienced foster care fare when they are treated for substance abuse issues as adults. This article presents an exploratory study using the Alcohol and Drug…

  14. The psychosocial needs of children in foster care with a history of sexual abuse: Are they recognized?

    NARCIS (Netherlands)

    Steenbakkers, Anne; Ellingsen, Ingunn; van der Steen, Stephanie; Grietens, Hans

    2017-01-01

    Youth in family foster care who have experienced sexual abuse have specific psychosocial needs. However, youth themselves are rarely asked about their needs, and it is unknown if caretakers recognize these needs as such. Using Q-methodology, this study aimed to describe what youth consider their

  15. Meaning-Making Dynamics of Emancipated Foster Care Youth Transitioning into Higher Education: A Constructivist-Grounded Theory

    Science.gov (United States)

    Okumu, Jacob O.

    2014-01-01

    This study explored college transition meaning-making dynamics of emancipated foster care youth and the role campus environments play in that process. It adds to the college student development theoretical base by acknowledging the needs, goals, and values of disenfranchised college students transitioning into higher education. Emancipated foster…

  16. After Foster Care and Juvenile Justice: A Preview of the Youth Villages Transitional Living Evaluation. Policy Brief

    Science.gov (United States)

    Muller-Ravett, Sara; Jacobs, Erin

    2012-01-01

    Young people who are leaving the foster care and juvenile justice systems often experience a difficult transition to adulthood that is characterized by a number of troubling outcomes, including poverty, low levels of education and employment, and housing instability. While some services are available for these populations, there is little evidence…

  17. Use of a brief standardized screening instrument in a primary care setting to enhance detection of social-emotional problems among youth in foster care.

    Science.gov (United States)

    Jee, Sandra H; Halterman, Jill S; Szilagyi, Moira; Conn, Anne-Marie; Alpert-Gillis, Linda; Szilagyi, Peter G

    2011-01-01

    To determine whether systematic use of a validated social-emotional screening instrument in a primary care setting is feasible and improves detection of social-emotional problems among youth in foster care. Before-and-after study design, following a practice intervention to screen all youth in foster care for psychosocial problems using the Strengths and Difficulties Questionnaire (SDQ), a validated instrument with 5 subdomains. After implementation of systematic screening, youth aged 11 to 17 years and their foster parents completed the SDQ at routine health maintenance visits. We assessed feasibility of screening by measuring the completion rates of SDQ by youth and foster parents. We compared the detection of psychosocial problems during a 2-year period before systematic screening to the detection after implementation of systematic screening with the SDQ. We used chart reviews to assess detection at baseline and after implementing systematic screening. Altogether, 92% of 212 youth with routine visits that occurred after initiation of screening had a completed SDQ in the medical record, demonstrating high feasibility of systematic screening. Detection of a potential mental health problem was higher in the screening period than baseline period for the entire population (54% vs 27%, P youth had 2 or more significant social-emotional problem domains on the SDQ. Systematic screening for potential social-emotional problems among youth in foster care was feasible within a primary care setting and doubled the detection rate of potential psychosocial problems. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. Enhancing and Adapting Treatment Foster Care: Lessons Learned in Trying to Change Practice.

    Science.gov (United States)

    Murray, Maureen M; Southerland, Dannia; Farmer, Elizabeth M; Ballentine, Kess

    2010-01-01

    Evidence-based practices to improve outcomes for children with severe behavioral and emotional problems have received a great deal of attention in children's mental health. Therapeutic Foster Care (TFC), a residential intervention for youth with emotional or behavioral problems, is one of the few community-based programs that is considered to be evidence-based. However, as for most treatment approaches, the vast majority of existing programs do not deliver the evidence-based version. In an attempt to fill this gap and improve practice across a wide range of TFC agencies, we developed an enhanced model of TFC based on input from both practice and research. It includes elements associated with improved outcomes for youth in "usual care" TFC agencies as well as key elements from Chamberlain's evidence-based model. The current manuscript describes this "hybrid" intervention - Together Facing the Challenge - and discusses key issues in implementation. We describe the sample and settings, highlight key implementation strategies, and provide "lessons learned" to help guide others who may wish to change practice in existing agencies.

  19. An Examination of Differences between Promotion Rates of Third Grade Youth in Foster Care: A Study on One-to-One Tutoring

    Science.gov (United States)

    Franklin, Josette R.

    2017-01-01

    This quantitative research study analyzed archival data to determine if there was a significant difference in promotion rates from third to fourth grade between students in foster care who received one-to-one tutoring and those students in foster care who did not receive one-to-one tutoring over two school years. This study also analyzed student…

  20. Preparing for a "Next Generation" Evaluation of Independent Living Programs for Youth in Foster Care: Project Overview. OPRE Report No. 2014-71

    Science.gov (United States)

    McDaniel, Marla; Courtney, Mark E.; Pergamit, Michael R.; Lowenstein, Christopher

    2014-01-01

    Youth transitioning out of foster care and into adulthood need multiple supports to navigate the challenges they face. Over the past three decades, federal child welfare policy has significantly increased the availability of those supports. In 1999, the Chafee Foster Care Independence Program was created, increasing the amount of funds potentially…

  1. Factors Influencing Risk of Homelessness among Youth in Transition from Foster Care in Oklahoma: Implications for Reforming Independent Living Services and Opportunities.

    Science.gov (United States)

    Crawford, Brandon L; McDaniel, Jacqueline; Moxley, David; Salehezadeh, Zohre; Cahill, Alisa West

    Research suggests that youth aging out of foster care may be at higher risk of experiencing homelessness than other youth. Among this already at-risk population there may be certain characteristics that further exacerbate the risk. This paper uses data collected from various local and state agencies to further examine significant predictors of homelessness among youth who have aged out of foster care.

  2. Mandates for Collaboration: Health Care and Child Welfare Policy and Practice Reforms Create the Platform for Improved Health for Children in Foster Care.

    Science.gov (United States)

    Zlotnik, Sarah; Wilson, Leigh; Scribano, Philip; Wood, Joanne N; Noonan, Kathleen

    2015-10-01

    Improving the health of children in foster care requires close collaboration between pediatrics and the child welfare system. Propelled by recent health care and child welfare policy reforms, there is a strong foundation for more accountable, collaborative models of care. Over the last 2 decades health care reforms have driven greater accountability in outcomes, access to care, and integrated services for children in foster care. Concurrently, changes in child welfare legislation have expanded the responsibility of child welfare agencies in ensuring child health. Bolstered by federal legislation, numerous jurisdictions are developing innovative cross-system workforce and payment strategies to improve health care delivery and health care outcomes for children in foster care, including: (1) hiring child welfare medical directors, (2) embedding nurses in child welfare agencies, (3) establishing specialized health care clinics, and (4) developing tailored child welfare managed care organizations. As pediatricians engage in cross-system efforts, they should keep in mind the following common elements to enhance their impact: embed staff with health expertise within child welfare settings, identify long-term sustainable funding mechanisms, and implement models for effective information sharing. Now is an opportune time for pediatricians to help strengthen health care provision for children involved with child welfare. Copyright © 2015. Published by Elsevier Inc.

  3. Mental health beliefs and barriers to accessing mental health services in youth aging out of foster care.

    Science.gov (United States)

    Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K

    2014-01-01

    To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  4. An intervention to improve sibling relationship quality among youth in foster care: Results of a randomized clinical trial.

    Science.gov (United States)

    Kothari, Brianne H; McBeath, Bowen; Sorenson, Paul; Bank, Lew; Waid, Jeff; Webb, Sara Jade; Steele, Joel

    2017-01-01

    Sibling programming is an important part of a prevention framework, particularly for youth in foster care. After children are removed from their families and placed into foster care in the aftermath of maltreatment, the sibling relationship is often the most viable ongoing relationship available to the child, and may be critical to a youth's sense of connection, emotional support, and continuity. The promise of dyadic sibling programming in particular rests on the ability of interventions to enhance the quality of sibling relationships; yet little research exists that suggests that sibling interventions can improve relationship quality among foster youth. The primary aim of the current study was to examine the effects of a specific dyadic sibling-focused intervention for older and younger siblings on sibling relationship quality. One hundred sixty four dyads (328 youth) participated in the study, with each dyad consisting of an older sibling between 11 and 15 years of age at baseline and a younger sibling separated in age by less than 4 years. Hierarchical linear models were applied to self-reported, observer-reported and observational data over the 18-month study period. Findings suggest that the sibling intervention holds promise for improving sibling relationship quality among youth in foster care. Implications and future directions for research are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Fostering a strategic alliance between patients' associations and health care professionals.

    Science.gov (United States)

    Mosconi, Paola; Colombo, Cinzia

    2010-01-01

    The Laboratory for Medical Research and Consumer Involvement was established in 2005 at Mario Negri Institute, a nonprofit institute for pharmacological research, as a consequence of the increasing interest in boosting citizens' and patients' involvement in the health care debate. It has developed several projects with patients' associations, researchers, and clinicians. Its objectives are to foster a strategic alliance among health care professionals, patients, and their organizations, developing activities with different levels of involvement. Among the laboratory' s activities, the PartecipaSalute project has organized training courses for consumers, published a Web site disseminating evidence-based information and critical appraisal tools, and collected research priorities set by patients. Two consensus conferences have been organized, one dealing with brain injury patients' assistance and the other with hormone therapy and menopause. The quality of health information covered by different sources (press articles, Web sites, and brochures) has also been assessed. Seventy consumers attended the training courses from 2006 to 2008, and between January 2008 and June 2009 the PartecipaSalute Web site registered a mean of 30 500 single visits monthly. At the consensus conference Informing women on hormone replacement therapy, 7 members of the 14-member panel defining the final recommendations were lay people. Other data from the laboratory's main activities are given in this article. The criteria for selecting patients and their organizations, the methods of involvement, and evaluation of the impact of the activities are still open questions. We are now developing ways of evaluating our activities, and trying to boost citizens' and patients' participation in decisional settings, concerning health care assistance and research studies.

  6. The Role of Therapeutic Mentoring in Enhancing Outcomes for Youth in Foster Care

    Science.gov (United States)

    Johnson, Sara B.; Pryce, Julia M.; Martinovich, Zoran

    2011-01-01

    Effective service interventions greatly enhance the well-being of foster youth. A study of 262 foster youth examined one such intervention, therapeutic mentoring. Results showed that mentored youth improved significantly in the areas of family and social functioning, school behavior, and recreational activities, as well as in the reduction of…

  7. Effect of early institutionalization and foster care on long-term white matter development: a randomized clinical trial.

    Science.gov (United States)

    Bick, Johanna; Zhu, Tong; Stamoulis, Catherine; Fox, Nathan A; Zeanah, Charles; Nelson, Charles A

    2015-03-01

    radiata and external capsule [right FA, β = 0.01 (P = .03); left FA, β = 0.01 (P = .03); RD, β = -0.01 (P = .01); MD, β = -0.01 (P = .03)]), and sensory processing (medial lemniscus [AD, β = -0.02 (P = .045); MD, β = -0.01 (P = .04)] and retrolenticular internal capsule [FA, β = -0.01 (P = .002); RD, β = 0.01 (P = .003); MD, β = 0.01 (P = .04)]). Follow-up analyses revealed that early intervention promoted more normative white matter development among previously neglected children who entered foster care. Results suggest that removal from conditions of neglect in early life and entry into a high-quality family environment can support more normative trajectories of white matter growth. Our findings have implications for public health and policy efforts designed to promote normative brain development among vulnerable children. clinicaltrials.gov Identifier: NCT00747396.

  8. Placement shift, sibling relationship quality, and child outcomes in foster care: a controlled study.

    Science.gov (United States)

    Linares, L Oriana; Li, MiMin; Shrout, Patrick E; Brody, Gene H; Pettit, Gregory S

    2007-12-01

    Sibling unity during family transitions is considered a protective factor for child behavior problems, but there is little empirical support for the widespread child protection policy of placing siblings together in foster care. In a prospective study of 156 maltreated children, siblings were classified in 1 of 3 placement groups: continuously together (n = 110), continuously apart (n = 22), and disrupted placement (siblings placed together were separated; n = 24). Changes in child adjustment as a function of sibling relationship and placement group were examined. Sibling positivity predicted lower child problems at follow-up (about 14 months later), while sibling negativity predicted higher child problems. Placement group did not affect child behavior problems at follow-up; however, compared to siblings in continuous placement (either together or apart), siblings in disrupted placement with high initial behavior problems were rated as having fewer problems at follow-up, while siblings in disrupted placement with low initial behavior problems were rated as having more problems at follow-up. These findings highlight the importance of considering relationships between siblings and the risk that one poses to another before early placement decisions are made.

  9. Comparisons of substance abuse, high-risk sexual behavior and depressive symptoms among homeless youth with and without a history of foster care placement.

    Science.gov (United States)

    Hudson, Angela L; Nandy, Karabi

    2012-10-01

    The purpose of this study was to compare prevalence of substance use, high-risk sexual behaviors, and depression symptoms between homeless youth with and without a history of foster care placement. Approximately 26,000 young persons exit foster care annually in the United States. Once they 'age out' of foster care, however, many young persons do not have access to comprehensive health care. They also are at risk for substance abuse, homelessness, or mental illness. Because persons with a history of foster care are at risk for negative psycho-social outcomes, it is unclear if these young people might be different than homeless youth without this history. The design is descriptive and cross-sectional. A total of 156 homeless young persons, of whom 44 had a history of foster care placement, were recruited from a drop-in center that caters to homeless youth and young adults. The sample was majority male and white; ages were 16-25. Significantly higher proportion of homeless former foster youth used methamphetamine within the last six months compared to non-fostered homeless youth p = 0.03). Homeless former foster youth were significantly older (p = 0.02) and less educated (p = 0.02) than their homeless counterparts without a history of foster care placement. Prevalence of using tobacco, marijuana, alcohol, crack cocaine, and powder cocaine were similar for both groups. Although not significant, a higher proportion of homeless former foster youth reported trading sex for money or drugs compared to non-fostered, homeless youth (19% versus 12% [trading sex for money], and 26% versus 14% [trading sex for drugs], respectively. Findings from this study show that, in general, homelessness is a negative outcome, irrespective of having a foster care history. However, those with that history need continued support when transitioning to independent living, such as access to health care, and encouragement to further their education. It is important that nurses, who serve homeless

  10. Psychological impact of fostering on biological children of foster parents.

    OpenAIRE

    TÁBOROVÁ, Pavla

    2013-01-01

    Foster care is currently being discussed a great deal, in particular in connection with the planned shutdown of infant care centres. Currently it is preferred to place a child in foster care rather than in institutional care. However, attention should not only be paid to the children placed in foster families. The families that receive the children should also be given a lot of attention. Within a family, one cannot only consider the adults who will become foster parents for the placed childr...

  11. Evaluation of a multi-site program designed to strengthen relational bonds for siblings separated by foster care.

    Science.gov (United States)

    Waid, Jeffrey; Wojciak, Armeda Stevenson

    2017-10-01

    Sibling relationships in foster care settings have received increased attention in recent years. Despite growing evidence regarding the protective potential of sibling relationships for youth in care, some sibling groups continue to experience foster care related separation, and few programs exist to address the needs of these youth. This study describes and evaluates Camp To Belong, a multi-site program designed to provide short-term reunification to separated sibling groups through a week-long summer camp experience. Using a pre-test post-test survey design, this paper examines changes in youth ratings of sibling conflict and sibling support across camps located in six geographically distinct regions of the United States. The effects of youth age, number of prior camp exposures, and camp location were tested using multilevel modeling procedures. Findings suggest that participation in Camp To Belong may reduce sibling conflict, and improvements in sibling support are noted for youth who have had prior exposure to the camp's programming. Camp-level variance in the sibling support outcome highlight the complex nature of relationships for siblings separated by foster care, and suggest the need for additional research. Lessons learned from this multi-site evaluation and future directions are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Fostering the exchange of real world data across different countries to answer primary care research questions: an UNLOCK study from the IPCRG.

    Science.gov (United States)

    Cragg, Liza; Williams, Siân; van der Molen, Thys; Thomas, Mike; Correia de Sousa, Jaime; Chavannes, Niels H

    2018-03-08

    There is growing awareness amongst healthcare planners, providers and researchers of the need to make better use of routinely collected health data by translating it into actionable information that improves efficiency of healthcare and patient outcomes. There is also increased acceptance of the importance of real world research that recruits patients representative of primary care populations and evaluates interventions realistically delivered by primary care professionals. The UNLOCK Group is an international collaboration of primary care researchers and practitioners from 15 countries. It has coordinated and shared datasets of diagnostic and prognostic variables for COPD and asthma to answer research questions meaningful to professionals working in primary care over a 6-year period. Over this time the UNLOCK Group has undertaken several studies using data from unselected primary care populations from diverse contexts to evaluate the burden of disease, multiple morbidities, treatment and follow-up. However, practical and structural constraints have hampered the UNLOCK Group's ability to translate research ideas into studies. This study explored the constraints, challenges and successes experienced by the UNLOCK Group and its participants' learning as researchers and primary care practitioners collaborating to answer primary care research questions. The study identified lessons for future studies and collaborations that require data sharing across borders. It also explored specific challenges to fostering the exchange of primary care data in comparison to other datasets such as public health, prescribing or hospital data and mechanisms that may be used to overcome these.

  13. Challenges in the Transition to Higher Education for Foster Care Youth

    Science.gov (United States)

    Piel, Megan Hayes

    2018-01-01

    This chapter acknowledges the contextual considerations in preparation and success in higher education and establishes a foundation of knowledge for researchers, educators, and practitioners to support foster youth in community college settings.

  14. Psychosocial pathways to sexually transmitted infection risk among youth transitioning out of foster care: evidence from a longitudinal cohort study.

    Science.gov (United States)

    Ahrens, Kym R; McCarty, Cari; Simoni, Jane; Dworsky, Amy; Courtney, Mark E

    2013-10-01

    To test the fit of a theoretically driven conceptual model of pathways to sexually transmitted infection (STI) risk among foster youth transitioning to adulthood. The model included (1) historical abuse and foster care experiences; (2) mental health and attachment style in late adolescence; and (3) STI risk in young adulthood. We used path analysis to analyze data from a longitudinal study of 732 youth transitioning out of foster care. Covariates included gender, race, and an inverse probability weight. We also performed moderation analyses comparing models constrained and unconstrained by gender. Thirty percent reported they or a partner had been diagnosed with an STI. Probability of other measured STI risk behaviors ranged from 9% (having sex for money) to 79% (inconsistent condom use). Overall model fit was good (Standardized Root Mean Square Residual of .026). Increased risk of oppositional/delinquent behaviors mediated an association between abuse history and STI risk, via increased inconsistent condom use. There was also a borderline association with having greater than five partners. Having a very close relationship with a caregiver and remaining in foster care beyond age 18 years decreased STI risk. Moderation analysis revealed better model fit when coefficients were allowed to vary by gender versus a constrained model, but few significant differences in individual path coefficients were found between male and female-only models. Interventions/policies that (1) address externalizing trauma sequelae; (2) promote close, stable substitute caregiver relationships; and (3) extend care to age 21 years have the potential to decrease STI risk in this population. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  15. Public authority over home care.

    NARCIS (Netherlands)

    Genet, N.A.; Boerma, W.G.W.; Kroneman, M.

    2011-01-01

    Background: The ageing society, decreasing resources and financial constraints are putting governments under pressure. Across Europe, division of responsibilities for long-term care are being reconsidered. Under these pressures, the role of governments in home care could be changing. This paper will

  16. People Helping People: Partnerships between Professionals and Natural Helpers. Building Community Partnerships in Child Welfare, Part Four. Family to Family: Tools for Rebuilding Foster Care.

    Science.gov (United States)

    Annie E. Casey Foundation, Baltimore, MD.

    The Family to Family initiative has encouraged states to reconceptualize, redesign, and reconstruct their foster care systems. By 1996, the initiative was being implemented in five states, five Georgia counties, and Los Angeles County, California. This paper describes an approach for nontraditional partnerships that work to rebuild the foster care…

  17. FOSTER FAMILY AS A FORM OF UNITS FOR ORPHANS AND CHILDREN WITHOUT PARENTAL CARE (CASE STUDY OF SARATOV AND BELGOROD REGIONS

    Directory of Open Access Journals (Sweden)

    Oksana Vladimirovna Besschetnova

    2013-09-01

    Full Text Available This paper discusses the development and functioning of foster families, one of the priority interventions for children without parental care in Russia and abroad. The paper analyzes the current official statistics on the problem of child abandonment in Russia as a whole and in the Saratov and Belgorod regions of Russia in particular. The mechanism of social adaptation of children in foster care is based on the qualitative and quantitative methods (surveys and interviews of foster parents and foster children. The author identifies obstacles to the development of social institutions in the regions and the necessity of its active implementation in domestic social practices. The study found that foster care has been successful in areas where accepted legal basis allowed the recruiting, selecting candidates for adoptive parents, and foster care maintenance are carried out by social services. In addition, in order to reduce risk factors such as the secondary abandonment of foster children it is necessarily to increase assistance from the social guardianship bodies and professionals as well as building trusting parent-child relationships that use the democratic parenting style by foster parents.DOI: http://dx.doi.org/10.12731/2218-7405-2013-8-8

  18. A systematic review of cognitive functioning among young people who have experienced homelessness, foster care, or poverty.

    Science.gov (United States)

    Fry, Charlotte E; Langley, Kate; Shelton, Katherine H

    2017-11-01

    Young people who have experienced homelessness, foster care, or poverty are among the most disadvantaged in society. This review examines whether young people who have these experiences differ from their non-disadvantaged peers with respect to their cognitive skills and abilities, and whether cognitive profiles differ between these three groups. Three electronic databases were systematically searched for articles published between 1 January 1995 and 1 February 2015 on cognitive functioning among young people aged 15 to 24 years who have experienced homelessness, foster care, or poverty. Articles were screened using pre-determined inclusion criteria, then the data were extracted, and its quality assessed. A total of 31 studies were included. Compared to non-disadvantaged youth or published norms, cognitive performance was generally found to be impaired in young people who had experienced homelessness, foster care, or poverty. A common area of difficulty across all groups is working memory. General cognitive functioning, attention, and executive function deficits are shared by the homeless and poverty groups. Creativity emerges as a potential strength for homeless young people. The cognitive functioning of young people with experiences of impermanent housing and poverty has been relatively neglected and more research is needed to further establish cognitive profiles and replicate the findings reviewed here. As some aspects of cognitive functioning may show improvement with training, these could represent a target for intervention.

  19. Black-White Differences in Child Maltreatment Reports and Foster Care Placements: A Statistical Decomposition Using Linked Administrative Data.

    Science.gov (United States)

    Maloney, Tim; Jiang, Nan; Putnam-Hornstein, Emily; Dalton, Erin; Vaithianathan, Rhema

    2017-03-01

    Introduction Official statistics have confirmed that relative to their presence in the population and relative to white children, black children have consistently higher rates of contact with child protective services (CPS). We used linked administrative data and statistical decomposition techniques to generate new insights into black and white differences in child maltreatment reports and foster care placements. Methods Birth records for all children born in Allegheny County, Pennsylvania, between 2008 and 2010 were linked to administrative service records originating in multiple county data systems. Differences in rates of involvement with child protective services between black and white children by age 4 were decomposed using nonlinear regression techniques. Results Black children had rates of CPS involvement that were 3 times higher than white children. Racial differences were explained solely by parental marital status (i.e., being unmarried) and age at birth (i.e., predominantly teenage mothers). Adding other covariates did not capture any further racial differences in maltreatment reporting or foster care placement rates, they simply shifted differences already explained by marital status and age to these other variables. Discussion Racial differences in rates of maltreatment reports and foster care placements can be explained by a basic model that adjusts only for parental marital status and age at the time of birth. Increasing access to early prevention services for vulnerable families may reduce disparities in child protective service involvement. Using birth records linked to other administrative data sources provides an important means to developing population-based research.

  20. Maltreatment histories of foster youth exiting out-of-home care through emancipation: a latent class analysis.

    Science.gov (United States)

    Havlicek, Judy

    2014-01-01

    Little is known about maltreatment among foster youth transitioning to adulthood. Multiple entries into out-of-home care and unsuccessful attempts at reunification may nevertheless reflect extended exposure to chronic maltreatment and multiple types of victimization. This study used administrative data from the Illinois Department of Children and Family Services to identify all unduplicated allegations of maltreatment in a cohort of 801 foster youth transitioning to adulthood in the state of Illinois. A latent variable modeling approach generated profiles of maltreatment based on substantiated and unsubstantiated reports of maltreatment taken from state administrative data. Four indicators of maltreatment were included in the latent class analysis: multiple types of maltreatment, predominant type of maltreatment, chronicity, and number of different perpetrators. The analysis identified four subpopulations of foster youth in relation to maltreatment. Study findings highlight the heterogeneity of maltreatment in the lives of foster youth transitioning to adulthood and draw attention to a need to raise awareness among service providers to screen for chronic maltreatment and multiple types of victimization. © The Author(s) 2014.

  1. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre

    2012-01-01

    The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...... disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession...

  2. Smartphone text message service to foster hand hygiene compliance in health care workers.

    Science.gov (United States)

    Kerbaj, Jad; Toure, Youssoupha; Soto Aladro, Alberto; Boudjema, Sophia; Giorgi, Roch; Dufour, Jean Charles; Brouqui, Philippe

    2017-03-01

    Health care-associated infections are a major worldwide public health issue. Hand hygiene is a major component in the prevention of pathogen transmission in hospitals, and hand hygiene adherence by health care workers is low in many studies. We report an intervention using text messages as reminders and feedback to improve hand hygiene adherence. The study is a historical comparison proof-of-concept study. Eighteen health care workers were monitored during 12 months by a radiofrequency identification system. Afterward we sent 2 types of text messages, congratulation or encouragement, and we studied the evolution of hand hygiene adherence. We recorded 15,723 hand hygiene opportunities, 8,973 before intervention and 6,750 during and after the intervention. Using a multilevel logistic regression analysis, we found a significant increase in hand hygiene adherence during the intervention (odds ratio, 1.68) compared with the historical period. Despite limitations due to the type of study, a text message encouraging personnel to be more vigilant is effective in increasing hand hygiene adherence in health care workers. Text message feedback should be incorporated into multimodal approaches for improving hand hygiene compliance. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Do sleep problems mediate the link between adverse childhood experiences and delinquency in preadolescent children in foster care?

    Science.gov (United States)

    Hambrick, Erin P; Rubens, Sonia L; Brawner, Thomas W; Taussig, Heather N

    2018-02-01

    Adverse childhood experiences (ACEs) are associated with multiple mental and physical health problems. Yet, mechanisms by which ACEs confer risk for specific problems are largely unknown. Children in foster care typically have multiple ACEs and high rates of negative sequelae, including delinquent behaviors. Mechanisms explaining this link have not been explored in this population. Impaired sleep has been identified as a potential mechanism by which ACEs lead to delinquency in adolescents, because inadequate sleep may lead to poor executive function and cognitive control - known risk factors for delinquency. Interviews were conducted with 516 maltreated children in foster care, ages 9-11 years, and their caregivers regarding child exposure to ACEs, sleep problems, engagement in delinquent acts, symptoms of posttraumatic stress disorder, and current psychotropic medication use. ACEs data were also obtained from child welfare case records. After controlling for age, gender, race/ethnicity, placement type (residential, kin, foster), length of time in placement, posttraumatic stress symptoms, and current psychotropic medication use, sleep partially mediated the association between ACEs and delinquency. Although delinquency is likely multiply determined in this population, improving sleep may be one important strategy to reduce delinquency. © 2017 Association for Child and Adolescent Mental Health.

  4. Acolhimento familiar: uma alternativa de proteção para crianças e adolescentes Family foster care: a protective alternative for children and adolescents

    Directory of Open Access Journals (Sweden)

    Nina Rosa do Amaral Costa

    2009-01-01

    Full Text Available O acolhimento de crianças e adolescentes que vivenciam violação de direitos tem sido discutido no âmbito do desenvolvimento de políticas públicas e no meio acadêmico. Tais discussões visam elaborar diretrizes que garantam o direito à convivência familiar e comunitária e evidenciam um campo em reordenamento. Este artigo contextualiza o acolhimento familiar no cenário nacional, considerando-o como uma medida de proteção possível para crianças e adolescentes em situação de vulnerabilidade. Discute-se também o reflexo de algumas perspectivas teóricas que abordam as relações de vínculo afetivo em situações de acolhimento. Argumenta-se que ao fomentar uma nova cultura de acolhimento são necessárias mudanças nas concepções de infância e juventude, nas significações de vinculação afetiva e nas políticas de assistência à infância e juventude.Foster care of children and adolescents who have had their rights violated is being discussed both in the scientific literature and in agencies involved in the development of public policies. Such discussions, which aim to define some guidelines to guarantee the right to family and community inclusion, expose a field under change. This paper focuses on foster care in the Brazilian context and presents it as one of the possible alternatives for children and adolescents in risk situations. The (misleading influences of some theoretical perspectives that deal with affective bonds in foster care are also discussed. It is argued that a new foster culture requires changes in the conceptions of infancy and youth, in the meanings of affectionate bonds, and in welfare policies for children and adolescents.

  5. Social innovation in public elder care

    DEFF Research Database (Denmark)

    Bilfeldt, Annette; Andersen, John

    2013-01-01

    The chapter addresses the role of action research in social innovation related to elder care work at public nursing homes in Denmark. It is shown how critical utopian action research can contribute to the development of humanity in elder care to the benefit of the residents life quality...

  6. Attachment for Infants in Foster Care: The Role of Caregiver State of Mind.

    Science.gov (United States)

    Dozier, Mary; Stovall, K. Chase; Albus, Kathleen E.; Bates, Brady

    2001-01-01

    Examined concordance between foster mothers' attachment state of mind and infants' attachment quality. Found that two-way correspondence between maternal state of mind and infant attachment quality was similar to that of biological mother-infant dyads. Age at placement was not related to attachment quality. Concordance between maternal state of…

  7. Emerging versus Emancipating: The Transition to Adulthood for Youth in Foster Care

    Science.gov (United States)

    Berzin, Stephanie Cosner; Singer, Erin; Hokanson, Kimberly

    2014-01-01

    Emerging adulthood has been defined as a distinct developmental stage in which youth experience opportunities for identity development and transition toward independence. While this period has been examined for youth in the general population, less is known about how foster youth experience this transition. This study uses qualitative interviews…

  8. A Trauma-Informed Care Approach to Supporting Foster Youth in Community College

    Science.gov (United States)

    Hallett, Ronald E.; Westland, Melinda A.; Mo, Elaine

    2018-01-01

    This chapter describes the ways that the trauma of childhood frames the academic, social, and personal lives of many foster youth as they navigate higher education. In particular, we focus on the role of homelessness, social network fragmentation, and abuse and neglect.

  9. A Functional Approach to Reducing Runaway Behavior and Stabilizing Placements for Adolescents in Foster Care

    Science.gov (United States)

    Clark, Hewitt B.; Crosland, Kimberly A.; Geller, David; Cripe, Michael; Kenney, Terresa; Neff, Bryon; Dunlap, Glen

    2008-01-01

    Teenagers' running from foster placement is a significant problem in the field of child protection. This article describes a functional, behavior analytic approach to reducing running away through assessing the motivations for running, involving the youth in the assessment process, and implementing interventions to enhance the reinforcing value of…

  10. Cortisol production patterns in young children living with birth parents vs children placed in foster care following involvement of Child Protective Services.

    Science.gov (United States)

    Bernard, Kristin; Butzin-Dozier, Zachary; Rittenhouse, Joseph; Dozier, Mary

    2010-05-01

    To examine differences in waking to bedtime cortisol production between children who remained with birth parents vs children placed in foster care following involvement of Child Protective Services (CPS). Between-subject comparison of cortisol patterns among 2 groups of children. Children referred from the child welfare system. Three hundred thirty-nine children aged 2.9 to 31.4 months who were living with birth parents (n = 155) or placed in foster care (n = 184) following CPS involvement as well as 96 unmatched children from low-risk environments. Main Exposures Involvement by CPS and foster care. Main Outcome Measure Salivary cortisol samples obtained at waking and bedtime for children on 2 days. Child Protective Services-involved children who continued to live with birth parents and CPS-involved children placed in foster care differed in cortisol production, with children living with their birth parents showing flatter slopes in waking to bedtime values. Continuing to live with birth parents following involvement of CPS is associated with greater perturbation to the diurnal pattern of cortisol production than living with foster parents. Foster care may have a regulating influence on children's cortisol among children who have experienced maltreatment.

  11. Longitudinal Assessment of Self-Harm Statements of Youth in Foster Care: Rates, Reporters, and Related Factors.

    Science.gov (United States)

    Gabrielli, Joy; Hambrick, Erin P; Tunno, Angela M; Jackson, Yo; Spangler, Amanda; Kanine, Rebecca M

    2015-12-01

    Self-harm in youth is a risk factor related to mental health and future morbidity, yet, relatively little is known about the rates and course of self-harm in youth residing in foster care. This study examined self-harm talk in foster youth based on caregiver and child report for 135 children between the ages of 8- and 11-years old. Longitudinal data on course of self-harm talk from both youth and caregivers also are provided. Caregivers identified that 24% of youth participants had disclosed a desire to die or to hurt themselves. Youth self-report revealed that 21% of children indicated a desire for self-harm, and rates of self-harm from both reporters decreased over time. While overall rates were similar across reporters, findings show discrepancies between youth self-report and caregiver report within individuals. Also, caregivers for youth in residential facilities were more likely to report youth self-harm talk than caregivers from foster home settings.

  12. Food security and the nutritional status of children in foster care: new horizons in the protection of a fragile population.

    Science.gov (United States)

    Ferrara, Pietro; Scancarello, Marta; Khazrai, Yeganeh M; Romani, Lorenza; Cutrona, Costanza; DE Gara, Laura; Bona, Gianni

    2016-10-12

    The nutritional status of foster children, the quality of daily menus in group homes and the Food Security inside these organizations have been poorly studied and this study means to investigate them. A sample of 125 children, ranging in age from 0-17 years, among seven group homes (group A) was compared with 121 children of the general population we (group B). To evaluate nutritional status, BMI percentiles were used. Mean percentiles of both groups were compared through statistical analysis. Both nutritional and caloric daily distributions in each organization were obtained using the 24-hour recall method. A specific questionnaire was administered to evaluate Food Security. From the analysis of mean BMI-for-age (or height-for-length) percentiles, did not observe statistically significant differences between group A and group B. The average daily nutrient and calorie distribution in group homes proves to be nearly optimal with the exception of a slight excess in proteins and a slight deficiency in PUFAs. Moreover, a low intake of iron and calcium was revealed. All organizations obtained a "High Food Security" profile. Nutritional conditions of foster children are no worse than that of children of the general population. Foster care provides the necessary conditions to support their growth.

  13. Multidimensional Treatment Foster Care as a Preventive Intervention to Promote Resiliency Among Youth in the Child Welfare System

    Science.gov (United States)

    Leve, Leslie D.; Fisher, Philip A.; Chamberlain, Patricia

    2009-01-01

    Demographic trends indicate that a growing segment of families is exposed to adversity such as poverty, drug use problems, caregiver transitions, and domestic violence. Although these risk processes and the accompanying poor outcomes for children have been well-studied, little is known about why some children develop resilience in the face of such adversity, particularly when it is severe enough to invoke child welfare involvement. This paper describes a program of research involving families in the child welfare system. Using a resiliency framework, evidence from four randomized clinical trials that included components of the Multidimensional Treatment Foster Care program is presented. Future directions and next steps are proposed. PMID:19807861

  14. The Use of Expressive Therapies and Social Support with Youth in Foster Care: The Performing Arts Troupe

    Directory of Open Access Journals (Sweden)

    Audra Holmes Greene

    2009-03-01

    Full Text Available The Performing Arts Troupe is a program that provides youth in foster care and youth from low income neighborhoods with expressive therapies and social support. The program is designed to assist youth in addressing the effects of trauma and developing competencies as they prepare to transition to adulthood. The article discusses the literature base for the program, the program activities and describes the impact of the program on youth through preliminary evaluations and case studies. The program offers an innovative combination of expressive therapies and social supports that has effectively met the needs of vulnerable youth.

  15. Effect of childhood age in foster care on the incidence of divorce in adulthood.

    Science.gov (United States)

    Rusby, James S M

    2010-02-01

    This retrospective study examines the long-term effect of the age at which British children were fostered in World War II on their divorce rate. A total of 859 respondents, aged 62 to 72 years, were recruited who had childhood homes in the county of Kent in southeast England during the war. Of these, 770 had been evacuated and fostered, and the remainder stayed at home. Reflecting the wartime concerns of Bowlby, Miller, and Winnicott (1939) regarding the wisdom of separating young children from their parents for a potentially long period, male and female respondents evacuated between the ages of 4 to 6 years had a significantly higher incidence of divorce compared with those in the 13- to 15-year age group. This association was found to be mediated by attachment style in which the fearful category was predominant. The relevance of these results in the broader developmental context, and to family counseling, are briefly discussed.

  16. Insights in public health: Building support for an evidence-based teen pregnancy and sexually transmitted infection prevention program adapted for foster youth.

    Science.gov (United States)

    Smith, Tamara; Clark, Judith F; Nigg, Claudio R

    2015-01-01

    Hawai'i Youth Services Network (HYSN) was founded in 1980 and is incorporated as a 501(c) (3) organization. HYSN plays a key role in the planning, creation, and funding of local youth services. One of HYSN's focuses is teen pregnancy and sexually transmitted infections (STI) prevention among foster youth. Foster youth are at a greater risk for teen pregnancy and STI due to a variety of complex factors including instability, trauma, and emancipation from the foster care system. This article highlights how HYSN is leveraging both federal and local funding, as well as other resources, in order to implement an evidence-based teen pregnancy and STI prevention program adapted for foster youth.

  17. Prior trauma exposure and serious illness at end of life: A national study of children in the US foster care system from 2005 to 2015.

    Science.gov (United States)

    Lindley, Lisa C; Slayter, Elspeth M

    2018-06-08

    Children in foster care suffer with serious illness at end of life. However, the relationship between prior trauma exposure and serious illness has received little empirical attention. The objectives were to examine the prevalence and type of trauma exposure, and investigate the relationship between prior trauma and serious illness among foster children at end of life. We used national longitudinal foster care data. We included children who were less than 18 years with residence in the United States. Serious illness (i.e., physical health, mental/behavioral health, developmental disabilities) was measured via the foster care files. Three measures of prior trauma exposure (i.e., maltreatment, drug/alcohol exposure, psychosocial stressors) were created. Using multivariate logistic regressions, we evaluated the influence of prior trauma on serious illness at end of life, while controlling for demographic, geographic, and foster care support characteristics. Sixty-eight percent of children experienced maltreatment, 28% exposure to parental drug/alcohol misuse, and 39% psychosocial stressors prior to entering foster care. Maltreatment was positively associated with physical health and developmental disabilities, while parental drug/alcohol exposure was inversely related to developmental disabilities. Psychosocial stressors contributed to the prediction of poor physical, mental, and developmental health. These findings suggest that trauma-informed end-of-life care may be a critical need among children in foster care with serious illness. Future directions are discussed, including collaboration between end-of-life clinicians and social service workers and the importance of future research to understand and improve the quality of health at end of life for this underserved population. Copyright © 2018. Published by Elsevier Inc.

  18. Building positive self-image in adolescents in foster care: the use of role models in an interactive group approach.

    Science.gov (United States)

    Yancey, A K

    1998-01-01

    In a previous article (Yancey, 1992), the literature on identity development in individuals from socially devalued racial and ethnic groups was summarized. It was postulated that the social maladaptation of adolescents in residential group foster care is reflective of identity disturbances created by the negative images of African-Americans and Latinos perpetuated by the dominant society and unfiltered by optimal parental racial/ethnic socialization. The present article describes the development of a pilot preventive mental health intervention, the PRIDE (Personal and Racial/ethnic Identity Development and Enhancement) program, designed to provide components of parenting that are necessary for promoting positive self-image in ethnically marginalized adolescents and that are typically lacking in the group foster care milieu. PRIDE utilizes successful, ethnically relevant role models in interactive group sessions to create a significant cognitive and emotional experience for teens. While the utility of role modeling for at-risk youth is widely accepted, there is little research on the packaging, delivery, and influence of this intervention modality. This study demonstrates the feasibility of a "hybrid" role-modeling approach (intermediate in intensity of exposure and cost between one-to-one mentoring and career-day programs). Implications for further research on this type of intervention are discussed.

  19. "How Can You Know? You're Not a Foster Child":

    DEFF Research Database (Denmark)

    Warming, H.

    2006-01-01

    to give voice to foster children so that their knowledge about "the life as a child in foster care" could find its way to social workers and foster parents as well as politicians, thus influencing, democratizing and qualifying social work with children and youth in foster care. "Børneting" was established......Based on Axel Honneth's Theoty of Recognition and an empirical action research project entitled "Børnetinget" (Children's Parliament), conducted in Denmark by the author, this article discuss dilemmas and possibilities of giving voice to children in foster care. The Børnetinget project aimed...... with a core group of 15 foster children, aged 10-13, and a web-based "foster children's public forum". This article focuses on learning about participation from the Børnetinget experience, both as a model of participatory research practice and for the insights it provides in relation to how we understand...

  20. Overweight and obesity among Hispanic children entering foster care: a preliminary examination of polyvictimization.

    Science.gov (United States)

    Schneiderman, Janet U; Smith, Caitlin; Arnold-Clark, Janet S; Fuentes, Jorge; Duan, Lei; Palinkas, Lawrence A

    2013-11-01

    This retrospective medical chart review examined the prevalence of overweight/obesity (≥85th percentile) and obesity (≥95th percentile) in Hispanic foster children aged 2-18 years in Los Angeles, California. Logistic regression was used for boys and girls separately to analyze polyvictimization (i.e., one vs. two or more types of maltreatment), type of maltreatment (abuse vs. neglect), and age-group as risk factors for overweight and obesity. Almost 40% of participants were overweight/obese, with the highest prevalence (47.7%) observed among children aged 12-18. Children aged 6-18 were at an increased risk of overweight/obesity and obesity compared with children aged 2-5. Although polyvictimization has been shown to have adverse health effects, in this study, it was related to slightly lower odds of obesity for boys but was unrelated to high weight for girls. Addressing the obesity epidemic among Hispanic foster children is vital to preventing continued obesity and the development of obesity-related health problems, especially by focusing on important community and family influences.

  1. Multidimensional Treatment Foster Care for Girls in the Juvenile Justice System: 2-Year Follow-Up of a Randomized Clinical Trial

    Science.gov (United States)

    Chamberlain, Patricia; Leve, Leslie D.; DeGarmo, David S.

    2007-01-01

    This study is a 2-year follow-up of girls with serious and chronic delinquency who were enrolled in a randomized clinical trial conducted from 1997 to 2002 comparing multidimensional treatment foster care (MTFC) and group care (N = 81). Girls were referred by juvenile court judges and had an average of over 11 criminal referrals when they entered…

  2. Public trust in Dutch health care.

    NARCIS (Netherlands)

    Straten, G.F.M.; Friele, R.D.; Groenewegen, P.P.

    2002-01-01

    This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed, or operationalized in earlier research. The new instrument will be used

  3. How Do Private Sector Schools Serve the Public Good by Fostering Inclusive Service Delivery Models?

    Science.gov (United States)

    Scanlan, Martin; Tichy, Karen

    2014-01-01

    Conversations about promoting educational reforms that redress educational inequities often ignore private schools as irrelevant. Yet pursuits of inclusivity in private sector schools serve the public interest. This article focuses on how the system of Catholic schools in the Archdiocese of St. Louis has been purposefully striving for 2 decades to…

  4. Effects of Motor Development Stimulation on Anthropometric Indices of Infants Aged 1-12 Months in Foster Care Homes

    Directory of Open Access Journals (Sweden)

    Arezou NikNezhad Jalali

    2015-12-01

    Full Text Available Background: The first three years of life have a pivotal role in growth and development of infants. Extra-uterine environment largely affects brain development of infants during the first year of life.However,no specific programs are available for brain development stimulation in foster homes. Aim: This study aimed to evaluate the effects of motor development stimulation package on anthropometric indices of infants staying in foster homes. Method: This experimental study was conducted on 50 infants aged 1-12 months at Ali Asghar foster home of Mashhad, Iran in 2013. Infants were randomly divided into two groups of intervention (n=25 and control (n=25. Motor development stimulation packages were used for intervention group three times a week for eight consecutive weeks (24 sessions, two hours each. Anthropometric indices of infants were evaluated using standard instruments before and after intervention. Data analysis was performed in SPSS V.11.5 using independent T-test and Mann-Whitney U test. Results: In this study, mean age of infants in intervention and control groups was 6.04±3.48 and 4.3±3.70 months, respectively. In total, 68% of infants were male, and 32% were female. After intervention, Mann-Whitney test results showed no statistically significant difference in height (P=0.47 and head circumference (P=0.11 of infants between the groups. However, independent T-test showed a statistically significant difference in body weight of infants (P=0.007 between the groups after intervention with the stimulation care package. Implications for Practice: According to the results of this study, use of evidence-based motor development stimulation package for eight weeks resulted in increased weight of infants, while it had no effect on height and head circumference. Therefore, it is recommended that complementary studies be conducted in this regard.

  5. The Blind Men and the Elephant: Identification of a Latent Maltreatment Construct for Youth in Foster Care

    Science.gov (United States)

    Gabrielli, Joy; Jackson, Yo; Tunno, Angela M.; Hambrick, Erin P.

    2017-01-01

    Child maltreatment is a major public health concern due to its impact on developmental trajectories and consequences across mental and physical health outcomes. Operationalization of child maltreatment has been complicated, as research has used simple dichotomous counts to identification of latent class profiles. This study examines a latent measurement model assessed within foster youth inclusive of indicators of maltreatment chronicity and severity across four maltreatment types: physical, sexual, and psychological abuse, and neglect. Participants were 500 foster youth with a mean age of 12.99 years (SD = 2.95 years). Youth completed survey questions through a confidential audio computer-assisted self-interview program. A two-factor model with latent constructs of chronicity and severity of maltreatment revealed excellent fit across fit indices; however, the latent constructs were correlated .972. A one-factor model also demonstrated excellent model fit to the data (χ2 (16, n = 500) =28.087, p =.031, RMSEA (0.012 – 0.062) =.039, TLI =.990, CFI =.994, SRMR =.025) with a nonsignificant chi-square difference test comparing the one- and two-factor models. Invariance tests across age, gender, and placement type also were conducted with recommendations provided. Results suggest a single-factor latent model of maltreatment severity and chronicity can be attained. Thus, the maltreatment experiences reported by foster youth, though varied and complex, were captured in a model that may prove useful in later predictions of outcome behaviors. Appropriate identification of both the chronicity and severity of maltreatment inclusive of the range of maltreatment types remains a high priority for future research. PMID:28254690

  6. Public Relations and Religious Diversity: A Conceptual Framework for Fostering a Spirit of Communitas

    Directory of Open Access Journals (Sweden)

    Donn James Tilson

    2011-01-01

    Full Text Available Changes in immigration law, globalization and increased ease of transportation have transformed modern societies into culturally diverse landscapes with religious diversity, in particular, presenting both opportunities and challenges. The author proposes a conceptual framework that embraces an interpretation of public relations as a social function, a covenantal model as a theoretical ground, an expanded worldview to include tolerance as an essential defining presupposition, and expanded communicative conceptual parameters that include religion in definitions of diversity and generic principles of excellent practice. An anecdotal review of faith communities in the U.S. reveals that public relations professionals and other communicators model the conceptual framework in interfaith initiatives and that the framework would serve as a helpful foundation for guiding communication professionals toward such behaviour. The study also illustrates that socially-responsible behaviour often has a foundation of faith common across various faith traditions.

  7. Fostering Scientific and Numerate Practices in Journalism to Support Rapid Public Learning

    Directory of Open Access Journals (Sweden)

    Louise Yarnall

    2017-01-01

    Full Text Available Journalism has the potential––and arguably the mandate––to expand public understanding of societally important phenomena. However, some methods for more effectively educating the public have been persistently underutilized: in particular, embedding informative numerical rates and efficient scientific explanations in news reports. In the current era of disrupting and downsizing the news business, the challenges to using such methods have only increased. To address this problem, this article seeks to (a raise awareness about the psychological reasons that help explain why it is crucial to use such elements in news reports, and (b exhibit some methods for doing so that require modest effort. Building on a review of relevant psychological literatures, principles, and existing reporting methods, we describe findings from a series of cognitive-scientific studies that demonstrate how using key––and relatively minimal––scientific and numerical elements can enhance public learning from news reports. We conclude by also describing curricula and resources designed to help journalists and bloggers use these methods.

  8. Educational project for the nuclear power and nuclear waste public acceptance fostering

    International Nuclear Information System (INIS)

    Constantin, M.; Diaconu, Daniela

    2005-01-01

    Full text: Until now, public acceptance of nuclear power in Romania can be assessed as good. The main motivations could be: the primacy effect of the information, the poverty, the absence of the interest, the relative low informing level. However we expect important changes in the near future: more active NGOs with anti-nuclear opinion, the public's awareness will be more important, serious opposition against the continuation of the nuclear development may appear followed by a reformulation of the Romanian ecologists ideas. The problem of radioactive nuclear wastes (RNW) is the most sensitive and, related to the public opinion, we expect it will become crucial in 10-15 years. The main assumption of our project is that children who are now in schools will be tomorrow's decision makers on 'nuclear energy and RNW. Thus, we intend to prepare the young generation for the future participation in the decision making process related to RNW. The paper shows the main ideas (initial conditions obtained by actual knowledge level measurements, constraints, methods, information contents, evaluation methods and produced outputs) of the educational proposed programme. The work is part of the Romanian contribution to COWAM FP6 project. (authors)

  9. Fostering excellence

    Science.gov (United States)

    Hogg, William; Kendall, Claire; Muggah, Elizabeth; Mayo-Bruinsma, Liesha; Ziebell, Laura

    2014-01-01

    Abstract Problem addressed A key priority in primary health care research is determining how to ensure the advancement of new family physician clinician investigators (FP-CIs). However, there is little consensus on what expectations should be implemented for new investigators to ensure the successful and timely acquisition of independent salary support. Objective of program Support new FP-CIs to maximize early career research success. Program description This program description aims to summarize the administrative and financial support provided by the C.T. Lamont Primary Health Care Research Centre in Ottawa, Ont, to early career FP-CIs; delineate career expectations; and describe the results in terms of research productivity on the part of new FP-CIs. Conclusion Family physician CI’s achieved a high level of research productivity during their first 5 years, but most did not secure external salary support. It might be unrealistic to expect new FP-CIs to be self-financing by the end of 5 years. This is a career-development program, and supporting new career FP-CIs requires a long-term investment. This understanding is critical to fostering and strengthening sustainable primary care research programs. PMID:24522688

  10. Fostering a "Feeling of Worth" Among Vulnerable HIV Populations: The Role of Linkage to Care Specialists.

    Science.gov (United States)

    Broaddus, Michelle R; Owczarzak, Jill; Schumann, Casey; Koester, Kimberly A

    2017-10-01

    To address barriers to adequate engagement in medical care among people living with HIV, Wisconsin's AIDS/HIV Program created a new position, the Linkage to Care (LTC) Specialist. Specialists provide intensive, short-term case management and patient navigation services for small caseloads of individuals at high risk of disengaging with medical care. Clients are eligible if they are newly diagnosed with HIV or new to medical care, recently released from incarceration, recently out of care, nonadherent to scheduled medical care visits, or have detectable viral load while in care. Interviews with 30 clients of Specialists were conducted to understand experiences with the program and medical care. Common themes included the ability of Specialists to navigate complex systems of care and support services, the unique role Specialists played in their clients' lives, and the challenges of transitioning out of the program. Although the primary goal of Specialists is to address barriers to medical care, they often adopted a holistic approach that also included housing, financial assistance, and other social determinants of health. Descriptions of the Specialist's role in implementation manuals focus on their functional roles and the services provided. However, clients often discussed the emotional support they received, especially for clients without strong social support networks. Many clients also desired an ongoing relationship with their Specialists even after discharge, but had been able to establish independence and self-efficacy. The LTC Specialists are resource-intensive considering their small caseloads, but fill an important gap in existing, often overtaxed case management systems.

  11. Public trust in Dutch health care.

    Science.gov (United States)

    Straten, G F M; Friele, R D; Groenewegen, P P

    2002-07-01

    This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed, or operationalized in earlier research. The new instrument will be used in a research project to monitor trust and to predict behaviour of people such as consulting "alternative practitioners". The idea for the research was suggested by economic research into public trust. In the study, a phased design was used to overcome the operationalization problem. In the first phase, a qualitative study was conducted; and, in the second, a quantitative study. In the first phase, more than 100 people were interviewed to gain insight into the issues they associated with trust. Eight categories of issues that were derived from the interviews were assumed to be possible dimensions of trust. On the basis of these eight categories and the interviews, a questionnaire was developed that was used in the second phase. In this phase, the questionnaire was sent to 1500 members of a consumer panel; the response was 70 percent. The analysis reveals that six of the eight possible dimensions appear in factor analysis. These dimensions are trust in: the patient-focus of health care providers; macro policies level will have no consequences for patients; expertise of health care providers; quality of care; information supply and communication by care providers and the quality of cooperation. The reliability of most scales is higher than 0.8. The validity of the dimensions is assessed by determining the correlation between the scales on the one hand, and people's experience and a general mark they would assign on the other. We conclude that public trust is a multi-dimensional concept, including not only issues that relate to the patient-doctor relationship, but also issues that relate to health care institutions. The instrument appears to be reliable and valid.

  12. Fostering a supportive moral climate for health care providers: Toward cultural safety and equity

    Directory of Open Access Journals (Sweden)

    Adel F. Almutairi

    Full Text Available In Western forms of health care delivery around the globe, research tells us that nurses experience excessive workloads as they face increasingly complex needs in the populations they serve, professional conflicts, and alienation from leadership in health care bureaucracies. These problems are practical and ethical as well as cultural. Cultural conflicts can arise when health care providers and the populations they serve come from diverse economic, ethnic, and cultural backgrounds. The purpose in this paper is to draw from Almutairi’s research with health care teams in Saudi Arabia to show the complexity of culturally and morally laden interactions between health care providers and patients and their families. Then, I will argue for interventions that promote social justice and cultural safety for nurses, other health care providers, and the individuals, families, and communities they serve. This will include addressing international implications for nursing practice, leadership, policy and research. Keywords: Moral climate, Social justice, Equity, Cultural diversity

  13. Enhancing local distinctiveness fosters public acceptance of tidal energy: A UK case study

    International Nuclear Information System (INIS)

    Devine-Wright, Patrick

    2011-01-01

    Tidal energy has the technical potential to form part of a low carbon electricity sector, however, its 'social potential' is less clear, as few empirical studies of public beliefs and responses have been conducted to date. This research addressed this gap by investigating a tidal energy convertor in Northern Ireland, said to be the first grid-connected device of its kind in the world. Data was collected from 313 residents of two nearby villages using mixed methods, guided by a conceptual framework that avoided 'NIMBY' assumptions and instead drew on place theory. Findings indicated strong support for the project, arising from beliefs that the project enhanced local distinctiveness by 'putting the area on the map worldwide'; appeared visually familiar and helped tackle climate change. These positive beliefs outweighed concerns about outcome and process aspects, which were preponderant in one of the two villages. The project was interpreted to have few positive local economic outcomes, to potentially threaten local livelihoods and local ecology. Moreover, residents expressed cynicism about consultation procedures, and reported low levels of behavioural engagement. Implications of the findings for the literature on public acceptance of renewable energy, and for the emerging marine energy sector specifically, are discussed.

  14. Health insurance coverage and use of family planning services among current and former foster youth: implications of the health care reform law.

    Science.gov (United States)

    Dworsky, Amy; Ahrens, Kym; Courtney, Mark

    2013-04-01

    This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population.

  15. Attachment security as a mechanism linking foster care placement to improved mental health outcomes in previously institutionalized children.

    Science.gov (United States)

    McLaughlin, Katie A; Zeanah, Charles H; Fox, Nathan A; Nelson, Charles A

    2012-01-01

    Children reared in institutions experience elevated rates of psychiatric disorders. Inability to form a secure attachment relationship to a primary caregiver is posited to be a central mechanism in this association. We determined whether the ameliorative effect of a foster care (FC) intervention on internalizing disorders in previously institutionalized children was explained by the development of secure attachment among children placed in FC. Second we evaluated the role of lack of attachment in an institutionalized sample on the etiology of internalizing disorders within the context of a randomized trial. A sample of 136 children (aged 6-30 months) residing in institutions was recruited in Bucharest, Romania. Children were randomized to FC (n = 68) or to care as usual (CAU; n = 68). Foster parents were recruited, trained, and overseen by the investigative team. Attachment security at 42 months was assessed using the Strange Situation Procedure, and internalizing disorders at 54 months were assessed using the Preschool Age Psychiatric Assessment. Girls in FC had fewer internalizing disorders than girls in CAU (OR = 0.17, p = .006). The intervention had no effect on internalizing disorders in boys (OR = 0.47, p = .150). At 42 months, girls in FC were more likely to have secure attachment than girls in CAU (OR = 12.5, p security predicted lower rates of internalizing disorders in both sexes. Development of attachment security fully mediated intervention effects on internalizing disorders in girls. Placement into FC facilitated the development of secure attachment and prevented the onset of internalizing disorders in institutionalized girls. The differential effects of FC on attachment security in boys and girls explained gender differences in the intervention effects on psychopathology. Findings provide evidence for the critical role of disrupted attachment in the etiology of internalizing disorders in children exposed to institutionalization. © 2011 The Authors

  16. Patient-centered boundary mechanisms to foster intercultural partnerships in health care: a case study in Guatemala.

    Science.gov (United States)

    Hitziger, Martin; Berger Gonzalez, Mónica; Gharzouzi, Eduardo; Ochaíta Santizo, Daniela; Solis Miranda, Regina; Aguilar Ferro, Andrea Isabel; Vides-Porras, Ana; Heinrich, Michael; Edwards, Peter; Krütli, Pius

    2017-08-08

    Up to one half of the population in Africa, Asia and Latin America has little access to high-quality biomedical services and relies on traditional health systems. Medical pluralism is thus in many developing countries the rule rather than the exception, which is why the World Health Organization is calling for intercultural partnerships to improve health care in these regions. They are, however, challenging due to disparate knowledge systems and lack of trust that hamper understanding and collaboration. We developed a collaborative, patient-centered boundary mechanism to overcome these challenges and to foster intercultural partnerships in health care. To assess its impact on the quality of intercultural patient care in a medically pluralistic developing country, we conducted and evaluated a case study. The case study took place in Guatemala, since previous efforts to initiate intercultural medical partnerships in this country were hampered by intense historical and societal conflicts. It was designed by a team from ETH Zurich's Transdisciplinarity Lab, the National Cancer Institute of Guatemala, two traditional Councils of Elders and 25 Mayan healers from the Kaqchikel and Q'eqchi' linguistic groups. It was implemented from January 2014 to July 2015. Scientists and traditional political authorities collaborated to facilitate workshops, comparative diagnoses and patient referrals, which were conducted jointly by biomedical and traditional practitioners. The traditional medical practices were thoroughly documented, as were the health-seeking pathways of patients, and the overall impact was evaluated. The boundary mechanism was successful in discerning barriers of access for indigenous patients in the biomedical health system, and in building trust between doctors and healers. Learning outcomes included a reduction of stereotypical attitudes towards traditional healers, improved biomedical procedures due to enhanced self-reflection of doctors, and improved

  17. The impact and efficiency of public administration excellence on fostering SMEs in EU countries

    Directory of Open Access Journals (Sweden)

    Aleksander Aristovnik

    2015-05-01

    Full Text Available The article investigates the impact and efficiency of bureaucracy on the development of small and medium-sized enterprises (SMEs in the European Union (EU. For this purpose, the article applies a non-parametric approach, i.e. data envelopment analysis (DEA, to assess the best performers in terms of transforming existing bureaucratic burdens into selected SME indicators, such as growth in their numbers, employment or value added in the 2010-2014 period. The empirical results show that Luxembourg, Sweden and, in particular, the Baltic States can serve as a good benchmark for transforming a relatively favourable environment of public administration excellence into SME indicator growth. On the other hand, Denmark and the UK, despite their top ease-of-doing-business rankings could not significantly spur SME growth in the considered period. Nevertheless, the main goal for the large majority of EU member states, especially in South-east Europe and the Mediterranean region, remains a further reduction of bureaucracy that could be useful for improving the regulatory environment of SMEs and thus aid in an even more rapid recovery from the crisis.

  18. YouTube videos of 'research in action' foster diverse public interest in science

    Directory of Open Access Journals (Sweden)

    Michael A. Gil

    2017-08-01

    Full Text Available Globally, scientific enterprises seek to diversify interest and participation in STEM fields, to both provide equitable opportunities and to push research forward. However, diversity in STEM remains low in many institutions. Internet-based video has emerged as a dominant communication medium that scientists can use to communicate the motivations, process, and products of their work to a diverse, mass audience. Here I describe my use of internet-based video about my research and career as a marine biologist as a tool to inspire broad public interest in science. With my YouTube videos, I have reached a diverse and growing global viewership, amassing >10,000 hours of watch time at the time of this writing. Viewer surveys revealed that my videos have improved individual perceptions about science and science careers, particularly among women and minority groups. I conclude that the emergence of internet-based video as a dominant, ever-expanding communication medium provides an unprecedented but largely untapped opportunity for scientists to broadly communicate their research and to inspire diverse interest in STEM careers.

  19. Mentoring the Next Generation of Social Workers in Palliative and End-of-Life Care: The Zelda Foster Studies Program.

    Science.gov (United States)

    Gardner, Daniel S; Gerbino, Susan; Walls, Jocelyn Warner; Chachkes, Esther; Doherty, Meredith J

    2015-01-01

    As Americans live longer with chronic illnesses, there is a growing need for social workers with the knowledge and skills to deliver quality palliative care to older adults and their families. Nevertheless, there remains a critical shortage of social workers prepared to provide quality palliative and end-of-life care (PELC) and to maintain the field into the next generation. Formal mentorship programs represent an innovative approach to enhancing practice, providing support and guidance, and promoting social work leadership in the field. This article reviews the literature on mentorship as an approach to professional and leadership development for emerging social workers in PELC. The Zelda Foster Studies Program in Palliative and End-of-Life Care bolsters competencies and mentors social workers in PELC over the trajectory of their careers, and enhances the capacity in the field. Findings from the first six years of two components of the ZF Program are examined to illustrate the feasibility, benefits, and challenges of formal mentorship programs. The authors describe the background, structure, and evaluation of the initiative's mentorship programs, and discuss the implications of mentorship in PELC for social work education, practice, and research.

  20. National Medical Care System May Impede Fostering of True Specialization of Radiation Oncologists: Study Based on Structure Survey in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Numasaki, Hodaka [Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka (Japan); Shibuya, Hitoshi [Department of Radiology, Tokyo Medical and Dental University, Tokyo (Japan); Nishio, Masamichi [Department of Radiology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Hokkaido (Japan); Ikeda, Hiroshi [Department of Radiology, Sakai Municipal Hospital, Sakai, Osaka (Japan); Sekiguchi, Kenji [Department of Radiation Oncology, St. Luke' s International Hospital, Tokyo (Japan); Kamikonya, Norihiko [Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo (Japan); Koizumi, Masahiko [Oncology Center, Osaka University Hospital, Suita, Osaka (Japan); Tago, Masao [Department of Radiology, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kawasaki, Kanagawa (Japan); Ando, Yutaka [Department of Medical Informatics, Heavy Ion Medical Center, National Institute of Radiological Sciences, Chiba (Japan); Tsukamoto, Nobuhiro [Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama (Japan); Terahara, Atsuro [Department of Radiology, Toho University Omori Medical Center, Tokyo (Japan); Nakamura, Katsumasa [Department of Radiology, Kyushu University Hospital at Beppu, Oita (Japan); Mitsumori, Michihide [Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine Kyoto University, Kyoto (Japan); Nishimura, Tetsuo [Division of Radiation Oncology, Shizuoka Cancer Center, Shizuoka (Japan); Hareyama, Masato [Department of Radiology, Sapporo Medical University, Hokkaido (Japan); Teshima, Teruki, E-mail: teshima@sahs.med.osaka-u.ac.jp [Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka (Japan)

    2012-01-01

    Purpose: To evaluate the actual work environment of radiation oncologists (ROs) in Japan in terms of working pattern, patient load, and quality of cancer care based on the relative time spent on patient care. Methods and Materials: In 2008, the Japanese Society of Therapeutic Radiology and Oncology produced a questionnaire for a national structure survey of radiation oncology in 2007. Data for full-time ROs were crosschecked with data for part-time ROs by using their identification data. Data of 954 ROs were analyzed. The relative practice index for patients was calculated as the relative value of care time per patient on the basis of Japanese Blue Book guidelines (200 patients per RO). Results: The working patterns of RO varied widely among facility categories. ROs working mainly at university hospitals treated 189.2 patients per year on average, with those working in university hospitals and their affiliated facilities treating 249.1 and those working in university hospitals only treating 144.0 patients per year on average. The corresponding data were 256.6 for cancer centers and 176.6 for other facilities. Geographically, the mean annual number of patients per RO per quarter was significantly associated with population size, varying from 143.1 to 203.4 (p < 0.0001). There were also significant differences in the average practice index for patients by ROs working mainly in university hospitals between those in main and affiliated facilities (1.07 vs 0.71: p < 0.0001). Conclusions: ROs working in university hospitals and their affiliated facilities treated more patients than the other ROs. In terms of patient care time only, the quality of cancer care in affiliated facilities might be worse than that in university hospitals. Under the current national medical system, working patterns of ROs of academic facilities in Japan appear to be problematic for fostering true specialization of radiation oncologists.

  1. Fostering evidence-based quality improvement for patient-centered medical homes: Initiating local quality councils to transform primary care.

    Science.gov (United States)

    Stockdale, Susan E; Zuchowski, Jessica; Rubenstein, Lisa V; Sapir, Negar; Yano, Elizabeth M; Altman, Lisa; Fickel, Jacqueline J; McDougall, Skye; Dresselhaus, Timothy; Hamilton, Alison B

    Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation. Our evaluation objectives were to (a) assess design element implementation, (b) describe implementation barriers and facilitators, and (c) assess successful quality improvement project completion and spread. We analyzed administrative records and conducted interviews with 85 organizational leaders. We developed and applied criteria for assessing design element implementation using hybrid deductive/inductive analytic techniques. All quality councils implemented interdisciplinary leadership and a structured quality improvement process, and all but one completed at least one quality improvement project and a toolkit for spreading improvements. Quality councils were perceived as most effective when service line leaders had well-functioning interdisciplinary communication. Matching positions within leadership hierarchies with appropriate supportive roles facilitated frontline quality improvement efforts. Two key resources were (a) a dedicated internal facilitator with project management, data collection, and presentation skills and (b) support for preparing customized data reports for identifying and addressing practice level quality issues. Overall, quality councils successfully cultivated interdisciplinary, multilevel primary care quality improvement leadership with accountability mechanisms and generated frontline innovations suitable for spread. Practice level performance data and quality improvement project management support

  2. National medical care system may impede fostering of true specialization of radiation oncologists: study based on structure survey in Japan.

    Science.gov (United States)

    Numasaki, Hodaka; Shibuya, Hitoshi; Nishio, Masamichi; Ikeda, Hiroshi; Sekiguchi, Kenji; Kamikonya, Norihiko; Koizumi, Masahiko; Tago, Masao; Ando, Yutaka; Tsukamoto, Nobuhiro; Terahara, Atsuro; Nakamura, Katsumasa; Mitsumori, Michihide; Nishimura, Tetsuo; Hareyama, Masato; Teshima, Teruki

    2012-01-01

    To evaluate the actual work environment of radiation oncologists (ROs) in Japan in terms of working pattern, patient load, and quality of cancer care based on the relative time spent on patient care. In 2008, the Japanese Society of Therapeutic Radiology and Oncology produced a questionnaire for a national structure survey of radiation oncology in 2007. Data for full-time ROs were crosschecked with data for part-time ROs by using their identification data. Data of 954 ROs were analyzed. The relative practice index for patients was calculated as the relative value of care time per patient on the basis of Japanese Blue Book guidelines (200 patients per RO). The working patterns of RO varied widely among facility categories. ROs working mainly at university hospitals treated 189.2 patients per year on average, with those working in university hospitals and their affiliated facilities treating 249.1 and those working in university hospitals only treating 144.0 patients per year on average. The corresponding data were 256.6 for cancer centers and 176.6 for other facilities. Geographically, the mean annual number of patients per RO per quarter was significantly associated with population size, varying from 143.1 to 203.4 (p working mainly in university hospitals between those in main and affiliated facilities (1.07 vs 0.71: p working in university hospitals and their affiliated facilities treated more patients than the other ROs. In terms of patient care time only, the quality of cancer care in affiliated facilities might be worse than that in university hospitals. Under the current national medical system, working patterns of ROs of academic facilities in Japan appear to be problematic for fostering true specialization of radiation oncologists. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Long-Term Effects of Pre-Placement Risk Factors on Children's Psychological Symptoms and Parenting Stress among Families Adopting Children from Foster Care

    Science.gov (United States)

    Nadeem, Erum; Waterman, Jill; Foster, Jared; Paczkowski, Emilie; Belin, Thomas R.; Miranda, Jeanne

    2017-01-01

    This exploratory longitudinal study examined behavioral outcomes and parenting stress among families with children adopted from foster care, taking into account environmental and biological risk factors. Child internalizing and externalizing problems and parenting stress were assessed in 82 adopted children and their families at 2 months…

  4. Walking Our Talk in the Neighborhoods: Partnerships between Professionals and Natural Helpers. Building Community Partnerships in Child Welfare, Part Three. Family to Family: Tools for Rebuilding Foster Care.

    Science.gov (United States)

    Annie E. Casey Foundation, Baltimore, MD.

    The Family to Family initiative has encouraged states to reconceptualize, redesign, and reconstruct their foster care systems. By 1996, the initiative was being implemented in five states, five Georgia counties, and Los Angeles County, California. This paper describes some of the ways natural helpers can assist professionals achieve the necessary…

  5. Effective Early Childhood Care and Education: Successful Approaches and Didactic Strategies for Fostering Child Development

    Science.gov (United States)

    Burger, Kaspar

    2015-01-01

    This research article attempts to determine strategies that can be used to support children's cognitive and social-emotional development in early childhood care and education programs. By synthesizing empirical evidence about pedagogical techniques that promote children's competencies, the article aims to identify those characteristics of programs…

  6. Fostering critical thinking skills: a strategy for enhancing evidence based wellness care

    Directory of Open Access Journals (Sweden)

    Jamison Jennifer R

    2005-09-01

    Full Text Available Abstract Chiropractic has traditionally regarded itself a wellness profession. As wellness care is postulated to play a central role in the future growth of chiropractic, the development of a wellness ethos acceptable within conventional health care is desirable. This paper describes a unit which prepares chiropractic students for the role of "wellness coaches". Emphasis is placed on providing students with exercises in critical thinking in an effort to prepare them for the challenge of interfacing with an increasingly evidence based health care system. Methods This case study describes how health may be promoted and disease prevented through development of personalized wellness programs. As critical thinking is essential to the provision of evidence based wellness care, diverse learning opportunities for developing and refining critical thinking skills have been created. Three of the learning opportunities are an intrinsic component of the subject and, taken together, contributed over 50% of the final grade of the unit. They include a literature review, developing a client wellness contract and peer evaluation. In addition to these 3 compulsory exercises, students were also given an opportunity to develop their critical appraisal skills by undertaking voluntary self- and unit evaluation. Several opportunities for informal self-appraisal were offered in a structured self-study guide, while unit appraisal was undertaken by means of a questionnaire and group discussion at which the Head of School was present. Results Formal assessment showed all students capable of preparing a wellness program consistent with current thinking in contemporary health care. The small group of students who appraised the unit seemed to value the diversity of learning experiences provided. Opportunities for voluntary unit and self-appraisal were used to varying degrees. Unit evaluation provided useful feedback that led to substantial changes in unit structure

  7. Social media in public health care

    DEFF Research Database (Denmark)

    Andersen, Kim Normann; Medaglia, Rony; Henriksen, Helle Zinner

    2012-01-01

    This paper investigates the impacts of social media use in Danish public health care with respect to capabilities, interactions, orientations, and value distribution. Taking an exploratory approach, the paper draws on an array of quantitative and qualitative data, and puts forward four propositions......: social media transform the access to health-related information for patients and general practitioners, the uptake of social media can be a cost driver rather than a cost saver, social media provide empowerment to patients, and the uptake of social media is hindered by legal and privacy concerns...

  8. Public trust in health care : Exploring the mechanisms

    NARCIS (Netherlands)

    van der Schee, E.

    2016-01-01

    The aim of this thesis is to investigate how public trust in health care is formed, by studying the mechanisms behind it, addressing the following research question: ‘Which mechanisms explain differences in public trust in health care?’. Public trust in health care is important. Low levels of trust

  9. Fostering caring relationships: Suggestions to rethink liberal perspectives on the ethics of newborn screening.

    Science.gov (United States)

    van der Burg, Simone; Oerlemans, Anke

    2018-03-01

    Newborn screening (NBS) involves the collection of blood from the heel of a newborn baby and testing it for a list of rare and inheritable disorders. New biochemical screening technologies led to expansions of NBS programs in the first decade of the 21st century. It is expected that they will in time be replaced by genetic sequencing technologies. These developments have raised a lot of ethical debate. We reviewed the ethical literature on NBS, analyzed the issues and values that emerged, and paid particular interest to the type of impacts authors think NBS should have on the lives of children and their families. Our review shows that most authors keep their ethical reflection confined to policy decisions, about for instance (a) the purpose of the program, and (b) its voluntary or mandatory nature. While some authors show appreciation of how NBS information empowers parents to care for their (diseased) children, most authors consider these aspects to be 'private' and leave their evaluation up to parents themselves. While this division of moral labor fits with the liberal conviction to leave individuals free to decide how they want to live their private lives, it also silences the ethical debate about these issues. Given the present and future capacity of NBS to offer an abundance of health-related information, we argue that there is good reason to develop a more substantive perspective to whether and how NBS can contribute to parents' good care for children. © 2018 The Authors. Bioethics Published by John Wiley & Sons Ltd.

  10. Assessing Restrictiveness: A Closer Look at the Foster Care Placements and Perceptions of Youth With and Without Disabilities Aging Out of Care

    Science.gov (United States)

    Cunningham, Miranda; Dalton, Lawrence D.; Powers, Laurie E.; Geenen, Sarah; Orozco, Claudia Guadalupe

    2014-01-01

    The aim of the study was to examine the experience of restrictiveness among transition-aged youth with disabilities in foster care. Utilizing a sample of 207 youth, placement types were explored for differences in disability status, race and sex. Further, youth perceptions of restriction around communication, movement around one’s home, and access to the community were examined for youth receiving special education services (SPED), youth receiving developmental disability services (DD), and youth without disabilities. Youth with disabilities were more likely to be placed in more restrictive placement types and had significantly higher levels of perceived restriction around communication, movement, and community when compared to youth without disabilities. Additionally, males with disabilities experienced higher levels of restrictiveness, particularly those who received DD services, while White youth with disabilities also experienced greater community restrictiveness. PMID:24489523

  11. Fostering Future Leadership in Quality and Safety in Health Care through Systems Thinking.

    Science.gov (United States)

    Phillips, Janet M; Stalter, Ann M; Dolansky, Mary A; Lopez, Gloria McKee

    2016-01-01

    There is a critical need for leadership in quality and safety to reform today's disparate spectrum of health services to serve patients in complex health care environments. Nurse graduates of degree completion programs (registered nurse-bachelor of science in nursing [RN-BSN]) are poised for leadership due to their recent education and nursing practice experience. The authors propose that integration of systems thinking into RN-BSN curricula is essential for developing these much needed leadership skills. The purpose of this article is to introduce progressive teaching strategies to help nurse educators achieve the student competencies described in the second essential of the BSN Essentials document (American Association of Colleges of Nursing, 2009), linking them with the competencies in Quality and Safety Education for Nurses (QSEN; L. Cronenwett et al., 2007) using an author-created model for curricular design, the Systems-level Awareness Model. The Systems Thinking Tool (M. A. Dolansky & S. M. Moore, 2013) can be used to evaluate systems thinking in the RN-BSN curriculum. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?

    Directory of Open Access Journals (Sweden)

    Gustavo S. Fernandes

    Full Text Available OBJECTIVES: With the development of next-generation sequencing (NGS technologies, DNA sequencing has been increasingly utilized in clinical practice. Our goal was to investigate the impact of genomic evaluation on treatment decisions for heavily pretreated patients with metastatic cancer. METHODS: We analyzed metastatic cancer patients from a single institution whose cancers had progressed after all available standard-of-care therapies and whose tumors underwent next-generation sequencing analysis. We determined the percentage of patients who received any therapy directed by the test, and its efficacy. RESULTS: From July 2013 to December 2015, 185 consecutive patients were tested using a commercially available next-generation sequencing-based test, and 157 patients were eligible. Sixty-six patients (42.0% were female, and 91 (58.0% were male. The mean age at diagnosis was 52.2 years, and the mean number of pre-test lines of systemic treatment was 2.7. One hundred and seventy-seven patients (95.6% had at least one identified gene alteration. Twenty-four patients (15.2% underwent systemic treatment directed by the test result. Of these, one patient had a complete response, four (16.7% had partial responses, two (8.3% had stable disease, and 17 (70.8% had disease progression as the best result. The median progression-free survival time with matched therapy was 1.6 months, and the median overall survival was 10 months. CONCLUSION: We identified a high prevalence of gene alterations using an next-generation sequencing test. Although some benefit was associated with the matched therapy, most of the patients had disease progression as the best response, indicating the limited biological potential and unclear clinical relevance of this practice.

  13. Perspectives of Youth in Foster Care on Essential Ingredients for Promoting Self-determination and Successful Transition to Adult Life: My Life Model.

    Science.gov (United States)

    Powers, Laurie E; Fullerton, Ann; Schmidt, Jessica; Geenen, Sarah; Oberweiser-Kennedy, Molly; Dohn, JoAnn; Nelson, May; Iavanditti, Rosemary; Blakeslee, Jennifer

    2018-02-01

    Research clearly documents the serious challenges and poor outcomes experienced by many young people exiting foster care, as well as compounded disparities for the high percentage of youth in care who are identified with disabilities and/or mental health challenges. However, very little research has been conducted to specify or validate effective models for improving the transition trajectories of youth exiting care. Evidence suggests the My Life self-determination enhancement model offers a promising approach for supporting youths' self-determined and positive transition to adulthood. The model includes youth-directed, experientially oriented coaching in the application of self-determination skills to achieve youth-identified transition goals, coupled with peer mentoring workshops that provide opportunities for learning, networking and fun. This in depth qualitative study of 10 youth who completed the My Life intervention focused on investigating coaching and mentoring elements and processes that youth participants identify as most important to their success, with the intention of informing the further development of youth-directed approaches to supporting young people who are transitioning to adulthood. Themes emerged around the centrality of youth self-direction, important processes in the coaching relationship, the essential value of experiential activities and self-determination skill development, and peer mentoring experiences that youth identified as fostering their success. Implications are discussed for research and practice in supporting youth exiting foster care.

  14. 77 FR 4336 - Notice of Proposed Information Collection for Public Comment on the Study of: Housing for Youth...

    Science.gov (United States)

    2012-01-27

    ... Information Collection for Public Comment on the Study of: Housing for Youth Aging Out of Foster Care AGENCY... information: Title of Proposal: Housing for Youth Aging Out of Foster Care. OMB Control Number: XXXX-pending... serving youth aging out of foster care, and why or why not; and for those PHAs that are serving youth, to...

  15. Psychosocial Pathways to Sexually Transmitted Infection (STI) Risk Among Youth Transitioning Out of Foster Care: Evidence from a Longitudinal Cohort Study

    Science.gov (United States)

    McCarty, Cari; Simoni, Jane; Dworsky, Amy; Courtney, Mark E.

    2013-01-01

    Purpose To test the fit of a theoretically driven conceptual model of pathways to STI risk among foster youth transitioning to adulthood. The model included: 1) historical abuse and foster care experiences, 2) mental health and attachment style in late adolescence, and 3) STI risk in young adulthood. Methods We used path analysis to analyze data from a longitudinal study of 732 youth transitioning out of foster care. Covariates included gender, race and an inverse probability weight. We also performed moderation analyses comparing models constrained and unconstrained by gender. Results Thirty percent reported they or a partner had been diagnosed with an STI. Probability of other measured STI risk behaviors ranged from 9% (having sex for money) to 79% (inconsistent condom use). Overall model fit was good (Standardized Root Mean Squared Residual of 0.026). Increased risk of oppositional/delinquent behaviors mediated an association between abuse history and STI risk, via increased inconsistent condom use. There was also a borderline association with having greater than 5 partners. Having a very close relationship with a caregiver and remaining in foster care beyond age 18 decreased STI risk. Moderation analysis revealed better model fit when coefficients were allowed to vary by gender versus a constrained model, but few significant differences in individual path coefficients were found between male and female-only models. Conclusions Interventions/policies that: 1) address externalizing trauma sequelae, 2) promote close, stable substitute caregiver relationships, and 3) extend care to age 21 years have the potential to decrease STI risk in this population. PMID:23859955

  16. Defining a target population at high risk of long-term foster care: barriers to permanency for families of children with serious emotional disturbances.

    Science.gov (United States)

    Akin, Becci A; Bryson, Stephanie A; McDonald, Tom; Walker, Sheila

    2012-01-01

    Long-term foster care (LTFC) is an enduring problem that lacks evidence of effective strategies for practice or policy. This article describes initial activities of a statewide project of the national Permanency Innovations Initiative. The authors sought to: (1) verify the relevance of children's mental health as a predictor of LTFC, (2) describe critical barriers encountered by parents of children with serious emotional disturbances, and (3) identify systems barriers that hinder permanency for this target population.

  17. Engagement with Cognitively-Based Compassion Training is associated with reduced salivary C-reactive protein from before to after training in foster care program adolescents.

    Science.gov (United States)

    Pace, Thaddeus W W; Negi, Lobsang Tenzin; Dodson-Lavelle, Brooke; Ozawa-de Silva, Brendan; Reddy, Sheethal D; Cole, Steven P; Danese, Andrea; Craighead, Linda W; Raison, Charles L

    2013-02-01

    Children exposed to early life adversity (ELA) have been shown to have elevated circulating concentrations of inflammatory markers that persist into adulthood. Increased inflammation in individuals with ELA is believed to drive the elevated risk for medical and psychiatric illness in the same individuals. This study sought to determine whether Cognitively Based Compassion Training (CBCT) reduced C-reactive protein (CRP) in adolescents in foster care with high rates of ELA, and to evaluate the relationship between CBCT engagement and changes in CRP given prior evidence from our group for an effect of practice on inflammatory markers. It was hypothesized that increasing engagement would be associated with reduced CRP from baseline to the 6-week assessment. Seventy-one adolescents in the Georgia foster care system (31 females), aged 13-17, were randomized to either 6 weeks of CBCT or a wait-list condition. State records were used to obtain information about each participant's history of trauma and neglect, as well as reason for placement in foster care. Saliva was collected before and again after 6 weeks of CBCT or the wait-list condition. Participants in the CBCT group completed practice diaries as a means of assessing engagement with the CBCT. No difference between groups was observed in salivary CRP concentrations. Within the CBCT group, practice sessions during the study correlated with reduced CRP from baseline to the 6-week assessment. Engagement with CBCT may positively impact inflammatory measures relevant to health in adolescents at high risk for poor adult functioning as a result of significant ELA, including individuals placed in foster care. Longer term follow-up will be required to evaluate if these changes are maintained and translate into improved health outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Fostering maternal and newborn care in India the Yashoda way: does this improve maternal and newborn care practices during institutional delivery?

    Directory of Open Access Journals (Sweden)

    Beena Varghese

    Full Text Available BACKGROUND: The Yashoda program, named after a legendary foster-mother in Indian mythology, under the Norway-India Partnership Initiative was launched as a pilot program in 2008 to improve the quality of maternal and neonatal care at facilities in select districts of India. Yashodas were placed mainly at district hospitals, which are high delivery load facilities, to provide support and care to mothers and newborns during their stay at these facilities. This study presents the results from the evaluation of this intervention in two states in India. METHODS: Data collection methods included in-depth interviews with healthcare providers and mothers and a survey of mothers who had recently delivered within a quasi-experimental design. Fifty IDIs were done and 1,652 mothers who had delivered in the past three months were surveyed during 2010 and 2011. RESULTS: A significantly higher proportion of mothers at facilities with Yashodas (55 percent to 97 percent received counseling on immunization, breastfeeding, family planning, danger signs, and nutrition compared to those in control districts (34 percent to 66 percent. Mothers in intervention facilities were four to five times more likely to receive postnatal checks than mothers in control facilities. Among mothers who underwent cesarean sections, initiation of breastfeeding within five hours was 50 percent higher in intervention facilities. Mothers and families also reported increased support, care and respect at intervention facilities. CONCLUSION: Yashoda as mothers' aide thus seems to be an effective intervention to improve quality of maternal and newborn care in India. Scaling up of this intervention is recommended in district hospitals and other facilities with high volume of deliveries.

  19. Factors influencing women's utilization of public health care services ...

    African Journals Online (AJOL)

    the determinants influencing women's use of public health facilities at the time they give birth. Results: Of .... due to distance between their places of abode and health care facilities ..... care: what works for safe motherhood: Bull World Health.

  20. Transition Planning for Foster Youth

    Science.gov (United States)

    Geenen, Sarah J.; Powers, Laurie E.

    2006-01-01

    The study evaluated the IEPs/Individualized Transition Plans of 45 students who were in special education and foster care, and compared them to the plans of 45 students who were in special education only. Results indicate that the transition plans of foster youth with disabilities were poor in quality, both in absolute terms and in comparison to…

  1. The wellbeing of foster children and their relationship with foster parents and biological parents : a child’s perspective

    NARCIS (Netherlands)

    Maaskant, A.M.; van Rooij, F.B.; Bos, H.M.W.; Hermanns, J.M.A.

    2016-01-01

    Most Dutch foster children live permanently in foster families. It is often assumed that foster children have ambivalent loyalties and attachments to their birth parents and foster parents and are torn between the two. In this study 59 children between 10 and 18 years placed in long term foster care

  2. Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project.

    Science.gov (United States)

    Vanderwert, Ross E; Zeanah, Charles H; Fox, Nathan A; Nelson, Charles A

    2016-02-01

    Extreme social and cognitive deprivation as a result of institutional care has profound effects on developmental outcomes across multiple domains for many abandoned or orphaned children. The Bucharest Early Intervention Project (BEIP) examines the outcomes for children originally placed in institutions who were assessed comprehensively and then randomized to foster care (FCG) or care as usual (CAUG) and followed longitudinally. Here we report on the brain electrical activity (electroencephalogram: EEG) of 12-year-old children enrolled in the BEIP. Previous reports suggested improvement in resting EEG activity for the group of children placed in the foster care intervention, particularly those placed before 24 months of age compared to children who were randomized to CAUG or those placed into families after this age. At 12 years, differences between those in the FCG and those in the CAUG persist in the alpha band (8-13 Hz), but not in higher frequency bands (i.e. in the beta band; 15-30 Hz), except in those children placed into the FCG who remained in high quality care environments over the course of the study. These findings highlight the importance of maintaining a stable high quality caregiving environment, particularly for children exposed to early psychosocial deprivation, for promoting healthy brain development. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Maltreatment histories of aging out foster youth: A comparison of official investigated reports and self-reports of maltreatment prior to and during out-of-home care.

    Science.gov (United States)

    Havlicek, Judy; Courtney, Mark E

    2016-02-01

    This study compared official investigated reports of child maltreatment with retrospective self-reports prior to and during out-of-home care for a sample of foster youth who reached the age of majority in out-of-home care in Illinois. Using matched administrative and self-reported data for 474 youth who completed a baseline interview in the Midwest Evaluation of Adult Functioning of Former Foster Youth (i.e. the Midwest study) at ages 17-18, and 386 youth who completed a follow up interview at age 19, this study finds that official reports and self-reports of maltreatment prior to and during out-of-home care differ significantly. Findings from this study add insight into measurement discrepancies, and help to inform understanding of the extent of maltreatment experienced by this sub-sample of young people exiting out-of-home care in adulthood. Study findings have implications for independent living policy and practice in child welfare. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Reducing Ex-offender Health Disparities through the Affordable Care Act: Fostering Improved Health Care Access and Linkages to Integrated Care

    Directory of Open Access Journals (Sweden)

    Lacreisha Ejike-King

    2014-04-01

    Full Text Available Despite steadily declining incarceration rates overall, racial and ethnic minorities, namely African Americans, Latinos, and American Indians and Alaska Natives, continue to be disproportionately represented in the justice system. Ex-offenders commonly reenter communities with pressing health conditions but encounter obstacles to accessing care and remaining in care. The lack of health insurance coverage and medical treatment emerge as the some of the most reported reentry health needs and may contribute to observed health disparities. Linking ex-offenders to care and services upon release increases the likelihood that they will remain in care and practice successful disease management. The Affordable Care Act (ACA offers opportunities to address health disparities experienced by the reentry population that places them at risk for negative health outcomes and recidivism. Coordinated efforts to link ex-offenders with these newly available opportunities may result in a trajectory for positive health and overall well-being as they reintegrate into society.

  5. Organizational factors influencing successful primary care and public health collaboration.

    Science.gov (United States)

    Valaitis, Ruta; Meagher-Stewart, Donna; Martin-Misener, Ruth; Wong, Sabrina T; MacDonald, Marjorie; O'Mara, Linda

    2018-06-07

    Public health and primary care are distinct sectors within western health care systems. Within each sector, work is carried out in the context of organizations, for example, public health units and primary care clinics. Building on a scoping literature review, our study aimed to identify the influencing factors within these organizations that affect the ability of these health care sectors to collaborate with one another in the Canadian context. Relationships between these factors were also explored. We conducted an interpretive descriptive qualitative study involving in-depth interviews with 74 key informants from three provinces, one each in western, central and eastern Canada, and others representing national organizations, government, or associations. The sample included policy makers, managers, and direct service providers in public health and primary care. Seven major organizational influencing factors on collaboration were identified: 1) Clear Mandates, Vision, and Goals; 2) Strategic Coordination and Communication Mechanisms between Partners; 3) Formal Organizational Leaders as Collaborative Champions; 4) Collaborative Organizational Culture; 5) Optimal Use of Resources; 6) Optimal Use of Human Resources; and 7) Collaborative Approaches to Programs and Services Delivery. While each influencing factor was distinct, the many interactions among these influences are indicative of the complex nature of public health and primary care collaboration. These results can be useful for those working to set up new or maintain existing collaborations with public health and primary care which may or may not include other organizations.

  6. Prenatal Care for Pregnant Adolescents in a Public High School.

    Science.gov (United States)

    Berg, Marjorie; And Others

    1979-01-01

    Two groups of pregnant adolescents were studied using a retrospective analysis of obstetrical summary to demonstrate the relationship of the availability of a comprehensive, program of prenatal care in a public school setting to the achievement of early and continuous prenatal care, and to the minimizing of obstetrical complications. (JMF)

  7. The problems and prospects of public health care development in ...

    African Journals Online (AJOL)

    The abysmal failure of public health care system in Nigeria has attracted comments and criticisms from local and national levels. The provision of adequate health care services to the citizens, particularly those residing at the rural areas has left much to be desired. In spite of media propaganda and the current health sector ...

  8. Child Maltreatment, Trauma, and Physical Health Outcomes: The Role of Abuse Type and Placement Moves on Health Conditions and Service Use for Youth in Foster Care.

    Science.gov (United States)

    Jackson, Yo; Cushing, Christopher C; Gabrielli, Joy; Fleming, Kandace; O'Connor, Bridget M; Huffhines, Lindsay

    2016-01-01

    The purpose of the study was to investigate the relations between abuse types, non-maltreatment-related trauma, and health service utilization in a sample of youth in foster care with and without chronic medical conditions. A total of 213 youth, aged 8-21 years, provided self-report of general trauma and abuse exposure. Medicaid claims for each child were collected from official state databases. Exposure to sexual abuse, neglect, or general trauma but not exposure to physical abuse or psychological abuse increased the rates of medical visits, while only general trauma increased medical hospitalizations.  Trauma types are not equally predictive of health care utilization for youth with chronic health conditions. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Caring for our youngest: public attitudes in the United States.

    Science.gov (United States)

    Sylvester, K

    2001-01-01

    Families make choices about employment and care for their children in a context that is shaped by public policies and colored by public opinion. Debates over whether the government should increase funding for child care or do more to help parents stay home with their children reflect tensions among strongly held ideas about family life, work, and the role of government. This article summarizes the results of public opinion polls that probe attitudes about parent and government roles and responsibilities with respect to children's care. The polling findings yield three main lessons: The American public believes that parents should be the primary influence in their children's lives and that it is best if mothers can be home to care for the very young. The public also values family self-sufficiency and understands that low-income families may need child care assistance to balance child rearing and employment responsibilities. However, skepticism about the appropriateness of government involvement in family life limits public support for proposals that the government act directly to provide or improve child care. From these lessons, the author draws several conclusions for policymakers: Policies focused on caregiving should respect the rights of parents to raise their children by ensuring that an array of options is available. Public programs should help families who are struggling economically to balance their obligations to work and family. Rather than directly providing child care services, government should fund community-based child care programs, and provide flexible assistance to help families secure the services they need and want.

  10. Primary health care and public policy.

    Science.gov (United States)

    Mangelsdorf, K L; Luna, J; Smith, H L

    1988-01-01

    The health problems of Ecuador are similar to those in other developing countries where the standard of living is low, and housing and sanitation are inadequate. Women, children, and those living in rural areas are those most severely affected. National policy has been to attempt to increase access to health care in rural areas through the construction of new facilities and the appointment of highly paid medical staff. However, little attention was paid to sociocultural factors, which caused the peasantry to reject the medical care system, or to problems of internal efficiency which inhibited utilization. Since the 1970s various national and international organizations have attempted to implement primary health care (PHC) through the use of trained community health workers (CHWs). The primary problems faced by the CHWs were shortages of medicines and supplies, an almost total lack of supervision, and lack of transportation available to take staff to isolated villages. The poor supervision is blamed for the 17% drop out rate among CHWs since 1980. Independent PHC programs have also been established in Ecuador by voluntary organizations. These work best when coordinated with governmental programs, in order to allow monitoring and to avoid the duplication of services. Problems with the establishment of PHC programs in Ecuador will continue, as the government has no clear cut policy, and difficulties financing on a broad national scale. Other problems include the absence of effective supervision and logistical support for even small pilot programs, and inconsistencies in the training and role definition for CHWs. These problems need to be met in the implementation of a national PHC policy.

  11. Improving understanding, promoting social inclusion, and fostering empowerment related to epilepsy: Epilepsy Foundation public awareness campaigns--2001 through 2013.

    Science.gov (United States)

    Price, P; Kobau, R; Buelow, J; Austin, J; Lowenberg, K

    2015-03-01

    It is a significant public health concern that epilepsy, the fourth most common neurological disorder in the United States, is generally poorly understood by both the public and those living with the condition. Lack of understanding may magnify the challenges faced by those with epilepsy, including limiting treatment opportunities, effective management of symptoms, and full participation in daily life activities. Insufficient awareness of epilepsy and appropriate seizure first aid among the public and professionals can result in insufficient treatment, inappropriate seizure response, physical restraint, social exclusion, or other negative consequences. To address the need for increased public education and awareness about epilepsy, the national Epilepsy Foundation, supported by the Centers for Disease Control and Prevention, has conducted yearly multifaceted public education and awareness campaigns designed to reach the broad population and targeted segments of the population including youth, young adults, racial/ethnic groups (i.e., African-, Hispanic-, and Asian-Americans), and people with epilepsy and their caregivers. Campaign channels have included traditional media, social media, and community opinion leaders and celebrity spokespersons. The key activities of these campaigns, conducted from 2001 to 2013, are summarized in this report. Published by Elsevier Inc.

  12. Care satisfaction among older people receiving public care and service at home or in special accommodation.

    Science.gov (United States)

    Karlsson, Staffan; Edberg, Anna-Karin; Jakobsson, Ulf; Hallberg, Ingalill R

    2013-02-01

    To explore care satisfaction in relation to place of living, health-related quality of life, functional dependency and health complaints among people 65 years or older, receiving public care and service. The concept public care and service concerns formal care from the municipality, including home help, home nursing care, rehabilitation and a special accommodation. To be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential. Cross-sectional, including comparison and correlation. One-hundred sixty-six people receiving public care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health-related quality of life was measured with SF-12, and self-rated care satisfaction was measured with a questionnaire. Low self-rated care satisfaction was associated with dependency in Instrumental Activities of Daily Living, blindness, faeces incontinence and anxiety, while high self-rated care satisfaction was associated with dependency in Personal Activities of Daily Living. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity and personal relations; they thought that the staff had more time and were more respectful and quiet, than the ratings by those in a special accommodation (equivalent to a nursing home). Care satisfaction and health-related quality of life among older people was more associated with functional impairment and health complaints than to whether care and service was received at home or in a special accommodation. An approach using intervention focused on functional ability and health complaints is important for development of improved care satisfaction for older people receiving public care and service. © 2013 Blackwell Publishing Ltd.

  13. Protocol for the economic evaluation of a complex intervention to improve the mental health of maltreated infants and children in foster care in the UK (The BeST? services trial).

    Science.gov (United States)

    Deidda, Manuela; Boyd, Kathleen Anne; Minnis, Helen; Donaldson, Julia; Brown, Kevin; Boyer, Nicole R S; McIntosh, Emma

    2018-03-14

    Children who have experienced abuse and neglect are at increased risk of mental and physical health problems throughout life. This places an enormous burden on individuals, families and society in terms of health services, education, social care and judiciary sectors. Evidence suggests that early intervention can mitigate the negative consequences of child maltreatment, exerting long-term positive effects on the health of maltreated children entering foster care. However, evidence on cost-effectiveness of such complex interventions is limited. This protocol describes the first economic evaluation of its kind in the UK. An economic evaluation alongside the Best Services Trial (BeST?) has been prospectively designed to identify, measure and value key resource and outcome impacts arising from the New Orleans intervention model (NIM) (an infant mental health service) compared with case management (CM) (enhanced social work services as usual). A within-trial economic evaluation and long-term model from a National Health Service/Personal Social Service and a broader societal perspective will be undertaken alongside the National Institute for Health Research (NIHR)-Public Health Research Unit (PHRU)-funded randomised multicentre BeST?. BeST? aims to evaluate NIM compared with CM for maltreated children entering foster care in a UK context. Collection of Paediatric Quality of Life Inventory (PedsQL) and the recent mapping of PedsQL to EuroQol-5-Dimensions (EQ-5D) will facilitate the estimation of quality-adjusted life years specific to the infant population for a cost-utility analysis. Other effectiveness outcomes will be incorporated into a cost-effectiveness analysis (CEA) and cost-consequences analysis (CCA). A long-term economic model and multiple economic evaluation frameworks will provide decision-makers with a comprehensive, multiperspective guide regarding cost-effectiveness of NIM. The long-term population health economic model will be developed to synthesise

  14. Public health emergencies and the public health/managed care challenge.

    Science.gov (United States)

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

    2002-01-01

    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

  15. Reading and Writing with a Public Purpose: Fostering Middle School Students' Academic and Critical Community Literacies through Debate

    Science.gov (United States)

    Mirra, Nicole; Honoroff, Benjamin; Elgendy, Suzanne; Pietrzak, Gabriel

    2016-01-01

    Middle school is a crucial transition period for adolescents; in addition to beginning to grapple with the academic literacy demands of college and career readiness, they are working to find their place in public life and developing opinions about civic issues. This article presents debate as a literacy practice that is uniquely suited to helping…

  16. Physicians' fees and public medical care programs.

    Science.gov (United States)

    Lee, R H; Hadley, J

    1981-01-01

    In this article we develop and estimate a model of physicians' pricing that explicitly incorporates the effects of Medicare and Medicaid demand subsidies. Our analysis is based on a multiperiod model in which physicians are monopolistic competitors supplying services to several markets. The implications of the model are tested using data derived from claims submitted by a cohort of 1,200 California physicians during the years 1972-1975. We conclude that the demand for physician's services is relatively elastic; that increases in the local supply of physicians reduce prices somewhat; that physicians respond strategically to attempts to control prices through the customary-prevailing-reasonable system; and that price controls limit the rate of increase in physicians' prices. The analysis identifies a family of policies that recognize the monopsony power of public programs and may change the cost-access trade-off. PMID:7021479

  17. Underserved parents, underserved youth: Considering foster parent willingness to foster substance-using adolescents

    Science.gov (United States)

    Meyers, Kathleen; Kaynak, Övgü; Clements, Irene; Bresani, Elena; White, Tammy

    2014-01-01

    Adolescents involved with foster care are five times more likely to receive a drug dependence diagnosis when compared to adolescents in the general population. Prior research has shown that substance use is often hidden from providers, negating any chance for treatment and almost guaranteeing poor post-foster care outcomes. There are virtually no studies that examine the willingness (and its determinants) to foster youth with substance abuse problems. The current study conducted a nationally-distributed survey of 752 currently licensed foster care parents that assessed willingness to foster youth overall and by type of drug used, and possible correlates of this decision (e.g., home factors, system factors, and individual foster parent factors such as ratings of perceived difficulty in fostering this population). Overall, willingness to foster a youth involved with alcohol and other drugs (AOD) was contingent upon the types of drugs used. The odds that a parent would foster an AOD-involved youth were significantly increased by being licensed as a treatment foster home, having fostered an AOD-involved youth in the past, having AOD-specific training and past agency-support when needed, and self-efficacy with respect to positive impact. Surprisingly, when religion played a large part in the decision to foster any child, the odds of willingness to foster an AOD-involved youth dropped significantly. These results suggest that a large proportion of AOD-involved youth who find themselves in the foster care system will not have foster families willing to parent them, thereby forcing placement into a variety of congregate care facilities (e.g., residential treatment facilities, group homes). Specific ways in which the system can address these issues to improve placement and permanency efforts is provided. PMID:25878368

  18. Public and private health-care financing with alternate public rationing rules.

    Science.gov (United States)

    Cuff, Katherine; Hurley, Jeremiah; Mestelman, Stuart; Muller, Andrew; Nuscheler, Robert

    2012-02-01

    We develop a model to analyze parallel public and private health-care financing under two alternative public sector rationing rules: needs-based rationing and random rationing. Individuals vary in income and severity of illness. There is a limited supply of health-care resources used to treat individuals, causing some individuals to go untreated. Insurers (both public and private) must bid to obtain the necessary health-care resources to treat their beneficiaries. Given individuals' willingnesses-to-pay for private insurance are increasing in income, the introduction of private insurance diverts treatment from relatively poor to relatively rich individuals. Further, the impact of introducing parallel private insurance depends on the rationing mechanism in the public sector. We show that the private health insurance market is smaller when the public sector rations according to need than when allocation is random. Copyright © 2010 John Wiley & Sons, Ltd.

  19. Public health capacity in the provision of health care services.

    Science.gov (United States)

    Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick

    2015-12-01

    In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services.

  20. Congenital Anomalies: Public Health Interventions to Ensure its Prevention and Expansion of Care to the Patients

    Directory of Open Access Journals (Sweden)

    Saurabh RamBihariLal Shrivastava

    2015-03-01

    Full Text Available Congenital anomalies can be defined as structural or functional anomalies, including metabolic / biochemical disorders, which are present at the time of birth. Congenital anomalies has been recognized as a major public health concern, owing to its universal distribution, associated long-term disability; social stigma; emotional / psychological stress for the family members; increased medical expenditure; and burden on the health care delivery system and societies. To prevent the occurrence of congenital anomalies, due attention should be given to establishment of appropriate surveillance systems to record cases from both community and hospital settings; strengthening of public health system; promoting research to explore the etiological factors and diagnosis/prevention strategies; fostering international cooperation; and discouraging the practice of consanguineous marriage / conception at an advanced age / further reproduction after birth of a malformed child. To conclude, there is an indispensable need to formulate a comprehensive policy, that should be well-supported by an efficient surveillance system, dedicated health care professionals and involvement of all stakeholders. [Cukurova Med J 2015; 40(1.000: 135-137

  1. Public perceptions of health care professionals' participation in pharmaceutical marketing.

    Science.gov (United States)

    Crigger, Nancy J; Courter, Laura; Hayes, Kristen; Shepherd, K

    2009-09-01

    Trust in the nurse-patient relationship is maintained not by how professionals perceive their actions but rather by how the public perceives them. However, little is known about the public's view of nurses and other health care professionals who participate in pharmaceutical marketing. Our study describes public perceptions of health care providers' role in pharmaceutical marketing and compares their responses with those of a random sample of licensed family nurse practitioners. The family nurse practitioners perceived their participation in marketing activities as significantly more ethically appropriate than did the public responders. Further research is warranted before conclusions can be drawn, but these early findings suggest that nurse practitioners should consider a conservative approach to participating in pharmaceutical marketing.

  2. Social inequalities in the organization of pregnancy care in a universally funded public health care system.

    Science.gov (United States)

    Sutherland, Georgina; Yelland, Jane; Brown, Stephanie

    2012-02-01

    To examine the social organization of pregnancy care and the extent to which socioeconomic factors affect women's experience of care. We consider these data in the global discussion on taking action to reduce health inequalities. This study draws on cross-sectional data from a large population-based survey of Australian women 6 months after giving birth. Only those women reporting to attend publically-funded models of antenatal care (i.e., public clinic, midwife clinic, shared care, primary medical care, primary midwife care) were included in analyses. Results showed a social patterning in the organization and experience of care with clear links between model of care attended in pregnancy and a number of individual-level indicators of social disadvantage. Our findings show model of care is a salient feature in how women view their care. How women from socially disadvantaged backgrounds navigate available care options are important considerations. Pregnancy care is recognized as an opportunity to intervene to give children 'the best start in life.' Our data show the current system of universally accessible pregnancy care in Australia is failing to support the most vulnerable women and families. This information can inform actions to reduce social disparities during this critical period.

  3. Effectiveness of Collaborative Care for Depression in Public-Sector Primary Care Clinics Serving Latinos.

    Science.gov (United States)

    Lagomasino, Isabel T; Dwight-Johnson, Megan; Green, Jennifer M; Tang, Lingqi; Zhang, Lily; Duan, Naihua; Miranda, Jeanne

    2017-04-01

    Quality improvement interventions for depression care have been shown to be effective for improving quality of care and depression outcomes in settings with primarily insured patients. The aim of this study was to determine the impact of a collaborative care intervention for depression that was tailored for low-income Latino patients seen in public-sector clinics. A total of 400 depressed patients from three public-sector primary care clinics were enrolled in a randomized controlled trial of a tailored collaborative care intervention versus enhanced usual care. Social workers without previous mental health experience served as depression care specialists for the intervention patients (N=196). Depending on patient preference, they delivered a cognitive-behavioral therapy (CBT) intervention or facilitated antidepressant medication given by primary care providers or both. In enhanced usual care, patients (N=204) received a pamphlet about depression, a letter for their primary care provider stating that they had a positive depression screen, and a list of local mental health resources. Intent-to-treat analyses examined clinical and process-of-care outcomes at 16 weeks. Compared with patients in the enhanced usual care group, patients in the intervention group had significantly improved depression, quality of life, and satisfaction outcomes (ppublic-sector clinics. Social workers without prior mental health experience can effectively provide CBT and manage depression care.

  4. Chiropractic practice in the Danish public health care sector

    DEFF Research Database (Denmark)

    Myburgh, Corrie

    2009-01-01

    This commentary offers preliminary considerations around a phenomenological investigation of chiropractic services in a Danish public sector setting. In this narrative description, the main venue for chiropractic public (secondary) sector practice in the Danish context is briefly described...... and defined. Furthermore, a contextually relevant definition of an integral health care service is presented; and the professional importance for chiropractic in providing such services is also discussed. Finally, salient questions requiring empirical investigation in this context are posed; and selected...

  5. Survival, Signaling, and Security: Foster Carers' and Residential Carers' Accounts of Self-Harming Practices Among Children and Young People in Care.

    Science.gov (United States)

    Evans, Rhiannon E

    2018-05-01

    Research on clinicians' interpretations of self-harming practices has shown that they can often be negative. To date there has been limited consideration of other professionals' narratives, notably those working in social care. This article presents focus group and interview data generated with foster carers ( n = 15) and residential carers ( n = 15) to explore the symbolic meanings ascribed to self-harm among the children and young people they care for. Three repertoires of interpretation are presented: survival, which conceives self-harm as a mechanism for redefining the identity of "looked-after"; signaling, which understands self-harm as a communicative tool for the expression of emotion; and security, which sees self-harming practices as testing the authenticity and safety of the caring relationship. Through their focus on sociocultural narratives, carers position themselves as experts on self-harm due to their intimacy with young people's social worlds. This construction potentially creates distance from health professionals, which is problematic given the current privileging of interprofessional working.

  6. Orphanages run by nuns in Druga Rzeczpospolita (The Second Republic of Poland – Poland between 1918-1939. An outline of the history of foster care (outside the family in Poland.

    Directory of Open Access Journals (Sweden)

    EDYTA BARTKOWIAK

    2017-10-01

    Full Text Available : Child foster care organized by nuns and meant for children deprived of infamily upbringing dates back as far as the 13 century. The prototypes of orphanages run by nuns were medieval hospitals, that is care institutions for all those in need. The beginnings of care/educational work with orphaned and abandoned children are connected with the activity of The Holy Spirit de Saxia male congregation, whose members were called “duchaki” in Poland. Since the 16 century the members of the Sisters of Mercy and Sisters of Charity congregations have specialized in institutional foster care. In nationally sovereign Druga Rzeczpospolita orphanages run by nuns were numerous and they were characterized by relative financial stability, the continuity of educational processes and creativity in finding new solutions to be used in the work with the children who were cared for

  7. Who does the public think should perform health care tasks?

    Science.gov (United States)

    Koteski, D R; McKinney, S

    1988-10-01

    The dietitian was identified as the most appropriate provider of such key nutrition services as nutrition assessment, determination of caloric requirements, provision of diet counseling, and prescription of diets. Several tasks fundamental to nutrition services were not viewed as highly suitable tasks for the dietitian, e.g., plan for care at home, monitor client progress, and check laboratory values. Activities that constitute key nutrition services need to be accentuated to clarify the numerous skills and extensive knowledge that dietitians possess. In the health care system of today, the dietetic profession must be associated with a wider range of health-related tasks than the traditional triad of diet, food, and hospital. Public relations and marketing strategies should focus on activities that provide the public with a clearer understanding of how the dietetic profession contributes to patient/client care.

  8. Public or private care: where do specialists spend their time?

    Science.gov (United States)

    Freed, Gary L; Turbitt, Erin; Allen, Amy

    2017-10-01

    Objectives The aim of the present study was to provide data to help clarify the public-private division of clinical care provision by doctors in Australia. Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields. The specialties were orthopaedic surgery, otolaryngology, ophthalmology, cardiology, neurology, nephrology, gastroenterology and rheumatology. Results For the specialities analysed in the present study, a large majority of the time spent in patient care was provided in the private sector. For the surgical specialties studied, on average less than 30% of clinical time was spent in the public sector. There was considerable variation among specialties in whether a greater proportion of time was spent in out-patient versus in-patient care and how that was divided between the public and private sectors. Conclusions Ensuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation's needs. What is known about the topic? Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospitals, private consulting rooms) sectors. For all medical specialists combined, working hours have been reported to be similar in the public and

  9. The Effects of Staff Training on the Types of Interactions Observed at Two Group Homes for Foster Care Children

    Science.gov (United States)

    Crosland, Kimberly A.; Dunlap, Glen; Sager, Wayne; Neff, Bryon; Wilcox, Catherine; Blanco, Alfredo; Giddings, Tamela

    2008-01-01

    Objectives: An extensive literature base exists for behavioral parent training; however, few studies have focused on training direct care staff at group home and residential facilities for children. This study was conducted to determine whether a behavioral staff training program consisting of classroom training and in-home feedback would improve…

  10. Fostering internalization

    DEFF Research Database (Denmark)

    Baernholdt, Marianne; Drake, Emily; Maron, Frederic

    2013-01-01

    Aim This paper describes the development, implementation and evaluation of a semester-long exchange program between two Bachelor of Science in Nursing programs in the USA and Denmark. Background Nurses globally need to provide culturally sensitive care for an ethnically diverse population...... learning theory, we developed an exchange program with the objective of enhancing nursing students' cultural competence through knowledge building, attitudes and behaviour development. Lessons learned and implications for educational institutions and policy are discussed. Conclusion In internationalization....... Competencies on how to do so should start in basic nursing programs. A useful strategy is through immersion into another culture through an exchange program. Little is known about successful strategies for two-way or 360° exchange programs between schools from different countries. Guided by experiential...

  11. Fostering Integrity in Research

    Science.gov (United States)

    McNutt, M. K.

    2017-12-01

    The responsible conduct of research requires that all involved in the research enterprise - researchers, sponsors, reviewers, publishers, and communicators - adhere to a set of integrity principles to protect the public's investment. Given the increasing complexity and globalization of the research enterprise, the National Academies recently re-examined and updated its integrity recommendations for researchers in the report Fostering Integrity in Research, with sponsorship from the National Science Foundation. Major departures from the previous recommendations 25-years earlier are the recognition that practices that were previously classified as merely questionable are indeed detrimental to the responsible conduct of research. Furthermore, the report concludes that there has been insufficient effort to respond to the threats that lapses in research integrity pose to the quality of research products and the reputation of researchers as deserving of the public trust. It recommends the creation of an independent, non-profit entity dedicated to promoting research integrity by serving as a resource and clearing house for expertise, advice, materials, and best practices on fostering research integrity and responding to allegations of research misconduct.

  12. In search of connection: The foster youth and caregiver relationship

    OpenAIRE

    Storer, Heather L.; Barkan, Susan E.; Stenhouse, Linnea L.; Eichenlaub, Caroline; Mallillin, Anastasia; Haggerty, Kevin P.

    2014-01-01

    Placement instability is an ongoing challenge for the 125,000 foster youth aged 14 – 18 that are living in foster care, with youth living in approximately 3 placements before aging out of the system. Despite the importance caring adult relationships can play in promoting positive youth development and resiliency, there has been limited inquiry into the characteristics of the foster youth and caregiver relationship. The goal of this paper is to provide a descriptive account of the foster youth...

  13. Listening to the Voices of Children in Foster Care: Youths Speak out about Child Welfare Workforce Turnover and Selection

    Science.gov (United States)

    Strolin-Goltzman, Jessica; Kollar, Sharon; Trinkle, Joanne

    2010-01-01

    Child welfare workforce turnover rates across private and public child welfare agencies are concerning. Although research about the causes of child welfare workforce turnover has been plentiful, empirical studies on the effects of turnover on child outcomes are sparse. Furthermore, the voices and experiences of youths within the system have been…

  14. Health Risk Behavior in Foster Youth

    Science.gov (United States)

    Gramkowski, Bridget; Kools, Susan; Paul, Steven; Boyer, Cherrie; Monasterio, Erica; Robbins, Nancy

    2010-01-01

    Problem Adolescent health problems are predominantly caused by risk behavior. Foster adolescents have disproportionately poor health; therefore identification of risk behavior is critical. Method A secondary analysis of data from a larger study investigated the health risk behavior of 56 foster youth using the CHIP-AE. Findings Foster youth had some increased risk behavior. Younger adolescents and those in kinship care had less risky behavior. Youth had more risk behavior when: in group homes, parental death, histories of physical or emotional abuse, or history of attempted suicide. Conclusions These results point to areas of strength and vulnerability in foster youth. PMID:19490278

  15. Predictors of foster parents' satisfaction and intent to continue to foster.

    Science.gov (United States)

    Denby, R; Rindfleisch, N; Bean, G

    1999-03-01

    The United States General Accounting Office (United States General Accounting Office [USGAO], 1989) report on out-of-home care affirmed that the foster care system is in crisis. To shed light on some factors that influence retention, the study reported here asked "What factors influence the satisfaction of foster parents?" and "What factors influence the intent of licensed foster parents to continue to foster?" A sample of 539 foster parents in eight urban counties in a large Midwestern state completed questionnaires aimed at addressing these questions. Some of the factors exerting the strongest influence on satisfaction were: feeling competent to handle the children who were placed; wanting to take in children who needed loving parents; no regrets about investment in foster children; foster mother's age; and agency social worker providing information and showing approval for a job well done. An example of factors exerting influence on intent to continue to foster include overall satisfaction, readiness to phone the social worker, number of foster boys in the home, being treated like one needed help oneself, and agency affiliation (private). Efforts to increase the supply of foster homes through recruitment is not enough. The support, training, and professional regard given to parents after they have begun the fostering task is of greater need. Based on analysis of the findings, implications for practice, programming, and policy are offered.

  16. Perinatal mortality disparities between public care and private obstetrician-led care: a propensity score analysis.

    Science.gov (United States)

    Adams, N; Tudehope, D; Gibbons, K S; Flenady, V

    2018-01-01

    To examine whether disparities in stillbirth, and neonatal and perinatal mortality rates, between public and private hospitals are the result of differences in population characteristics and/or clinical practices. Retrospective cohort study. A metropolitan tertiary centre encompassing public and private hospitals. Women accessed care from either a private obstetrician or from public models of care - predominantly midwife-led care or care shared between midwives, general practitioners, and obstetricians. A total of 131 436 births during 1998-2013: 69 037 public and 62 399 private. Propensity score matching was used to select equal-sized public and private cohorts with similar characteristics. Logistic regression analysis was then used to explore the impact of public-private differences in the use of assisted reproductive technologies, plurality, major congenital anomalies, birth method, and gestational age. Stillbirth, and neonatal and perinatal mortality rates. After controlling for maternal and pregnancy factors, perinatal mortality rates were higher in the public than in the private cohort (adjusted odds ratio, aOR 1.53; 95% confidence interval, 95% CI 1.29-1.80; stillbirth aOR 1.56, 95% CI 1.26-1.94; neonatal death aOR 1.48, 95% CI 1.15-1.89). These disparities reduced by 15.7, 20.5, and 19.6%, respectively, after adjusting for major congenital anomalies, birth method, and gestational age. Perinatal mortality occurred more often among public than private births, and this disparity was not explained by population differences. Differences in clinical practices seem to be partly responsible. The impact of differences in clinical practices on maternal and neonatal morbidity was not examined. Further research is required. Private obstetrician-led care: more obstetric intervention and earlier births reduce perinatal mortality. Background Babies born in Australian public hospitals tend to die more often than those born in private hospitals. Our aim was to determine

  17. 'The public is too subjective': public involvement at different levels of health-care decision making.

    Science.gov (United States)

    Litva, Andrea; Coast, Joanna; Donovan, Jenny; Eyles, John; Shepherd, Michael; Tacchi, Jo; Abelson, Julia; Morgan, Kieran

    2002-06-01

    There are a number of impulses towards public participation in health care decision making including instrumentalist, communitarian, educative and expressive impulses and the desire for increased accountability. There has, however, been little research looking systematically at the public's preferences for being involved in particular types of rationing decisions, nor indeed, has there been a critical examination of the degree of involvement desired by the public. The research reported here uses findings from focus groups and in-depth interviews to explore these questions. Eight focus groups were conducted with a total of 57 informants, four amongst randomly selected members of the public and four with informants from health and non-health related organisations. Nineteen interviews were conducted to allow the elaboration of focus group comments, to probe views more deeply and to pursue emerging themes. The findings show variations in the willingness of members of the public to be involved in health care decisions and consistency across the different forms of the public as represented by the focus groups with randomly selected citizens and pre-existing organisations. There was a strong desire in all the groups for the public to be involved both at the system and programme levels, with much less willingness to be involved at the individual level. At the system and programme levels informants generally favoured consultation, without responsibility for decisions, but with the guarantee that their contribution would be heard and that decisions taken following consultation would be explained. At the patient level informants felt that the public should participate only by setting criteria for deciding between potential beneficiaries of treatment. The public has much to contribute, particularly at the system and programme levels, to supplement the inputs of health care professionals.

  18. Using data warehousing and OLAP in public health care.

    Science.gov (United States)

    Hristovski, D; Rogac, M; Markota, M

    2000-01-01

    The paper describes the possibilities of using data warehousing and OLAP technologies in public health care in general and then our own experience with these technologies gained during the implementation of a data warehouse of outpatient data at the national level. Such a data warehouse serves as a basis for advanced decision support systems based on statistical, OLAP or data mining methods. We used OLAP to enable interactive exploration and analysis of the data. We found out that data warehousing and OLAP are suitable for the domain of public health and that they enable new analytical possibilities in addition to the traditional statistical approaches.

  19. Disparities in Care for Publicly Insured Women With Pregestational Diabetes.

    Science.gov (United States)

    Easter, Sarah Rae; Rosenthal, Emily W; Morton-Eggleston, Emma; Nour, Nawal; Tuomala, Ruth; Zera, Chloe A

    2017-11-01

    To investigate the association among public health insurance, preconception care, and pregnancy outcomes in pregnant women with pregestational diabetes. This is a retrospective cohort of pregnant women with pregestational type 1 or type 2 diabetes from 2006 to 2011 in Massachusetts-a state with universal insurance coverage since 2006. Women delivering after 24 weeks of gestation and receiving endocrinology and obstetric care in a multidisciplinary clinic were included. Rates of preconception consultation, our primary outcome of interest, were then compared between publicly and privately insured women. We used univariate analysis followed by logistic regression to compare receipt of preconception consultation and other secondary diabetes care measures and pregnancy outcomes according to insurance status. Fifty-four percent (n=106) of 197 women had public insurance. Publicly insured women were younger (median age 30.4 compared with 35.3 years, P<.01) with lower rates of college education (12.3% compared with 45.1%, P<.01). Women with public insurance were less likely to receive a preconception consult (5.7% compared with 31.9%, P<.01), had lower rates of hemoglobin A1C less than 6% at the onset of pregnancy (37.2% compared with 58.4%, P=.01), and experienced higher rates of pregnancies affected by congenital anomalies (10.4% compared with 2.2%, P=.02) compared with those with private insurance. In adjusted analyses controlling for educational attainment, maternal age, and body mass index, women with public insurance were less likely to receive a preconception consult (adjusted odds ratio [OR] 0.21, 95% CI 0.08-0.58), although the odds of achieving the target hemoglobin A1C (adjusted OR 0.45, 95% CI 0.20-1.02) and congenital anomaly (adjusted OR 2.23, 95% CI 0.37-13.41) were similar after adjustment. Despite continuous access to health insurance, publicly insured women were less likely than privately insured women to receive a preconception consult-an evidence

  20. Care and pedagogical production: integration of Public Health System scenarios

    Directory of Open Access Journals (Sweden)

    Túlio Batista Franco

    2007-01-01

    Full Text Available Throughout Brazilian Public Health System's (Centralized Health System - SUS construction history there has been a reasonable investment in the education for the sector. However, it has been frequently noticed by health professionals and managers the fact that this investment in educational programs has not converted into change of healthcare practices. Assuming that education can be used as a tool for changes in health, the text suggests that the pedagogical practices should be directed towards the production of individuals implied with the care production. Hence it proposes to work on a field of subjectivity in addition to cognition. This work reveals the management of the Brazilian public health system and its flows of permanent education, focusing "micromanagement" to think about the context on which they structuralize the diverse scenarios of care production, treating them as Pedagogical Production Units where it would be possible to develop entailed educational methodologies to a general idea of permanent education in health.

  1. Public dental health care program for persons with disability

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Børge; Petersen, Poul Erik

    2005-01-01

    The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means......) payment of service, (4) providers of oral health care, (5) special training of staff, 6) dental services delivered, (7) ethical issues, and (8) patient rights. Less than one-third of persons estimated by the health authorities were enrolled in the program. On average, 0.4% of the municipal population...... of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large...

  2. Public perception of cancer care in Poland and Austria.

    Science.gov (United States)

    Jȩdrzejewski, Mariusz; Thallinger, Christiane; Mrozik, Magda; Kornek, Gabriela; Zielinski, Christoph; Jassem, Jacek

    2015-01-01

    We compared the public perception of cancer care in Poland and Austria. Both countries are members of the European Union (EU) but reflect two extremes in health-related per capita spending. Recently, the EUROCARE-5 study reported on very discrepant cancer outcomes between the two countries. A one-time survey was conducted to compare the public perception of cancer treatment in Poland and Austria. In total, 3,649 subjects, representing the general population, cancer patients, and cancer patients' family members, were surveyed. In both countries, cancer was considered the most challenging problem of the health care system, and health care was indicated as the most important issue influencing political election decisions. Polish compared with Austrian cancer patients gave a significantly lower positive assessment of overall cancer treatment efficacy and detection methods. Cancer cure rates estimated by Polish and Austrian citizens were 29% and 44%, respectively. The majority of all citizens interviewed thought that cancer patients should have access to all available registered cancer drugs. However, only 18% of Poles versus 62% of Austrians agreed with the notion that the available cancer treatment in their countries is of a standard comparable to that of other EU countries. Consequently, 24% of Poles and 7% of Austrians identified financial status, age, gender, and residence as factors influencing the availability of cancer treatments. In both countries, cancer is considered the most challenging problem of the health care system, and health care issues may strongly influence decisions for political elections. Vast differences in the two populations' perceptions of cancer care reflect actual cancer outcomes and the national per capita spending on health-related issues. ©AlphaMed Press.

  3. Complex trauma and mental health in children and adolescents placed in foster care: findings from the National Child Traumatic Stress Network.

    Science.gov (United States)

    Greeson, Johanna K P; Briggs, Ernestine C; Kisiel, Cassandra L; Layne, Christopher M; Ake, George S; Ko, Susan J; Gerrity, Ellen T; Steinberg, Alan M; Howard, Michael L; Pynoos, Robert S; Fairbank, John A

    2011-01-01

    Many children in the child welfare system (CWS) have histories of recurrent interpersonal trauma perpetrated by caregivers early in life often referred to as complex trauma. Children in the CWS also experience a diverse range of reactions across multiple areas of functioning that are associated with such exposure. Nevertheless, few CWSs routinely screen for trauma exposure and associated symptoms beyond an initial assessment of the precipitating event. This study examines trauma histories, including complex trauma exposure (physical abuse, sexual abuse, emotional abuse, neglect, domestic violence), posttraumatic stress, and behavioral and emotional problems of 2,251 youth (age 0 to 21; M = 9.5, SD = 4.3) in foster care who were referred to a National Child Traumatic Stress Network site for treatment. High prevalence rates of complex trauma exposure were observed: 70.4% of the sample reported at least two of the traumas that constitute complex trauma; 11.7% of the sample reported all 5 types. Compared to youth with other types of trauma, those with complex trauma histories had significantly higher rates of internalizing problems, posttraumatic stress, and clinical diagnoses, and differed on some demographic variables. Implications for child welfare practice and future research are discussed.

  4. Child protection and adult depression: evaluating the long-term consequences of evacuating children to foster care during World War II.

    Science.gov (United States)

    Santavirta, Nina; Santavirta, Torsten

    2014-03-01

    This paper combined data collected from war time government records with survey data including background characteristics, such as factors that affected eligibility, to examine the adult depression outcomes of individuals who were evacuated from Finland to temporary foster care in Sweden during World War II. Using war time government records and survey data for a random sample of 723 exposed individuals and 1321 matched unexposed individuals, the authors conducted least squares adjusted means comparison to examine the association between evacuation and adult depression (Beck Depression Inventory). The random sample was representative for the whole population of evacuees who returned to their biological families after World War II. The authors found no statistically significant difference in depressive symptoms during late adulthood between the two groups; for example, the exposed group had a 0.41 percentage points lower average Beck Depression Inventory score than the unexposed group (p = 0.907). This study provides no support for family disruption during early childhood because of the onset of sudden shocks elevating depressive symptoms during late adulthood. Copyright © 2013 John Wiley & Sons, Ltd.

  5. Health care inequities in north India: role of public sector in universalizing health care.

    Science.gov (United States)

    Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

    2012-09-01

    Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Data from National Sample Survey 60 th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure.

  6. Beyond Care Avoidance and Care Paralysis : Theorizing Public Mental Health Care

    NARCIS (Netherlands)

    Schout, Gert; de Jong, Gideon; Zeelen, Jacques

    Care avoidance refers to the condition wherein clients do not seek assistance and do not attend appointments although they are in need of help. Care avoidance is linked to another phenomenon, the inability to help clients with multiple and complex problems by social services and care facilities, in

  7. Italian public health care organizations: specialization, institutional deintegration, and public networks relationships.

    Science.gov (United States)

    Del Vecchio, Mario; De Pietro, Carlo

    2011-01-01

    The Italian National Health Service (INHS) has undergone profound changes over the past three decades. With establishment of the INHS in 1978--a tax-based public health care system with universal coverage--one of the underlying principles was integration. The recognition of health and health care as requiring integrated answers led to the creation of a single public organization, the Local Health Unit, responsible for the health status of the population of its catchment area. At the beginning of the 1990s, the scenario radically changed. The creation of hospital trusts, the development of quasi-market mechanisms and management control tools, the adoption of a prospective payment system for reimbursing health care providers--all were signs of deintegration and institutional unbundling. Two structural changes have deeply sustained this deintegration: patients' empowerment and the increased possibilities for outsourcing practices. In more recent years, a new reintegration effort has occurred, often led by regional governments and based on institutional cooperation and network relationships. However, the earlier structural changes require innovative approaches and solutions if public health care organizations want to retain their leading role.

  8. [Does public health insurance improve health care? The case of prenatal care for adolescents in Mexico].

    Science.gov (United States)

    Saavedra-Avendaño, Biani; Darney, Blair G; Reyes-Morales, Hortensia; Serván-Mori, Edson

    2016-01-01

    To test the association between public health insurance and adequate prenatal care among female adolescents in Mexico. Cross-sectional study, using the National Health and Nutrition Survey 2000, 2006, and 2012.We included 3 978 (N=4 522 296) adolescent (12-19) women who reported a live birth.We used logistic regression models to test the association of insurance and adequate (timeliness, frequency and content) prenatal care. The multivariable predicted probability of timely and frequent prenatal care improved over time, from 0.60 (IC95%:0.56;0.64) in 2000 to 0.71 (IC95%:0.66;0.76) in 2012. In 2012, the probability of adequate prenatal care was 0.54 (IC95%:0.49;0.58); women with Social Security had higher probability than women with Seguro Popular and without health insurance. Having Social Security is associated with receipt of adequate prenatal care among adolescents in Mexico.

  9. Fostering Child Development by Improving Care Quality: A Systematic Review of the Effectiveness of Structural Interventions and Caregiver Trainings in Institutional Care.

    Science.gov (United States)

    Hermenau, Katharin; Goessmann, Katharina; Rygaard, Niels Peter; Landolt, Markus A; Hecker, Tobias

    2017-12-01

    Quality of child care has been shown to have a crucial impact on children's development and psychological adjustment, particularly for orphans with a history of maltreatment and trauma. However, adequate care for orphans is often impacted by unfavorable caregiver-child ratios and poorly trained, overburdened personnel, especially in institutional care in countries with limited resources and large numbers of orphans. This systematic review investigated the effects of structural interventions and caregiver trainings on child development in institutional environments. The 24 intervention studies included in this systematic review reported beneficial effects on the children's emotional, social, and cognitive development. Yet, few studies focused on effects of interventions on the child-caregiver relationship or the general institutional environment. Moreover, our review revealed that interventions aimed at improving institutional care settings have largely neglected violence and abuse prevention. Unfortunately, our findings are partially limited by constraints of study design and methodology. In sum, this systematic review sheds light on obstacles and possibilities for the improvement in institutional care. There must be greater efforts at preventing violence, abuse, and neglect of children living in institutional care. Therefore, we advocate for combining attachment theory-based models with maltreatment prevention approaches and then testing them using rigorous scientific standards. By using approaches grounded in the evidence, it could be possible to enable more children to grow up in supportive and nonviolent environments.

  10. Improving Flood Risk Maps as a Capacity Building Activity: Fostering Public Participation and Raising Flood Risk Awareness in the German Mulde Region (project RISK MAP)

    Science.gov (United States)

    Luther, J.; Meyer, V.; Kuhlicke, C.; Scheuer, S.; Unnerstall, H.

    2012-04-01

    The EU Floods Directive requires the establishment of flood risk maps for high risk areas in all EU Member States by 2013. However, if existing at all, the current practice of risk mapping still shows some deficits: Risk maps are often seen as an information tool rather than a communication tool. This means that e.g. important local knowledge is not incorporated and forms a contrast to the understanding of capacity building which calls for engaging individuals in the process of learning and adapting to change and for the establishment of a more interactive public administration that learns equally from its actions and from the feedback it receives. Furthermore, the contents of risk maps often do not match the requirements of the end users, so that risk maps are often designed and visualised in a way which cannot be easily understood by laypersons and/or which is not suitable for the respective needs of public authorities in risk and flood event management. The project RISK MAP aimed at improving flood risk maps as a means to foster public participation and raising flood risk awareness. For achieving this aim, RISK MAP (1) developed rules for appropriate stakeholder participation enabling the incorporation of local knowledge and preferences; (2) improved the content of risk maps by considering different risk criteria through the use of a deliberative multicriteria risk mapping tool; and (3) improved the visualisation of risk maps in order to produce user-friendly risk maps by applying the experimental graphic semiology (EGS) method that uses the eye tracking approach. The research was carried out in five European case studies where the status quo of risk mapping and the legal framework was analysed, several stakeholder interviews and workshops were conducted, the visual perception of risk maps was tested and - based on this empirical work - exemplary improved risk maps were produced. The presentation and paper will outline the main findings of the project which

  11. The public health leadership certificate: a public health and primary care interprofessional training opportunity.

    Science.gov (United States)

    Matson, Christine C; Lake, Jeffrey L; Bradshaw, R Dana; Matson, David O

    2014-03-01

    This article describes a public health leadership certificate curriculum developed by the Commonwealth Public Health Training Center for employees in public health and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Public health employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited public health in Virginia.

  12. Ambivalent implications of health care information systems: a study in the Brazilian public health care system

    Directory of Open Access Journals (Sweden)

    João Porto de Albuquerque

    2011-01-01

    Full Text Available This article evaluates social implications of the "SIGA" Health Care Information System (HIS in a public health care organization in the city of São Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.

  13. Public trust in the Spanish health‐care system

    Science.gov (United States)

    Jovell, Albert; Blendon, Robert J.; Navarro, Maria Dolors; Fleischfresser, Channtal; Benson, John M.; DesRoches, Catherine M.; Weldon, Kathleen J.

    2007-01-01

    Abstract Background  Fifteen years ago, public opinion surveys in Spain showed substantial dissatisfaction with the health‐care system. Since that time, health‐care in Spain has undergone significant changes, including a decentralization of the system, an increase in spending and a change in the way the system is financed. Objective  This study examines how Spanish citizens rate the performance of their health system today, both as compared with other sectors of society and as compared with earlier time periods. Methods  Data are drawn from nationally representative telephone surveys of the non‐institutionalized adult Spanish population (age 18 years and over). The study was carried out in two phases: October–November 2005 (n = 3010) and January 2006 (n = 2101). Results  The majority of the Spanish population thinks the health system needs to be changed. The problems cited relate mostly to long wait times to get health‐care. Nevertheless, over the last 15 years, the proportion of people who have very negative views about the health system has decreased by half. The majority believes that not enough money is spent on health‐care, but few people would support an increase in taxes to provide additional funding. The survey finds the National Health System’s institutions and health professionals to be more highly trusted than other institutions and professional groups in the country. Conclusions  Government policy‐makers in Spain face a dilemma: the public wants more health spending to decrease wait times, but there is substantial resistance to increasing taxes as a means to finance improvements in the system’s capacity. PMID:17986071

  14. Gamification in Fostering Creativity

    Directory of Open Access Journals (Sweden)

    Marius Kalinauskas

    2014-10-01

    Full Text Available Purpose – to analyze gamification, as the method for fostering creativity.Design/methodology/approach – Author analyses the precognitions, which allowed gamification to attract mainstream attention, the diversity of understandings about the phenomenon, and the possible relations between usage of gamified platform and the development of creativity. The paper is based on the comparative analysis of scientific literature and related sources from sociology, business, and entertainment. The engagement is analyzed through the theories of self-determination and the “flow”. Creativity is understood as “any act, idea, or product that changes an existing domain, or that transforms an existing domain into a new one” (Csikszentmihalyi, 1996. Gamification is analyzed as “use of game design elements in non-game context” (Deterding, Dixon, Khaled, and Nacke (2011. Findings – Although the gamification is gaining more public attention, there is a lack of studies which would reveal its relations in fostering creativity. One of the main goals of any gamified platform is to raise the engagement of the participant while keeping subject interested in the process or activity. In some cases, there is a relation between “flow” and creativity. However, the strength of this relationship depends from the users of gamified content and the domain of interest.Research limitations / implications – There are very few empirical studies which would support correlation between experiencing the “flow” state and a raise of creativity. This issue requires more surveys, which would ground the idea.Practical implications – By developing further research in usage of gamification while fostering creativity it is possible to determine, whether or not the “creative domains” should apply more measures of gamification in their activities.Value – The article emphasizes on theoretical analysis of gamification and its applicability in fostering creativity

  15. the life experiences of foster parents who nurture foster children in ...

    African Journals Online (AJOL)

    The affected children are placed in the care of related or unrelated .... if they were part of the decision for the removal of the child (Pickin et al, 2011; Samrai .... Foster parents described denial and guilt when a foster child is removed from them.

  16. Helping Foster Children in School: A Guide for Foster Parents, Social Workers and Teachers

    Science.gov (United States)

    DeGarmo, John

    2015-01-01

    "Helping Foster Children in School" explores the challenges that foster children face in schools and offers positive and practical guidance tailored to help the parents, teachers and social workers supporting them. Children in care often perform poorly at school both in terms of their behavior and their academic performance, with many…

  17. The needs of foster children : A Q-sort study on the differences between the psychosocial needs of foster children with and without a history of sexual abuse

    NARCIS (Netherlands)

    Steenbakkers, Anne; van der Steen, Steffie; Ellingsen, Ingunn T.; Grietens, Hans

    2016-01-01

    Children in family foster care have a specific set of psychosocial needs, stemming from previous caregiving, (traumatic) experiences, and living in a foster family. Foster parents are expected to learn about these needs and incorporate them into their parenting and nurturing. When foster children

  18. Breastfeeding of a medically fragile foster child.

    Science.gov (United States)

    Gribble, Karleen D

    2005-02-01

    A case is presented in which a medically fragile baby was breastfed by her foster mother. As a result, the child's physical and emotional health were improved. The mechanisms whereby human milk improves health are well known. The act of breastfeeding may also have an analgesic and relaxant effect as a result of hormonal influences and skin-to-skin contact. Many foster babies may benefit from human milk or breastfeeding. However, the risk of disease transmission must be minimized. Provision of human milk to all medically fragile foster babies is desirable. Breastfeeding by the foster mother may be applicable in cases in which the child is likely to be in long-term care, the child has been previously breastfed, or the child's mother expresses a desire that the infant be breastfed. However, social barriers must be overcome before breastfeeding of foster babies can become more common.

  19. Kenya Hospices and Palliative Care Association: integrating palliative care in public hospitals in Kenya.

    Science.gov (United States)

    Ali, Zipporah

    2016-01-01

    In Kenya, cancers as a disease group rank third as a cause of death after infectious and cardiovascular diseases. It is estimated that the annual incidence of cancer is about 37,000 new cases with an annual mortality of 28,000 cases (Kenya National Cancer Control Strategy 2010). The incidence of non-communicable diseases accounts for more than 50% of total hospital admissions and over 55% of hospital deaths (Kenya National Strategy for the Prevention and Control of Non Communicable Diseases 2015-2020). The prevalence of HIV is 6.8 (KIAS 2014). Most of these patients will benefit from palliative care services, hence the need to integrate palliative care services in the public healthcare system. The process of integrating palliative care in public hospitals involved advocacy both at the national level and at the institutional level, training of healthcare professionals, and setting up services within the hospitals that we worked with. Technical support was provided to each individual institution as needed. Eleven provincial hospitals across the country have now integrated palliative care services (Palliative Care Units) and are now centres of excellence. Over 220 healthcare providers have been trained, and approximately, over 30,000 patients have benefited from these services. Oral morphine is now available in the hospital palliative care units. As a success of the pilot project, Kenya Hospices and Palliative Care Association (KEHPCA) is now working with the Ministry of Health Kenya to integrate palliative care services in 30 other county hospitals across the country, thus ensuring more availability and access to more patients. Other developing countries can learn from Kenya's successful experience.

  20. The Daily Operational Brief: Fostering Daily Readiness, Care Coordination, and Problem-Solving Accountability in a Large Pediatric Health Care System.

    Science.gov (United States)

    Donnelly, Lane F; Basta, Kathryne C; Dykes, Anne M; Zhang, Wei; Shook, Joan E

    2018-01-01

    At a pediatric health system, the Daily Operational Brief (DOB) was updated in 2015 after three years of operation. Quality and safety metrics, the patient volume and staffing assessment, and the readiness assessment are all presented. In addition, in the problem-solving accountability system, problematic issues are categorized as Quick Hits or Complex Issues. Walk-the-Wall, a biweekly meeting attended by hospital senior administrative leadership and quality and safety leaders, is conducted to chart current progress on Complex Issues. The DOB provides a daily standardized approach to evaluate readiness to provide care to current patients and improvement in the care to be provided for future patients. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  1. Comparison of childbirth care models in public hospitals, Brazil.

    Science.gov (United States)

    Vogt, Sibylle Emilie; Silva, Kátia Silveira da; Dias, Marcos Augusto Bastos

    2014-04-01

    To compare collaborative and traditional childbirth care models. Cross-sectional study with 655 primiparous women in four public health system hospitals in Belo Horizonte, MG, Southeastern Brazil, in 2011 (333 women for the collaborative model and 322 for the traditional model, including those with induced or premature labor). Data were collected using interviews and medical records. The Chi-square test was used to compare the outcomes and multivariate logistic regression to determine the association between the model and the interventions used. Paid work and schooling showed significant differences in distribution between the models. Oxytocin (50.2% collaborative model and 65.5% traditional model; p relief (85.0% collaborative model and 78.9% traditional model; p = 0.042). The association between the collaborative model and the reduction in the use of oxytocin, artificial rupture of membranes and episiotomy remained after adjustment for confounding. The care model was not associated with complications in newborns or mothers neither with the use of spinal or epidural analgesia. The results suggest that collaborative model may reduce interventions performed in labor care with similar perinatal outcomes.

  2. Being a Foster Family in Portugal—Motivations and Experiences

    Directory of Open Access Journals (Sweden)

    Elisete Diogo

    2017-12-01

    Full Text Available Foster care is an almost absent component in the child care system and scientific research conducted in Portugal foster comprises 3.2%1 of out-of-home care in Portugal. This research aims to contribute to a deeper visibility of the care phenomena, giving specific attention to the foster families themselves. This research adopted a qualitative analytical approach, inspired by Grounded Theory. Foster families’ motivation is rooted in altruism, affection for children, and sensitivity to maltreatment. Personal and professional biography or past contact with out-of-home care can also induce predisposition to become a carer. The experience of being a carer2 is one of traversing through a life of many challenges and rewards. Considering the recognition from the stakeholders, it is a rewarding task. The quality of the service provided and the performance of the care professionals are both key elements to foster care.

  3. Variations in levels of care between nursing home patients in a public health care system.

    Science.gov (United States)

    Døhl, Øystein; Garåsen, Helge; Kalseth, Jorid; Magnussen, Jon

    2014-03-05

    Within the setting of a public health service we analyse the distribution of resources between individuals in nursing homes funded by global budgets. Three questions are pursued. Firstly, whether there are systematic variations between nursing homes in the level of care given to patients. Secondly, whether such variations can be explained by nursing home characteristics. And thirdly, how individual need-related variables are associated with differences in the level of care given. The study included 1204 residents in 35 nursing homes and extra care sheltered housing facilities. Direct time spent with patients was recorded. In average each patient received 14.8 hours direct care each week. Multilevel regression analysis is used to analyse the relationship between individual characteristics, nursing home characteristics and time spent with patients in nursing homes. The study setting is the city of Trondheim, with a population of approximately 180 000. There are large variations between nursing homes in the total amount of individual care given to patients. As much as 24 percent of the variation of individual care between patients could be explained by variation between nursing homes. Adjusting for structural nursing home characteristics did not substantially reduce the variation between nursing homes. As expected a negative association was found between individual care and case-mix, implying that at nursing home level a more resource demanding case-mix is compensated by lowering the average amount of care. At individual level ADL-disability is the strongest predictor for use of resources in nursing homes. For the average user one point increase in ADL-disability increases the use of resources with 27 percent. In a financial reimbursement model for nursing homes with no adjustment for case-mix, the amount of care patients receive does not solely depend on the patients' own needs, but also on the needs of all the other residents.

  4. [Public and private: insurance companies and medical care in Mexico].

    Science.gov (United States)

    Tamez, S; Bodek, C; Eibenschutz, C

    1995-01-01

    During the late 70's and early 80's in Mexico, as in the rest of Latin-America, sanitary policies were directed to support the growth of the private sector of health care at the expense of the public sector. This work analyzes the evolution of the health insurance market as a part of the privatization process of health care. The analysis based on economic data, provides the political profile behind the privatization process as well as the changes in the relations between the State and the health sector. The central hypothesis is that the State promotes and supports the growth of the private market of medical care via a series of legal, fiscal and market procedures. It also discusses the State roll in the legal changes related to the national insurance activity. A comparative analysis is made about the evolution of the insurance industry in Argentina, Brazil, Chile and Mexico during the period 1986-1992, with a particular enfasis in the last country. One of the principal results is that the Premium/GNP and Premium/per capita, display a general growth in the 4 countries. This growth is faster for Mexico for each one) because the privatization process occurred only during the most recent years. For the 1984-1991 period in Mexico the direct premium as percentage of the GNP raised from 0.86% to 1.32%. If one focussed only in the insurance for health and accidents branches the rice goes form 8.84% in 1984 to 19.08% in 1991. This indicates that the insurance industry is one of the main targets of the privatization process of the health care system in Mexico. This is also shown by the State support to fast expansion of the big medical industrial complex of the country. Considering this situation in the continuity of the neoliberal model of Mexico, this will profound the inequity and inequality.

  5. 75 FR 43187 - Request for Public Comment and Consultation Meetings on the Adoption and Foster Care Analysis and...

    Science.gov (United States)

    2010-07-23

    ... 479 of the Social Security Act (the Act) requires that the Administration for Children and Families... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Request for... (AFCARS) AGENCY: Department of Health and Human Services, Administration for Children and Families...

  6. New Public Management, Care and Struggles about Recognition

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene

    2009-01-01

    - of these two logics in two different Danish municipalities that are strategically chosen to illustrate differences along the continuum of NPM translations. It asks which logic the home helpers feel is most dominant and relates the results to feelings of recognition and misrecognition as well as to strategies......New Public Management (NPM) is usually perceived as a homogeneous discourse. However, when we examine it by looking at micro-politics in municipalities and understand its consequences drawing on the voices of home helpers, the picture is more complex and ambiguous. NPM is seen as disciplining paid...... of resistance. The analysis applies feminist theories of recognition and care, and its findings are based on focus group interviews and feminist discourse analysis...

  7. Public support for social financing of health care in Switzerland.

    Science.gov (United States)

    Perneger, Thomas V; Hudelson, Patricia M

    2005-01-01

    The purpose of this study was to identify factors associated with the public's preference for financing health care according to people's ability to pay. The authors compared voters' support in 26 Swiss cantons for a legislative proposal to replace regionally rated health insurance premiums (current system) with premiums proportional to income and wealth, and co-financed through the value added tax. The vote took place in May 2003, and the initiative was rejected, with only 27 percent of support nationwide. However, support varied more than threefold, from 13 to 44 percent, among cantons. In multivariate analysis, support was most strongly correlated with the approval rate of the 1994 law on health insurance, which strengthened solidarity between the sick and the healthy. More modest associations were seen between support for the initiative and the health insurance premium of 2003, and proportions of elderly and urban residents in the population. Hence support for more social financing of health care was best explained by past preference for a social health insurance system in the local community.

  8. Conceptualizing the Step-Down for Foster Youth Approaching Adulthood: Perceptions of Service Providers, Caseworkers, and Foster Parents

    Science.gov (United States)

    Havlicek, Judy; McMillen, J. Curtis; Fedoravicius, Nicole; McNelly, David; Robinson, Debra

    2012-01-01

    Studies find considerable movement between residential treatment and less restrictive foster home settings, with approximately half of foster youth who are stepped down eventually returning to a higher level of care. Very little is known about the step down for foster youth who are approaching adulthood in locked residential facilities. A qualitative study of stepping down a small sample of foster youth, as perceived by team members delivering a model of treatment foster care, is presented. These findings reveal the dimensions of stepping down foster youth at the onset of adulthood, and highlight the importance of providing foster youth with developmental opportunities to engage in the social roles and tasks of late adolescence and/or early adulthood. Implications for further refining the concept of stepping down from a developmental perspective are discussed. PMID:23878410

  9. Effects of PMTO in foster families with children with behavior problems : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Maaskant, A.M.; van Rooij, F.B.; Overbeek, G.J.; Oort, F.J.; Arntz, M.; Hermanns, J.M.A.

    The present randomized controlled trial examined the effectiveness of Parent Management Training Oregon for foster parents with foster children (aged 4–12) with severe externalizing behavior problems in long-term foster care arrangements. Foster children’s behavior problems are challenging for

  10. Searching for effective interventions for young foster children under stress : A meta-analysis

    NARCIS (Netherlands)

    Van Andel, Hans W.H.; Grietens, Hans; Strijker, Johan; Van der Gaag, Rutger J.; Knorth, Erik J.

    Foster children experience a lot of stress because of their life histories and changes in their family circumstances, such as foster care placement. It is important that foster parents recognize the early signs of stress in foster children and learn how to act in a non-threatening and understanding

  11. Educational Experiences of Emancipated Foster Youth: An Exploratory Study

    Science.gov (United States)

    Stunkard, Cynthia Joyce

    2013-01-01

    The data obtained in this qualitative study focused on the educational experiences of youth formerly in foster care after graduation from high school from the viewpoint of the youth. Data were gathered from interviews from 10 participants. Themes included: (a) How do youth emancipated from foster care perceive their educational experiences? (b)…

  12. Public reporting in health care: how do consumers use quality-of-care information? A systematic review.

    NARCIS (Netherlands)

    Faber, M.J.; Bosch, M.C.; Wollersheim, H.C.H.; Leatherman, S.; Grol, R.P.T.M.

    2009-01-01

    BACKGROUND: One of the underlying goals of public reporting is to encourage the consumer to select health care providers or health plans that offer comparatively better quality-of-care. OBJECTIVE: To review the weight consumers give to quality-of-care information in the process of choice, to

  13. HOBE+, a case study: a virtual community of practice to support innovation in primary care in Basque Public Health Service.

    Science.gov (United States)

    Abos Mendizabal, Galder; Nuño Solinís, Roberto; Zaballa González, Irune

    2013-11-05

    A virtual professional community of practice (VCoP), HOBE+, has been set up to foster and facilitate innovation in primary care. It is aimed at all primary care professionals of the Basque Public Health Service (Osakidetza) in the provinces of Biscay and Araba. HOBE + is a VCoP that incorporates innovation management from the generation of ideas to their implementation in primary care practice. We used a case study method, based on the data provided by the technology platform that supports the VCoP, and from a survey completed by HOBE + users. The target population was all primary care staff (including all professional categories) from Araba and Biscay provinces of the Basque Country (Spain), who represent the target users of the VCoP. From a total of 5190 professionals across all the professional categories invited to join, 1627 (31.3%) actually registered in the VCoP and, during the study period, 90 (5.5% of the registered users) participated actively in some way. The total number of ideas proposed by the registered users was 133. Of these, 23 ideas (17.2%) are being implemented. Finally, 80% of the users who answered the satisfaction survey about their experience with HOBE + considered the initiative useful in order to achieve continuous improvement and real innovation in clinical and managerial processes. The experience shows that it is possible to create a virtual CoP for innovation in primary care where professionals from different professional categories propose ideas for innovation that are ultimately implemented.This manuscript objectives are to assess the process of developing and implementing a VCoP open to all primary care professionals in Osakidetza, including the take-up, participation and use of this VCoP in the first 15 months after its launch in October 2011. In addition, the usefulness of the VCoP was assessed through a survey gathering the opinions of the professionals involved.

  14. Viewpoint: Re-instating a 'public health' system under universal health care in India.

    Science.gov (United States)

    George, Mathew

    2015-02-01

    I examine possibilities for strengthening essential public health functions in the context of India's drive to implement universal health care. In a country where population health outcomes are rooted in social, political, economic, cultural, and ecological conditions, it is important to have a state mediated public health system that can modify the causes of the major public health problems. This calls for strengthening the social epidemiological approach in public health by demarcating public health functions distinct from medical care. This will be a prerequisite for the growth of the public health profession in the country, because it can offer avenues for newly trained professionals within the country to work in 'core' public health.

  15. Public and private pregnancy care in Reggio Emilia Province: an observational study on appropriateness of care and delivery outcomes.

    Science.gov (United States)

    Bonvicini, Laura; Candela, Silvia; Evangelista, Andrea; Bertani, Daniela; Casoli, Morena; Lusvardi, Annarella; Messori, Antonella; Giorgi Rossi, Paolo

    2014-02-17

    In industrialized countries, improvements have been made in both maternal and newborn health. While attention to antenatal care is increasing, excessive medicalization is also becoming more common.The aim of this study is to compare caesarean section (CS) frequency and ultrasound scan utilization in a public model of care involving both midwives and obstetricians with a private model in which care is provided by obstetricians only. Observational population-based study. Reggio Emilia Province. 5957 women resident in the province who delivered between October 2010 and November 2011. CS frequency and ultrasound scan utilization, stillbirths, and other negative perinatal outcomes. Women in the study were searched in the public family and reproductive health clinic medical records to identify those cared for in the public system. Outcomes of the two antenatal care models were compared through multivariate logistic regression adjusting for maternal characteristics and, for CS only, by stratifying by Robson's Group. Compared to women cared for in private services (N = 3,043), those in public service (N = 2,369) were younger, less educated, more frequently non-Italian, and multiparous. The probability of CS was slightly higher for women cared for by private obstetricians than for those cared for in the public system (31.8% vs. 27.1%; adjusted odds ratio: 1.10; 95% CI: 0.93-1.29): The probability of having more than 3 ultrasound scans was higher in private care (89.6% vs. 49.8%; adjusted odds ratio: 5.11; 95% CI: 4.30-6.08). CS frequency was higher in private care for all Robson's classes except women who underwent CS during spontaneous labour. Among negative perinatal outcomes only a higher risk of pre-term birth was observed for pregnancies cared for in private services. The public model provides less medicalized and more guidelines-oriented care than does the private model, with no increase in negative perinatal outcomes.

  16. Differences in essential newborn care at birth between private and public health facilities in eastern Uganda.

    Science.gov (United States)

    Waiswa, Peter; Akuze, Joseph; Peterson, Stefan; Kerber, Kate; Tetui, Moses; Forsberg, Birger C; Hanson, Claudia

    2015-01-01

    In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007). Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (pprivate facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was slightly lower in private compared to public facilities, calling for quality improvement in both

  17. The development of hospitalbased palliative care services in public hospitals in the Western Cape South Africa

    Directory of Open Access Journals (Sweden)

    L Gwyther

    2018-02-01

    Full Text Available With the recent approval of a South African (SA National Policy Framework and Strategy for Palliative Care by the National Health Council, it is pertinent to reflect on initiatives to develop palliative care services in public hospitals. This article reviews the development of hospital-based palliative care services in the Western Cape, SA. Palliative care services in SA started in the non-governmental sector in the 1980s. The first SA hospital-based palliative care team was established in Charlotte Maxeke Johannesburg Academic Hospital in 2001. The awareness of the benefit of palliative care in the hospital setting led to the development of isolated pockets of excellence providing palliative care in the public health sector in SA. This article describes models for palliative care at tertiary, provincial and district hospital level, which could inform development of hospital-based palliative care as the national policy for palliative care is implemented in SA.

  18. Public Policy Report. The Nanny Trap: Child Care Work Today.

    Science.gov (United States)

    Hostetler, Lana

    1984-01-01

    Reports testimony given before the Illinois House Labor and Commerce Committee concerning employment, wages, benefits, and conditions that affect the quality of child care and the status of child care institutions as employers of women. (RH)

  19. An Examination of the Protective Factors That Facilitate Motivation and Educational Attainment among Foster Youth

    Science.gov (United States)

    Schneider, Amy

    2016-01-01

    In the United States, there are approximately 400,000 foster youth. The state of California accounts for approximately 20% percent of youth placed in the foster care system. As a whole, this population is exposed to a multitude of risk factors while placed in the foster care system and as they emancipate. Re-victimization is not uncommon as youth…

  20. A Critical Analysis of Foster Youth Advisory Boards in the United States

    Science.gov (United States)

    Forenza, Brad; Happonen, Robin G.

    2016-01-01

    Background: The enactment of the John H. Chafee Foster Care Independence Act brought welcome attention to young people aging out of foster care, and sought to include them in both case planning and policy dialog. Foster Youth Advisory Boards help to promote such inclusion, though the implementation of those boards has not been formally analyzed.…

  1. Seeing the Whole Picture: Views from Diverse Participants on Barriers to Educating Foster Youths

    Science.gov (United States)

    Zetlin, Andrea G.; Weinberg, Lois A.; Shea, Nancy M.

    2006-01-01

    Many children in the foster care system are at great risk of academic difficulties and school failure. The purpose of this study was to bring together individuals within the foster care system to discuss the challenges to obtaining an appropriate education for foster youths and how best to provide the supports and structures needed for educational…

  2. Caring for Our Future: The Content of Prenatal Care. A Report of the Public Health Service Expert Panel on the Content of Prenatal Care.

    Science.gov (United States)

    National Institutes of Health (DHHS), Bethesda, MD.

    This report describes effective approaches for enhancing maternal, infant, and family outcomes based on the scientific and systematic assessment of the content of prenatal care conducted by the Public Health Service's Expert Panel on the Content of Prenatal Care. The range of risks, both medical and psychosocial, that the prenatal care provider…

  3. Patients' satisfaction with dental care provided by public dental ...

    African Journals Online (AJOL)

    Background: In Tanzania, patient satisfaction with dental services has received only minor attention. Objective: To assess patients' satisfaction with public dental health services in Dar es Salaam. Design: A cross-sectional study. Setting: Five public dental clinics randomly selected from a list of all the nine public dental ...

  4. A comparison of private and public sector intensive care unit ...

    African Journals Online (AJOL)

    Only 7 (28.0%) and 1 (16.7%) of the private and public ICUs, respectively, had sufficient space around the beds. Twenty-two private ICUs (88.0%) and 4 public ICUs (66.7%) had isolation rooms, but only some of these isolation rooms (15 private and 2 public) had appropriate mechanical ventilation. None of the ICUs had ...

  5. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    Science.gov (United States)

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  6. How can a policy foster local pharmaceutical production and still protect public health? Lessons from the health-industry complex in Brazil.

    Science.gov (United States)

    da Fonseca, Elize Massard

    2018-04-01

    The global health community is increasingly advocating for the local production of pharmaceuticals in developing countries as a way to promote technology transfer, capacity building and improve access to medicines. However, efforts to advance drug manufacturing in these countries revive an old dilemma of fostering technological development versus granting access to social services, such as healthcare. This paper explores the case of Brazil, a country that has developed large-scale health-inspired industrial policies, but is, yet, little understood. Brazil's experience suggests that progressive healthcare bureaucrats can create innovative practices for technology and knowledge transfers. It also demonstrates that highly competitive pharmaceutical firms can collaborate with each other, if a government provides them the right incentives. Reforming regulatory policies is crucial for guaranteeing high-quality products in developing countries, but governments must play a crucial role in supporting local firms to adapt to these regulations. These findings send a strong message to global health policymakers and practitioners on the conditions to create a suitable environment for local production of medical products.

  7. Strengthening primary health care through primary care and public health collaboration: the influence of intrapersonal and interpersonal factors.

    Science.gov (United States)

    Valaitis, Ruta K; O'Mara, Linda; Wong, Sabrina T; MacDonald, Marjorie; Murray, Nancy; Martin-Misener, Ruth; Meagher-Stewart, Donna

    2018-04-12

    AimThe aim of this paper is to examine Canadian key informants' perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration. Primary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context. This interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor - effective communication - interacted with all of them. Results support and extend our understanding of what influences

  8. Financing Child Care. A Public Policy Report from the Ewing Marion Kauffman Foundation. Winter 2002.

    Science.gov (United States)

    Ewing Marion Kauffman Foundation, Kansas City, MO.

    This public policy report focuses on financing child care in the United States. The report contains brief articles on the following topics: (1) child care wages in comparison to other positions; (2) benefits to businesses when employees have high-quality child care; (3) resources for funding early education systems; (4) comparison of the cost of…

  9. Foster parenting, human imprinting and conventional handling ...

    African Journals Online (AJOL)

    ... the present study indicates that improvements can be made by adopting alternative approaches. Further studies are needed to ascertain how foster parenting and imprinting may be utilized to optimize chick performance, including the long-term consequences of these practices. Keywords: Parental care, Struthio camelus, ...

  10. 45 CFR 1355.37 - Opportunity for Public Inspection of Review Reports and Materials.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Opportunity for Public Inspection of Review Reports and Materials. 1355.37 Section 1355.37 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE...

  11. Matching children with foster carers : A literature review

    NARCIS (Netherlands)

    Zeijlmans, Kirti; López, Monica; Grietens, Hans; Knorth, Erik J.

    Matching in family foster care is a form of complex decision-making influenced by more than case factors alone. Organizational, contextual, and decision-maker factors also contribute to the process. This scoping review has synthesized the empirical literature on matching decisions in family foster

  12. Public trust in health care: a comparison of Germany, the Netherlands, and England and Wales.

    NARCIS (Netherlands)

    Schee, E. van der; Braun, B.; Calnan, M.; Schnee, M.; Groenewegen, P.

    2003-01-01

    Aim: To describe and analyse public trust in health care in three European countries Background: Public trust in the social institutions of modern societies is important for the smooth functioning of society. Data on public trust are regularly collected in the EU for some institutional fields, such

  13. Public awareness of Pharmaceutical care availability in community ...

    African Journals Online (AJOL)

    Furthermore, the awareness of availability of pharmaceutical care services in community pharmacies was 3% while 75% of the respondents believed a community pharmacy was just a place drugs can be obtained. As the profession and pharmacists endeavour to improve knowledge and skill to deliver pharmaceutical care ...

  14. Respectful maternity care in Ethiopian public health facilities

    NARCIS (Netherlands)

    Sheferaw, Ephrem D.; Bazant, Eva; Gibson, Hannah; Fenta, Hone B.; Ayalew, Firew; Belay, Tsigereda B.; Worku, Maria M.; Kebebu, Aelaf E.; Woldie, Sintayehu A.; Kim, Young-Mi; van den Akker, T.; Stekelenburg, Jelle

    2017-01-01

    Background: Disrespect and abuse of women during institutional childbirth services is one of the deterrents to utilization of maternity care services in Ethiopia and other low- and middle-income countries. This paper describes the prevalence of respectful maternity care (RMC) and mistreatment of

  15. Bargaining and idle public sector capacity in health care

    OpenAIRE

    Xavier Martinez-Giralt; Barros Pedro Pita

    2005-01-01

    A feature present in countries with a National Health Service is the co-existence of a public and a private sector. Often, the public payer contracts with private providers while holding idle capacity. This is often seen as inefficiency from the management of public facilities. We present here a different rationale for the existence of such idle capacity: the public sector may opt to have idle capacity as a way to gain bargaining power vis-Ã -vis the private provider, under the assumption of ...

  16. Evaluating Palliative Care Resources Available to the Public Using the Internet and Social Media.

    Science.gov (United States)

    Claudio, Celeste H; Dizon, Zoelle B; October, Tessie W

    2018-01-01

    Accessible information about palliative care available to the public on the Internet is growing. We do not know whether this information is consistent with the current accepted definition of palliative care. To identify resources on the Internet and social media regarding palliative care and evaluate the information conveyed. A cross-sectional study of "palliative care" search results. Top 10 Google websites, top 10 most viewed YouTube videos, and social media platforms, Facebook and Twitter, were searched. The most popular Google websites were mostly from national organizations promoting palliative care, whose definitions of palliative care consistently mention "quality of life" and "relief from symptoms and stress." None of the websites mentioned children, and 77% cited palliative care as treatment for cancer with less focus on other diseases. No personal stories were included in Google websites, while 60% of YouTube videos included personal stories. Five main themes were generated from 266 YouTube video comments analyzed. The most common theme was emotionality, of which 91% were positive statements. Facebook and Twitter were mostly used by health-care professionals and not the public. Palliative care resources are mostly positive and consistent with the current definition of palliative care. Major Internet search engines such as Google and YouTube provide valuable insight into information the public receives about palliative care. Future development of Internet resources on palliative care should consider including children and emphasizing palliative care for all life-limiting illnesses.

  17. Private vs. Public Care for Juvenile Offenders: A Qualitative Examination.

    Science.gov (United States)

    Kronick, Robert F.

    1993-01-01

    Examined effectiveness of methods used by public and private institutions' handling of incarcerated delinquents. Concluded that organizational culture is key concept in delivery of services to incarcerated children and youth; that private sector provides alternative to public in delivery of services; that alcohol and drug treatment programs are…

  18. A bookshelf in public health, medical care, and allied fields.

    Science.gov (United States)

    La Rocco, A; Jones, B

    1972-01-01

    This bibliography of nonserial publications consists of 610 annotations. It is intended as a guide to the development of a collection for librarians and for health professionals in research and education. References are mostly to publications from 1960. Titles are in English. Both primary and secondary sources are cited.

  19. In search of connection: The foster youth and caregiver relationship

    Science.gov (United States)

    Storer, Heather L.; Barkan, Susan E.; Stenhouse, Linnea L.; Eichenlaub, Caroline; Mallillin, Anastasia; Haggerty, Kevin P.

    2015-01-01

    Placement instability is an ongoing challenge for the 125,000 foster youth aged 14 – 18 that are living in foster care, with youth living in approximately 3 placements before aging out of the system. Despite the importance caring adult relationships can play in promoting positive youth development and resiliency, there has been limited inquiry into the characteristics of the foster youth and caregiver relationship. The goal of this paper is to provide a descriptive account of the foster youth and caregiver relationship, and explore what qualities and experiences foster youth desire from their caregivers. Qualitative data were gathered from 9 focus groups. Data were analyzed using thematic content analysis approaches. Foster youth, caregivers, and child welfare staff described relationships lacking in formative bonds and connection, where youth didn’t “fit in”, and chaotic homes marked by reactivity and judgment. Characteristics of supportive foster homes include a sense of belonging, structure, guidance, and consistency. This research underscores the important role positive relationships can play in foster youth’s feelings of well-being and points to the need for foster parent training to include tangible strategies to develop stronger bonds. PMID:26052173

  20. A comparison of private and public sector intensive care unit ...

    African Journals Online (AJOL)

    achieving the optimal physical structure that facilitates the care of ... patients with varying levels of need in terms of ICU equipment. As part of .... Prevention and Control Unit and is based on the R158 regulations, ..... and organizational aspects.

  1. [The development of public policies for elderly care in Brazil].

    Science.gov (United States)

    Fernandes, Maria Teresinha de Oliveira; Soares, Sônia Maria

    2012-12-01

    The objective of this documental analysis is to discuss the legal aspects involved in the development of elderly care policies in Brazil, considering the socio-historical-political context, and in view of the aspects that outline the wellbeing of an aged individual. Data collection was performed between June and September of 2010 via governmental websites. Documents were included if they complied with the proposed objective; were connected with elderly care policies, and lay within the legal accomplishments regarding elderly care policies in 2006 and the Elói Chaves Law of 1923. This analysis indicated that elderly wellbeing depends significantly on resource allocation in sectors other than the healthcare area, with emphasis on the elderly in the labor market and the feminization of old age. It is expected that the community and administrators will discuss the needs of the elderly population and the integration of care networks that remain necessary for the heterogeneity of this population.

  2. Bargaining and idle public sector capacity in health care

    OpenAIRE

    Barros, Pedro Pita

    2005-01-01

    A feature present in countries with a National Health Service is the co−existence of a públic and a private sector. Often, the public payer contracts with private providers while holding idle capacity. This is often seen as inefficiency from the management of public facilities. We present here a different rationale for the existence of such idle capacity: the public sector may opt to have idle capacity as a way to gain bargaining power vis−à−vis the private provider, under the assumption of a...

  3. Public health and primary care: struggling to "win friends and influence people".

    Science.gov (United States)

    Mayes, Rick; McKenna, Sean

    2011-01-01

    Why are the goals of public health and primary care less politically popular and financially supported than those of curative medicine? A major part of the answer to this question lies in the fact that humans often worry wrongly by assessing risk poorly. This reality is a significant obstacle to the adequate promotion of and investment in public health, primary care, and prevention. Also, public health's tendency to infringe on personal privacy-as well as to call for difficult behavioral change-often sparks intense controversy and interest group opposition that discourage broader political support. Finally, in contrast to curative medicine, both the cost-benefit structure of public health (costs now, benefits later) and the way in which the profession operates make it largely invisible to and, thus, underappreciated by the general public. When curative medicine works well, most everybody notices. When public health and primary care work well, virtually nobody notices.

  4. Beyond bridging the know-do gap: a qualitative study of systemic interaction to foster knowledge exchange in the public health sector in The Netherlands

    NARCIS (Netherlands)

    Driessen Mareeuw, F.A. van den; Vaandrager, L.; Klerkx, L.; Naaldenberg, J.; Koelen, M.

    2015-01-01

    BACKGROUND: Despite considerable attention currently being given to facilitating the use of research results in public health practice, several concerns remain, resulting in the so-called know-do gap. This article aims to identify the key tensions causing the know-do gap from a broad perspective by

  5. Beyond bridging the know-do gap: a qualitative study of systemic interaction to foster knowledge exchange in the public health sector in The Netherlands.

    Science.gov (United States)

    van den Driessen Mareeuw, Francine; Vaandrager, Lenneke; Klerkx, Laurens; Naaldenberg, Jenneken; Koelen, Maria

    2015-09-19

    Despite considerable attention currently being given to facilitating the use of research results in public health practice, several concerns remain, resulting in the so-called know-do gap. This article aims to identify the key tensions causing the know-do gap from a broad perspective by using a systemic approach and considering the public health sector as an innovation system. An exploratory qualitative design including in-depth semi-structured interviews was used, with 33 interviewees from different actor categories in the Dutch public health innovation system. The analyses employed an innovation system matrix to highlight the principal tensions causing the know-do gap. Seven key tensions were identified, including: research priorities determined by powerful players; no consensus about criteria for knowledge quality; different perceptions about the knowledge broker role; competition engendering fragmentation; thematic funding engendering fragmentation; predominance of passive knowledge sharing; and lack of capacity among users to use and influence research. The identified tensions indicate that bridging the know-do gap requires much more than linking research to practice or translating knowledge. An innovation system perspective is crucial in providing information on the total picture of knowledge exchange within the Dutch public health sector. Such a system includes broader stakeholder involvement as well as the creation of social, economic, and contextual conditions (achieving shared visions, building networks, institutional change, removing financial and infrastructural barriers), as these create conducive factors at several system levels and induce knowledge co-creation and innovation.

  6. Who Cares for the Children? Denmark's Unique Public Child-Care Model.

    Science.gov (United States)

    Polakow, Valerie

    1997-01-01

    U.S. working mothers wrestle daily with a child-care crisis characterized by unavailable infant care, high costs, and inadequate access and regulation. In Denmark, high-quality child care is a guaranteed entitlement for every child. Other benefits include paid parental leaves, single-parent allowances, housing subsidies, and universal health care.…

  7. Genetics, health care, and public policy: an introduction to public health genetics

    National Research Council Canada - National Science Library

    Stewart, Alison

    2007-01-01

    ... initiative About this book Further reading and resources Principles of public health The emergence of public health genetics The human genome project and 'genomic medicine' Community genetics Current developments in public health genetics Genomics and global health 2 Genetic science and technology Basic molecular genetics Genes and the geno...

  8. Intersectoral cooperation in the sphere of public health care: ways of optimization

    Directory of Open Access Journals (Sweden)

    Natan G. Korshever

    2017-08-01

    Material and Methods — There were analyzed the normative legal field of public health care, the results of anonymous survey of 838 physicians – health care organizers including 34 experts, and of 6,106 persons not engaged in medical professions. Results — There were established the list and significance of 37 health determinants; the effect produced on them by 23 state and public sectors engaged in health care; characteristics of these sectors’ interaction. There were substantiated 38 informative vectors for evaluating the effectiveness of intersectoral cooperation in the sphere of public health care – 22 simple (each representing a single informative criterion and 16 complex (consisting of several, from 3 to 12 informative criteria. There was developed an automatic multi-vector method for assessing success in intersectoral cooperation in the sphere of public health care in a territorial formation (formations, and there was designed an appropriate technology of optimization, including the primary multi-vector analysis, purposeful correction and dynamic evaluation. Conclusion — Public health care optimization is a process which should be carried out with regard to hierarchic interaction of the engaged sectors and peculiarities of their influence on health determinants, multi-vector evaluation of intersectoral cooperation efficacy aimed to substantiate and choose such administrative decisions which prove to be the best from the viewpoint of resulting effective achievements. The obtained materials may be realized in everyday practice of public health care.

  9. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction.......To examine the costs to the public health care system of couples in medically assisted reproduction....

  10. Poverty among Foster Children: Estimates Using the Supplemental Poverty Measure

    Science.gov (United States)

    Pac, Jessica; Waldfogel, Jane; Wimer, Christopher

    2017-01-01

    We use data from the Current Population Survey and the new Supplemental Poverty Measure (SPM) to provide estimates for poverty among foster children over the period 1992 to 2013. These are the first large-scale national estimates for foster children who are not included in official poverty statistics. Holding child and family demographics constant, foster children have a lower risk of poverty than other children. Analyzing income in detail suggests that foster care payments likely play an important role in reducing the risk of poverty in this group. In contrast, we find that children living with grandparents have a higher risk of poverty than other children, even after taking demographics into account. Our estimates suggest that this excess risk is likely linked to their lower likelihood of receiving foster care or other income supports. PMID:28659651

  11. Lithuania 1940 / Herbert Foster Anderson

    Index Scriptorium Estoniae

    Foster Anderson, Herbert

    2004-01-01

    Stseenid Leedu ennesõjaaegsest pealinnast Kaunasest briti ärimehe H. Foster Andersoni silme läbi 1940. aastal. Lühikokkuvõte raamatust: Foster Anderson, Herbert. Borderline Russia. London : Cresset press, 1942

  12. Does corruption undermine trust in health care? Results from public opinion polls in Croatia.

    Science.gov (United States)

    Radin, Dagmar

    2013-12-01

    Health and health care provision are one of the most important topics in public policy, and often a highly debated topic in the political arena. The importance of considering trust in the health care sector is highlighted by studies showing that trust is associated, among others, with poor self-related health, and poorer health outcomes. Similarly, corruption has shown to create economic costs and inefficiencies in the health care sector. This is particularly important for a newly democratized country such as Croatia, where a policy responsive government indicates a high level of quality of democracy (Roberts, 2009) and where a legacy of corruption in the health care sector has been carried over from the previous regime. In this study, I assess the relationship between health care corruption and trust in public health care and hypothesize that experience with health care corruption as well as perception of corruption has a negative effect on trust in public care facilities. Data were collected in two surveys, administered in 2007 and 2009 in Croatia. Experience with corruption and salience with corruption has a negative effect on trust in public health care in the 2007 survey, but not in the 2009 survey. While the results are mixed, they point to the importance of further studying this relationship. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Changing Public and Private Roles in the Dutch Child-Care Sector

    NARCIS (Netherlands)

    Plantinga, Mirjam; Plantenga, Janneke; Siegers, Jacques; Knol, Hans

    2005-01-01

    In the session ‘Balancing Public and Private Roles in Care for the Elderly (developed countries)’ at the World Congress of the International Institute of Sociology in Stockholm, Sweden, July 5-9, 2005.

  14. Governing how we care: contesting community and defining difference in U.S. public health programs

    National Research Council Canada - National Science Library

    Shaw, Susan J., Dr

    2012-01-01

    ... the meanings of cultural difference, ethnicity, and inequality in health care. Drawing on ethnographic research conducted over six years in a small New England city, Shaw presents critical perspectives on public health intervention efforts...

  15. Staff knowledge, attitudes and practices in public sector primary care ...

    African Journals Online (AJOL)

    d S years, years ceptible). luation of frican tudy. The are higher f exposures .... PHCNs 40%, RNs 43 % and SNs 50%), 23% prevention of ..... Mea 1990. 7: 360 ... Improvong Health Care '''rough CI,mcal AUd,t CIT'Cl1ester- John W'ley ana Sons.

  16. Parental perception of neonatal intensive care in public sector ...

    African Journals Online (AJOL)

    Background. Little is known about parental experience and decision making with regard to premature infants requiring intensive care in developing countries. We undertook this study to characterise parents' experience of physician counselling and their role in making life-support decisions for very low-birth-weight (VLBW) ...

  17. Clients satisfaction of antenatal care services in public and private ...

    African Journals Online (AJOL)

    Background: Antenatal care involves screening for health and socioeconomic conditions likely to increase the possibility of specific adverse pregnancy outcomes, providing therapeutic interventions known to be effective and educating pregnant women about planning for safe birth. Quality and customer service have been ...

  18. Differences in essential newborn care at birth between private and public health facilities in eastern Uganda

    Directory of Open Access Journals (Sweden)

    Peter Waiswa

    2015-03-01

    Full Text Available Background: In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective: To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design: Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results: The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007. Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001. Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. Conclusions: In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was

  19. 10 CFR 455.141 - Grant awards for units of local government, public care institutions, and coordinating agencies.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Grant awards for units of local government, public care... CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED BY UNITS OF LOCAL GOVERNMENT AND PUBLIC CARE INSTITUTIONS Grant Awards § 455.141 Grant awards for units of local government, public care...

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

    OpenAIRE

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

    2013-01-01

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

  1. Public health approaches to end-of-life care in the UK: an online survey of palliative care services.

    Science.gov (United States)

    Paul, Sally; Sallnow, Libby

    2013-06-01

    The public health approach to end-of-life care has gained recognition over the past decade regarding its contribution to palliative care services. Terms, such as health-promoting palliative care, and compassionate communities, have entered the discourse of palliative care and practice; examples exist in the UK and globally. This scoping study aimed to determine if such initiatives were priorities for hospices in the UK and, if so, provide baseline data on the types of initiatives undertaken. An online survey was designed, piloted and emailed to 220 palliative care providers across the four UK countries. It included a total of six questions. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically. There was a 66% response rate. Of those providers, 60% indicated that public health approaches to death, dying and loss were a current priority for their organisation. Respondents identified a range of work being undertaken currently in this area. The most successful were felt to be working with schools and working directly with local community groups. The findings demonstrate the relevance of a public health approach for palliative care services and how they are currently engaging with the communities they serve. Although the approach was endorsed by the majority of respondents, various challenges were highlighted. These related to the need to balance this against service provision, and the need for more training and resources to support these initiatives, at both national and community levels.

  2. Why Should We Care What the Public Thinks?

    DEFF Research Database (Denmark)

    Thomsen, Frej Klem

    2014-01-01

    This chapter explores three versions of the argument to the effect that we ought to punish in accordance with popular sentiment: While the first two versions of the argument are rejected, it is held that the third argument may provide a reason in favour of incorporating public opinion....

  3. Obstacles to HIV prevention, treatment and care in selected public ...

    African Journals Online (AJOL)

    South Africa, like the rest of Southern Africa, is ravaged by AIDS. Higher education in South Africa has a significant role to play in the fight against the spread of HIV and AIDS. This article reports the factors contributing to the spread of HIV and AIDS in three selected public universities in South Africa. To achieve the stated ...

  4. The Limited English Proficiency Patient Family Advocate Role: Fostering Respectful and Effective Care Across Language and Culture in a Pediatric Oncology Setting.

    Science.gov (United States)

    Gil, Stephanie; Hooke, Mary C; Niess, Dawn

    2016-01-01

    Patients and families with limited English proficiency (LEP) face a multitude of barriers both inside and outside the hospital walls. These barriers can contribute to difficulty accessing care and understanding/adhering to treatment recommendations, ultimately placing them at higher risk for poorer outcomes than their English-speaking counterparts. The LEP Patient Family Advocate role was created with the aim of improving access, promoting effective communication, and equalizing care for children with cancer from families with LEP. The goal of this mixed methods study was to describe the level of satisfaction and experiences of parents and health care providers who used the LEP Patient Family Advocate while receiving or providing care. Twelve parents and 15 health care providers completed quantitative surveys and an open-ended question about their experiences. High levels of satisfaction were reported. Themes about the role from qualitative responses included its positive effect on communication, trust, and connectedness between parents and staff. Continuity of care and safety were improved, and parents thought the role helped decrease their stress. The LEP Patient Family Advocate has a positive influence on family-centered cultural care. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

  5. Investigating the health care delivery system in Japan and reviewing the local public hospital reform

    Directory of Open Access Journals (Sweden)

    Zhang X

    2016-03-01

    Full Text Available Xing Zhang, Tatsuo Oyama National Graduate Institute for Policy Studies, Tokyo, Japan Abstract: Japan's health care system is considered one of the best health care systems in the world. Hospitals are one of the most important health care resources in Japan. As such, we investigate Japanese hospitals from various viewpoints, including their roles, ownership, regional distribution, and characteristics with respect to the number of beds, staff, doctors, and financial performance. Applying a multivariate analysis and regression model techniques, we show the functional differences between urban populated prefectures and remote ones; the equality gap among all prefectures with respect to the distribution of the number of beds, staff, and doctors; and managerial differences between private and public hospitals. We also review and evaluate the local public hospital reform executed in 2007 from various financial aspects related to the expenditure and revenue structure by comparing public and private hospitals. We show that the 2007 reform contributed to improving the financial situation of local public hospitals. Strategic differences between public and private hospitals with respect to their management and strategy to improve their financial situation are also quantitatively analyzed in detail. Finally, the remaining problems and the future strategy to further improve the Japanese health care system are described. Keywords: health care system, health care resource, public hospital, multivariate regression model, financial performance

  6. 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.

  7. Public Health Insurance and Health Care Utilization for Children in Immigrant Families.

    Science.gov (United States)

    Percheski, Christine; Bzostek, Sharon

    2017-12-01

    Objectives To estimate the impacts of public health insurance coverage on health care utilization and unmet health care needs for children in immigrant families. Methods We use survey data from National Health Interview Survey (NHIS) (2001-2005) linked to data from Medical Expenditures Panel Survey (MEPS) (2003-2007) for children with siblings in families headed by at least one immigrant parent. We use logit models with family fixed effects. Results Compared to their siblings with public insurance, uninsured children in immigrant families have higher odds of having no usual source of care, having no health care visits in a 2 year period, having high Emergency Department reliance, and having unmet health care needs. We find no statistically significant difference in the odds of having annual well-child visits. Conclusions for practice Previous research may have underestimated the impact of public health insurance for children in immigrant families. Children in immigrant families would likely benefit considerably from expansions of public health insurance eligibility to cover all children, including children without citizenship. Immigrant families that include both insured and uninsured children may benefit from additional referral and outreach efforts from health care providers to ensure that uninsured children have the same access to health care as their publicly-insured siblings.

  8. Assessment of foster carers : their willingness to raise children with special needs

    NARCIS (Netherlands)

    Strijker, Johan; Knorth, Erik J.

    2018-01-01

    A substantial part of children placed out of home in family foster care suffers severe emotional and behavioural problems. These problems can enlarge the risk of a placement breakdown: the stay of a child in a foster family comes prematurely to an end because, for instance, the foster carers are not

  9. Distinct Subgroups of Former Foster Youth during Young Adulthood: Implications for Policy and Practice

    Science.gov (United States)

    Courtney, Mark E.; Hook, Jennifer L.; Lee, JoAnn S.

    2012-01-01

    The Fostering Connections to Success and Increasing Adoptions Act of 2008 ("Fostering Connections Act") fundamentally changed the nature of federal support for young people in state care by extending entitlement funding under Title IV-E of the Social Security Act to age 21 beginning in FY2011. While the Fostering Connections Act provides…

  10. 5 CFR 870.303 - Eligibility of foster children under Option C.

    Science.gov (United States)

    2010-01-01

    ... biological parent becomes unable to care for the child due to a disability; or (4) The employee, annuitant....303 Eligibility of foster children under Option C. (a) Effective October 30, 1998, foster children are eligible for coverage as family members under Option C. (b) To qualify for coverage as a foster child, the...

  11. Responding to the Needs of Foster Teens in a Rural School District

    Science.gov (United States)

    DeGarmo, John Nelson

    2012-01-01

    As more children are placed under foster care, schools often have difficulty in responding to newly placed foster teens. Foster teens often exhibit both academic and behavioral adjustment issues, leading to disciplinary problems and high failure, and dropout rates. Attachment theory related to placement disruptions, school performance and…

  12. Health Care in Brazil: Implications for Public Health and Epidemiology.

    Science.gov (United States)

    Younger, David S

    2016-11-01

    A network of family-based community-oriented primary health programs, or Programa Agentes Communita˙rios de Saúde, and family health programs, or Programa Saúde da Família, introduced almost 2 decades ago were the Brazilian government's health care models to restructure primary care under the Unified Health System, or Sistema Único de Saúde. The latter offers comprehensive coverage to all, although it is used by those of lower income, and despite achievement in the last quarter century, access to health services and gradients of health status continue to persist along income, educational background, racial, and religious lines. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Public trust and initiatives for new health care partnerships.

    Science.gov (United States)

    Mechanic, D

    1998-01-01

    Effective communication between doctor and patient is a critical component of high-quality care. The physician's credibility has a significant effect on treatment outcomes. Because changes in medicine and larger cultural trends challenge the ability of clinicians to engage their patients' trust, new kinds of partnerships must be created. To do this effectively, physicians have to sharpen their communication skills and devise strategies for assuring that their patients become informed allies in their own treatment. A number of innovations are helping to build these alliances: training in communication skills; creative uses of the Internet and videotape technologies; improved "customer service" programs; critical pathways for patients; and special educational aids. All these tools promise to be useful, but they require careful development and evaluation.

  14. Reducing sibling conflict in maltreated children placed in foster homes.

    Science.gov (United States)

    Linares, L Oriana; Jimenez, Jessica; Nesci, Cristina; Pearson, Eva; Beller, Sarah; Edwards, Nancy; Levin-Rector, Alison

    2015-02-01

    Sibling aggression among maltreated children placed in foster homes is linked to other externalizing problems and placement disruption. The reduction of sibling conflict and aggression may be achieved via a multicomponent ecologically focused intervention for families in the foster care system. The focus of the study is to evaluate the feasibility and short-term effectiveness of a transtheoretical intervention model targeting sibling pairs and their foster parent that integrates family systems, social learning theory, and a conflict mediation perspective. In this pilot study, sibling pairs (N = 22) and their foster parent were randomized into a three-component intervention (n = 13) or a comparison (n = 9) group. Promoting Sibling Bonds (PSB) is an 8-week prevention intervention targeting maltreated sibling pairs ages 5-11 years placed together in a foster home. The siblings, parent, and joint components were delivered in a program package at the foster agency by a trained two-clinician team. Average attendance across program components was 73 %. Outcomes in four areas were gathered at pre- and postintervention: observed sibling interaction quality (positive and negative) including conflict during play, and foster parent reports of mediation strategies and sibling aggression in the foster home. At postintervention, adjusting for baseline scores and child age, intervention pairs showed higher positive (p conflict during play (p conflict mediation strategies than those in the comparison group (p conflict and promote parental mediation, which together may reduce sibling aggression in the foster home.

  15. Perceptions of patient-centred care at public hospitals in Nelson ...

    African Journals Online (AJOL)

    In South Africa, the quality of health care is directly related to the concept of patientcentred care and the enactment of the Batho Pele Principles and the Patients' Rights Charter. Reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with many patients being treated in ...

  16. Utilization of dental health services by Danish adolescents attending private or public dental health care systems

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Petersen, Poul Erik; Bastholm, Annelise

    2002-01-01

    The objectives of the study were: 1) to describe the choice of dental care system among 16-year-olds, 2) to describe the utilization of dental services among 16-17-year-olds enrolled in either public or private dental care systems, and to compare the dental services provided by the alternative...

  17. Making or buying environmental public goods: do consumers care?

    OpenAIRE

    Bougherara, Douadia; Costa, Sandrine; Teisl, Mario

    2012-01-01

    Firms may voluntary abate pollution using one of two options: internalizing its own external effects and incuring abatement costs ("making") or delegating environmental protection by purchasing offsets ("buying"). We aim to elicit consumers' WTP for producers' use of the "making" option as compared to the "buying" option, controlling for spatial effects (joint local public goods) and level of GHG emissions. Using a stated choice survey with 722 respondents, we find consumers are more willing ...

  18. How health economic evaluation (HEE) contributes to decision-making in public health care: the case of Brazil.

    Science.gov (United States)

    Elias, Flávia Tavares Silva; Araújo, Denizar Vianna

    2014-01-01

    The universal access to a health care system for the Brazilian population was established in 1990. Brazil is a country with no tradition in the production and use of health economic evaluation (HEE) to guide decision making in the public health system. It is only within the last two decades that HEEs using a microeconomic approach have appeared in the academic field. On a national level, HEE and Health Technology Assessment (HTA), in a wider sense, were first taken into account in 2003. Two policies deserve to be mentioned - (i) the regulation of medicines in the Brazilian market, and (ii) science, technology and innovation policy. The latter required the fostering of applied research to encourage the application of methods which employ systematic reviews and economic analyses of cost-effectiveness to guide the incorporation of technologies in the Brazilian health care system. The Ministry of Health has initiated the process of incorporating these new technologies on a federal level during the last ten years. In spite of the improvement of HEE methods at Brazilian universities and research institutes, these technologies have not yet reached the governmental bodies. In Brazil, the main challenge lies in the production, interpretation and application of HEE to all technologies within the access scheme(s), and there is limited capacity building. Setting priorities can be the solution for Brazil to be able to perform HEE for relevant technologies within the access scheme(s) while the universal coverage system struggles with a triple burden of disease. Copyright © 2014. Published by Elsevier GmbH.

  19. Rural-Urban Differences in Access to Preventive Health Care Among Publicly Insured Minnesotans.

    Science.gov (United States)

    Loftus, John; Allen, Elizabeth M; Call, Kathleen Thiede; Everson-Rose, Susan A

    2018-02-01

    Reduced access to care and barriers have been shown in rural populations and in publicly insured populations. Barriers limiting health care access in publicly insured populations living in rural areas are not understood. This study investigates rural-urban differences in system-, provider-, and individual-level barriers and access to preventive care among adults and children enrolled in a public insurance program in Minnesota. This was a secondary analysis of a 2008 statewide, cross-sectional survey of publicly insured adults and children (n = 4,388) investigating barriers associated with low utilization of preventive care. Sampling was stratified with oversampling of racial/ethnic minorities. Rural enrollees were more likely to report no past year preventive care compared to urban enrollees. However, this difference was no longer statistically significant after controlling for demographic and socioeconomic factors (OR: 1.37, 95% CI: 1.00-1.88). Provider- and system-level barriers associated with low use of preventive care among rural enrollees included discrimination based on public insurance status (OR: 2.26, 95% CI: 1.34-2.38), cost of care concerns (OR: 1.72, 95% CI: 1.03-2.89) and uncertainty about care being covered by insurance (OR: 1.70, 95% CI: 1.01-2.85). These and additional provider-level barriers were also identified among urban enrollees. Discrimination, cost of care, and uncertainty about insurance coverage inhibit access in both the rural and urban samples. These barriers are worthy targets of interventions for publicly insured populations regardless of residence. Future studies should investigate additional factors associated with access disparities based on rural-urban residence. © 2017 National Rural Health Association.

  20. Differences in Breast Cancer Survival between Public and Private Care in New Zealand: Which Factors Contribute?

    Science.gov (United States)

    Tin Tin, Sandar; Elwood, J Mark; Lawrenson, Ross; Campbell, Ian; Harvey, Vernon; Seneviratne, Sanjeewa

    2016-01-01

    Patients who received private health care appear to have better survival from breast cancer compared to those who received public care. This study investigated if this applied to New Zealand women and identified factors that could explain such disparities. This study involved all women who were diagnosed with primary breast cancer in two health regions in New Zealand, covering about 40% of the national population, between June 2000 and May 2013. Patients who received public care for primary treatment, mostly surgical treatment, were compared with those who received private care in terms of demographics, mode of presentation, disease factors, comorbidity index and treatment factors. Cox regression modelling was performed with stepwise adjustments, and hazards of breast cancer specific mortality associated with the type of health care received was assessed. Of the 14,468 patients, 8,916 (61.6%) received public care. Compared to patients treated in private care facilities, they were older, more likely to be Māori, Pacifika or Asian and to reside in deprived neighbourhoods and rural areas, and less likely to be diagnosed with early staged cancer and to receive timely cancer treatments. They had a higher risk of mortality from breast cancer (hazard ratio: 1.95; 95% CI: 1.75, 2.17), of which 80% (95% CI: 63%, 100%) was explained by baseline differences, particularly related to ethnicity, stage at diagnosis and type of loco-regional therapy. After controlling for these demographic, disease and treatment factors, the risk of mortality was still 14% higher in the public sector patients. Ethnicity, stage at diagnosis and type of loco-regional therapy were the three key contributors to survival disparities between patients treated in public and private health care facilities in New Zealand. The findings underscore the need for more efforts to improve the quality, timeliness and equitability of public cancer care services.

  1. Primary health care quality and hospitalizations for ambulatory care sensitive conditions in the public health system in Porto Alegre, Brazil.

    Science.gov (United States)

    Gonçalves, Marcelo Rodrigues; Hauser, Lisiane; Prestes, Isaías Valente; Schmidt, Maria Inês; Duncan, Bruce Bartholow; Harzheim, Erno

    2016-06-01

    To investigate the relation of hospitalization for ambulatory care sensitive conditions (ACSC) with the quality of public primary care health services in Porto Alegre, Brazil. Cohort study constructed by probabilistic record linkage performed from August 2006 to December 2011 in a population ≥18 years of age that attended public primary care health services. The Primary Care Assessment Tool (PCATool-Brazil) was used for evaluation of primary care services. Of 1200 subjects followed, 84 were hospitalized for primary care sensitive conditions. The main causes of ACSC hospital admissions were cardiovascular (40.5%) and respiratory (16.2%) diseases. The PCATool average score was 5.3, a level considerably below that considered to represent quality care. After adjustment through Cox proportional hazard modelling for covariates, >60 years of age [hazard ratio (HR): 1.13; P = 0.001), lesser education (HR: 0.66; P = 0.02), ethnicity other than white (HR: 1.77; P = 0.01) and physical inactivity (HR: 1.65; P = 0.04) predicted hospitalization, but higher quality of primary health care did not. Better quality of health care services, in a setting of overwhelmingly low quality services not adapted to the care of chronic conditions, did not influence the rate of avoidable hospitalizations, while social and demographic characteristics, especially non-white ethnicity and lesser schooling, indicate that social inequities play a predominant role in health outcomes. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Evaluating trauma care capabilities in Mexico with the World Health Organization's Guidelines for Essential Trauma Care publication.

    Science.gov (United States)

    Arreola-Risa, Carlos; Mock, Charles; Vega Rivera, Felipe; Romero Hicks, Eduardo; Guzmán Solana, Felipe; Porras Ramírez, Giovanni; Montiel Amoroso, Gilberto; de Boer, Melanie

    2006-02-01

    To identify affordable, sustainable methods to strengthen trauma care capabilities in Mexico, using the standards in the Guidelines for Essential Trauma Care, a publication that was developed by the World Health Organization and the International Society of Surgery to provide recommendations on elements of trauma care that should be in place in the various levels of health facilities in all countries. The Guidelines publication was used as a basis for needs assessments conducted in 2003 and 2004 in three Mexican states. The states were selected to represent the range of geographic and economic conditions in the country: Oaxaca (south, lower economic status), Puebla (center, middle economic status), and Nuevo León (north, higher economic status). The sixteen facilities that were assessed included rural clinics, small hospitals, and large hospitals. Site visits incorporated direct inspection of physical resources as well as interviews with key administrative and clinical staff. Human and physical resources for trauma care were adequate in the hospitals, especially the larger ones. The survey did identify some deficiencies, such as shortages of stiff suction tips, pulse oximetry equipment, and some trauma-related medications. All of the clinics had difficulties with basic supplies for resuscitation, even though some received substantial numbers of trauma patients. In all levels of facilities there was room for improvement in administrative functions to assure quality trauma care, including trauma registries, trauma-related quality improvement programs, and uniform in-service training. This study identified several low-cost ways to strengthen trauma care in Mexico. The study also highlighted the usefulness of the recommended norms in the Guidelines for Essential Trauma Care publication in providing a standardized template by which to assess trauma care capabilities in nations worldwide.

  3. 45 CFR 2552.46 - What cost reimbursements are provided to Foster Grandparents?

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false What cost reimbursements are provided to Foster..., Status and Cost Reimbursements § 2552.46 What cost reimbursements are provided to Foster Grandparents? Cost reimbursements include: (a) Stipend. Foster Grandparents who are income eligible will receive a...

  4. US Health Care Reform and Transplantation, Part II: impact on the public sector and novel health care delivery systems.

    Science.gov (United States)

    Axelrod, D A; Millman, D; Abecassis, M M

    2010-10-01

    The Patient Protection and Affordable Care Act passed in 2010 will result in dramatic expansion of publically funded health insurance coverage for low-income individuals. It is estimated that of the 32 million newly insured, 16 million will obtain coverage through expansion of the Medicaid Program, and the remaining 16 million will purchase coverage through their employer or newly legislated insurance exchanges. While the Act contains numerous provisions to improve access to private insurance as discussed in Part I of this analysis, public sector coverage will significantly be affected. The cost of health care reform will be borne disproportionately by Medicare, which faces nearly $500 billion in cuts to be identified by a new independent board. Transplant centers should be concerned about the impact of the reform on the financial aspects of transplantation. In addition, this legislation also utilizes the Medicare Program to drive reform of the health care delivery system, by encouraging the development of integrated Accountable Care Organizations, experimentation with new 'models' of healthcare delivery, and expanded support for Comparative Effectiveness Research. Transplant providers, including transplant centers and physicians/surgeons need to lead this movement, drawing on our experience providing comprehensive multidisciplinary care under global budgets with publically reported outcomes.

  5. Why good placements matter: Pre-placement and placement risk factors associated with mental health disorders in pre-school children in foster care.

    Science.gov (United States)

    Hillen, Thomas; Gafson, Leonie

    2015-07-01

    Pre-school children placed in local authority care show elevated rates of mental health disorders when compared to the general population. This study investigated risk factors for mental health disorders relating to the period prior to entering care and while in care. A representative sample of 43 children in care aged 0-72 months in an inner London borough underwent comprehensive multidimensional assessments. Presence of emotional, behavioural, attachment and adaptive disorders was ascertained. Exposure to two pre-placement risk factors and six placement risk factors was compared between children with and without a disorder. A total of 26 children (60.5%) had at least one mental health disorder. The two pre-placement risk factors, multiple types of maltreatment and entry into care after the age of 6 months, were both significantly associated with mental health disorders. The three placement risk factors of sudden placement moves, multiple placement moves and child-carer alienation showed a significant association with mental health disorders. There was a strong correlation between the number of risk factors and the number of co-morbid mental health disorders per child (r = .67, p school mental health. © The Author(s) 2014.

  6. The Impact of Public Health Awareness Campaigns on the Awareness and Quality of Palliative Care.

    Science.gov (United States)

    Seymour, Jane

    2018-01-01

    The right to health includes a right of access to good quality palliative care, but inequalities persist. Raising awareness is a key plank of the public health approach to palliative care, but involves consideration of subjects most of us prefer not to address. This review addresses the question: "do public health awareness campaigns effectively improve the awareness and quality of palliative care"? The evidence shows that public awareness campaigns can improve awareness of palliative care and probably improve quality of care, but there is a lack of evidence about the latter. Rapid review and synthesis. A comprehensive public awareness campaign about palliative care (including advance care planning and end-of-life decision making) should be based on clear and shared terminology, use well piloted materials, and the full range of mass media to suit different ages, cultures, and religious/spiritual perspectives. Arts and humanities have a role to play in allowing individuals and communities to express experiences of illness, death, and grief and encourage conversation and thoughtful reflection. There is evidence about key factors for success: targeting, networking, and use of specific, measurable, achievable, realistic time-bound objectives; continuous evaluation; and complementarity to national and international policy. Campaigns should be located within the framework of public health promotion and the synergy between short national mass media campaigns and longer term local community action initiatives carefully considered. National and local projects to raise awareness should identify and address any barriers at the level of individuals, communities, and systems of care, for example, literacy skills and unequal access to resources.

  7. Former foster youth's perspectives on independent living preparation six months after discharge.

    Science.gov (United States)

    Jones, Loring P

    2014-01-01

    Research findings have developed a troubling narrative of youth leaving foster care. Congress attempted to address the post-discharge difficulties of foster youth by passing the Independent Living Initiative in 1986, which mandated that the states develop services that would prepare youth for life after foster care. However, it is unclear what effect these programs have on post-foster care trajectories. This largely qualitative study examined the perceptions of a sample of discharged foster six months after leaving care. Most youth felt prepared for life and foster care. They were also for the most part were satisfied with their independent living program, but had significant dissatisfactions with elements of the program. These satisfactions and dissatisfactions are reported along with suggestions for improvement. The policy and practice implications of these suggestions are considered.

  8. Perceptions of patient-centred care at public hospitals in Nelson Mandela Bay

    Directory of Open Access Journals (Sweden)

    Sihaam Jardien-Baboo

    2016-10-01

    Full Text Available In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients' Rights Charter. Reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with many patients being treated in condemned hospitals which lacked piped water, electricity and essential medical equipment. Receiving quality care, and principally patient-centred care, in the face of such challenges is unlikely and consequently leads to the following question: “Are patients receiving patient-centred care in public hospitals?” A qualitative, explorative, descriptive and contextual study was conducted to explore and describe the perceptions of professional nurses regarding patient-centred care in public hospitals in Nelson Mandela Bay. Semi-structured interviews were conducted with a total of 40 purposively selected professional nurses working in public hospitals in Nelson Mandela Bay, Eastern Cape Province. Interviews were analysed according to the method described by Tesch in Creswell (2009:192. Professional nurses perceive patient-centred care as an awareness of the importance of the patient's culture, involving the patient's family, incorporating values of love and respect, optimal communication in all facets of patient care and accountability to the patient. Factors which enable patient-centred care were a positive work environment for staff, nursing manager's demonstrating exemplary professional leadership, continuous in service education for staff and collaborative teamwork within the interdisciplinary team. Barriers to patient-centred care were a lack of adequate resources, increased administrative work due to fear of litigation and unprofessional behaviour of nursing staff.

  9. Making the Case for Public-Private Child Care Partnerships: Child Care Partnership Project. [Videotape].

    Science.gov (United States)

    Finance Project, Washington, DC.

    The quality of child care in the United States has important implications for school preparedness, welfare reform, economic vitality, and the quality of family life. In this 8-minute videotape, business leaders describe why child care makes good business sense. Visuals explain the importance of early childhood for school and life success, and the…

  10. Managed Care Approaches to Children's Services within Public Systems of Care.

    Science.gov (United States)

    Pumariega, Andres; Fallon, Theodore, Jr.

    This report presents two discussions of conceptual and infrastructure issues that state mental health systems serving children with emotional disturbances must consider to make an effective transition towards a managed care organization of services under Medicaid. The first discussion, "Clinical Experiences in Managed Care Implementation for…

  11. The formation of nurses in residency programs in public and private intensive care units

    Directory of Open Access Journals (Sweden)

    Iasmim Lima Aguiar

    Full Text Available This qualitative study aimed to acknowledge the importance of practice in public and private institutions in the training of nurses in residency programs. Data were collected at two hospitals between February and March 2013, through interviews. From their analysis the following categories emerged: experience of graduate nurses in residency programs in ICUs of public and private institutions and potential for learning in public and private institutions regarding the training of nurses. Differences were detected in the work process and in the profile of patients between the public and private fields, and dissociation between caring and management functions carried out by residents was demonstrated. It was concluded that the development of practices in public and private institutions provides different and complementary experiences which prepare residents for management and care activities, improve management and technical assistance skills, encourages the exercise of in-service education and, by means of surveys, the search for solutions to problems that emerge from daily work.

  12. Comparing Dental and Pharmacy Students’ Perceptions on Public Health and Preventive Health Care Course

    Science.gov (United States)

    Mandiracioglu, Aliye; Dogan, Fethi

    2012-01-01

    Objectives: A Public health course has an important role in the undergraduate education of pharmacy and dentistry in terms of emphasizing preventive care. The purpose of this study is to evaluate the views of pharmacy and dentistry students on a public health course and preventive health care. Methods: 173 students enrolled at Ege University, Faculties of Pharmacy and Dentistry completed a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and replied to 18 Likert type question to determine their perceptions on a public health course and preventive health care. The comments of the students were reviewed and categorized into key themes. Results: SWOT analysis and the results of quantitative Likert type questions supported each other. According to the quantitative results, there was no significant difference between the scores of students from both schools in terms of their statements about the public health course and preventive care. Both groups of students mentioned the contribution of the public health course to their professions in the future. They also appreciated the importance of preventive care in the health services. PMID:22347604

  13. On Robust Methodologies for Managing Public Health Care Systems

    Directory of Open Access Journals (Sweden)

    Shastri L. Nimmagadda

    2014-01-01

    Full Text Available Authors focus on ontology-based multidimensional data warehousing and mining methodologies, addressing various issues on organizing, reporting and documenting diabetic cases and their associated ailments, including causalities. Map and other diagnostic data views, depicting similarity and comparison of attributes, extracted from warehouses, are used for understanding the ailments, based on gender, age, geography, food-habits and other hereditary event attributes. In addition to rigor on data mining and visualization, an added focus is on values of interpretation of data views, from processed full-bodied diagnosis, subsequent prescription and appropriate medications. The proposed methodology, is a robust back-end application, for web-based patient-doctor consultations and e-Health care management systems through which, billions of dollars spent on medical services, can be saved, in addition to improving quality of life and average life span of a person. Government health departments and agencies, private and government medical practitioners including social welfare organizations are typical users of these systems.

  14. Reducing Sibling Conflict in Maltreated Children Placed in Foster Homes

    Science.gov (United States)

    Linares, L. Oriana; Jimenez, Jessica; Nesci, Cristina; Pearson, Eva; Beller, Sarah; Edwards, Nancy; Levin-Rector, Alison

    2016-01-01

    Sibling aggression among maltreated children placed in foster homes is linked to other externalizing problems and placement disruption. The reduction of sibling conflict and aggression may be achieved via a multicomponent ecologically focused intervention for families in the foster care system. The focus of the study is to evaluate the feasibility and short-term effectiveness of a transtheoretical intervention model targeting sibling pairs and their foster parent that integrates family systems, social learning theory, and a conflict mediation perspective. In this pilot study, sibling pairs (N=22) and their foster parent were randomized into a three-component intervention (n=13) or a comparison (n=9) group. Promoting Sibling Bonds (PSB) is an 8-week prevention intervention targeting maltreated sibling pairs ages 5–11 years placed together in a foster home. The Siblings, Parent, and Joint components were delivered in a program package at the foster agency by a trained two-clinician team. Average attendance across program components was 73%. Outcomes in four areas were gathered at pre-and post-intervention: observed sibling interaction quality (positive and negative) including conflict during play, and foster parent reports of mediation strategies and sibling aggression in the foster home. At post-intervention, adjusting for baseline scores and child age, intervention pairs showed higher positive (p<.001) and negative (p<.05) interaction quality, and lower sibling conflict during play (p <.01) than comparison pairs. Foster parents in the intervention group reported a higher number of conflict mediation strategies than those in the comparison group (p <.001). Foster parents in the intervention group reported lower sibling physical aggression from the older toward the younger child than those in the comparison group (p <.05). Data suggest that the PSB intervention is a promising approach to reduce conflict and promote parental mediation which together may reduce

  15. World Health Organization Public Health Model: A Roadmap for Palliative Care Development.

    Science.gov (United States)

    Callaway, Mary V; Connor, Stephen R; Foley, Kathleen M

    2018-02-01

    The Open Society Foundation's International Palliative Care Initiative (IPCI) began to support palliative care development in Central and Eastern Europe and the Former Soviet Union in 1999. Twenty-five country representatives were invited to discuss the need for palliative care in their countries and to identify key areas that should be addressed to improve the care of adults and children with life-limiting illnesses. As a public health concern, progress in palliative care requires integration into health policy, education and training of health care professionals, availability of essential pain relieving medications, and health care services. IPCI created the Palliative Care Roadmap to serve as a model for government and/or nongovernment organizations to use to frame the necessary elements and steps for palliative care integration. The roadmap includes the creation of multiple Ministry of Health-approved working groups to address: palliative care inclusion in national health policy, legislation, and finance; availability of essential palliative care medications, especially oral opioids; education and training of health care professionals; and the implementation of palliative care services at home or in inpatient settings for adults and children. Each working group is tasked with developing a pathway with multiple signposts as indicators of progress made. The roadmap may be entered at different signposts depending upon the state of palliative care development in the country. The progress of the working groups often takes place simultaneously but at variable rates. Based on our experience, the IPCI Roadmap is one possible framework for palliative care development in resource constrained countries but requires both health care professional engagement and political will for progress to be made. Copyright © 2017. Published by Elsevier Inc.

  16. Postneoliberal Public Health Care Reforms: Neoliberalism, Social Medicine, and Persistent Health Inequalities in Latin America.

    Science.gov (United States)

    Hartmann, Christopher

    2016-12-01

    Several Latin American countries are implementing a suite of so-called "postneoliberal" social and political economic policies to counter neoliberal models that emerged in the 1980s. This article considers the influence of postneoliberalism on public health discourses, policies, institutions, and practices in Bolivia, Ecuador, and Venezuela. Social medicine and neoliberal public health models are antecedents of postneoliberal public health care models. Postneoliberal public health governance models neither fully incorporate social medicine nor completely reject neoliberal models. Postneoliberal reforms may provide an alternative means of reducing health inequalities and improving population health.

  17. Public health dental hygiene: an option for improved quality of care and quality of life.

    Science.gov (United States)

    Olmsted, Jodi L; Rublee, Nancy; Zurkawski, Emily; Kleber, Laura

    2013-10-01

    The purpose of this research was to document quality of life (QoL) and quality of care (QoC) measures for families receiving care from dental hygienists within public health departments, and to consider if oral health for families with economic disparities and cultural differences was improved. A descriptive research study using a retrospective record review was conducted considering QoC. A review of state epid "Do preventive oral health programs based in local health departments provide quality care services, thus impacting QoL for underserved populations?" A dental hygienist working in public health made significant contributions to improving access to care and QoL in a rural, socioeconomically disadvantaged community. A total of 2,364 children received education, 1,745 received oral screenings and 1,511 received dental sealants. Of these, 804 children with caries were referred, with 463 receiving restorations and follow-up care. QoL metrics basis assessed Health Outcomes & Health Determinants. Initial QoL data was ranked in the bottom half of the state, while 70% of original determinant data was also ranked in the bottom half of reported metrics. Dental hygienists in public health settings can positively affect patients offering preventive care outreach services. Education and sealant placement were considered effective as measured by access, delivery and, when required, referral for restorative care. Improvement in QoL for individuals was noted through improved health outcomes and determinant metrics.

  18. Fostering Nautical Tourism in the Balearic Islands

    OpenAIRE

    María J. Moreno; F. Javier Otamendi

    2017-01-01

    The aim of this paper is to determine pillars for fostering nautical tourism based on the beliefs and attitudes that professionals in the sector have towards the particularities and difficulties that the market is going through. To achieve these goals, in-depth interviews structured around 37 questions were carried out with agents of associations and nautical firms, public institutions, and the Chamber of Commerce. The qualitative analysis program NVIVO 11 was used to analyze the content of t...

  19. Initial care and outcome of glioblastoma multiforme patients in 2 diverse health care scenarios in Brazil: does public versus private health care matter?.

    Science.gov (United States)

    Loureiro, Luiz Victor Maia; Pontes, Lucíola de Barros; Callegaro-Filho, Donato; Koch, Ludmila de Oliveira; Weltman, Eduardo; Victor, Elivane da Silva; Santos, Adrialdo José; Borges, Lia Raquel Rodrigues; Segreto, Roberto Araújo; Malheiros, Suzana Maria Fleury

    2014-07-01

    The aim of this study was to describe the epidemiological and survival features of patients with glioblastoma multiforme treated in 2 health care scenarios--public and private--in Brazil. We retrospectively analyzed clinical, treatment, and outcome characteristics of glioblastoma multiforme patients from 2003 to 2011 at 2 institutions. The median age of the 171 patients (117 public and 54 private) was 59.3 years (range, 18-84). The median survival for patients treated in private institutions was 17.4 months (95% confidence interval, 11.1-23.7) compared with 7.1 months (95% confidence interval, 3.8-10.4) for patients treated in public institutions (P public setting (median of 64 days for the public hospital and 31 days for the private institution; P = .003). The patients at the private hospital received radiotherapy concurrent with chemotherapy in 59.3% of cases; at the public hospital, only 21.4% (P Brazil is critical.

  20. Towards equivalent health care of prisoners: European soft law and public health policy in Geneva.

    Science.gov (United States)

    Elger, Bernice S

    2008-07-01

    Prisoners have a right to health care and to be protected against inhumane and degrading treatment. Health care personnel and public policy makers play a central role in the protection of these rights and in the pursuit of public health goals. This article examines the legal framework for prison medicine in the canton of Geneva, Switzerland and provides examples of this framework that has shaped prisoners' medical care, including preventive measures. Geneva constitutes an intriguing example of how the Council of Europe standards concerning prison medicine have acquired a legal role in a Swiss canton. Learning how these factors have influenced implementation of prison medicine standards in Geneva may be helpful to public health managers elsewhere and encourage the use of similar strategies.

  1. Comparison of patients' experiences in public and private primary care clinics in Malta.

    Science.gov (United States)

    Pullicino, Glorianne; Sciortino, Philip; Calleja, Neville; Schäfer, Willemijn; Boerma, Wienke; Groenewegen, Peter

    2015-06-01

    Demographic changes, technological developments and rising expectations require the analysis of public-private primary care (PC) service provision to inform policy makers. We conducted a descriptive, cross-sectional study using the dataset of the Maltese arm of the QUALICOPC Project to compare the PC patients' experiences provided by public-funded and private (independent) general practitioners in Malta. Seven hundred patients from 70 clinics completed a self-administered questionnaire. Direct logistic regression showed that patients visiting the private sector experienced better continuity of care with more difficulty in accessing out-of-hours care. Such findings help to improve (primary) healthcare service provision and resource allocation. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  2. Preconception healthcare delivery at a population level: construction of public health models of preconception care.

    Science.gov (United States)

    Shannon, Geordan D; Alberg, Corinna; Nacul, Luis; Pashayan, Nora

    2014-08-01

    A key challenge of preconception healthcare is identifying how it can best be delivered at a population level. To review current strategies of preconception healthcare, explore methods of preconception healthcare delivery, and develop public health models which reflect different preconception healthcare pathways. Preconception care strategies, programmes and evaluations were identified through a review of Medline and Embase databases. Search terms included: preconception, pre-pregnancy, intervention, primary care, healthcare, model, delivery, program, prevention, trial, effectiveness, congenital disorders OR abnormalities, evaluation, assessment, impact. Inclusion criteria for review articles were: (1) English, (2) human subjects, (3) women of childbearing age, (4) 1980–current data, (5) all countries, (6) both high risk and universal approaches, (7) guidelines or recommendations, (8) opinion articles, (9) experimental studies. Exclusion criteria were: (1) non-human subjects, (2) non-English, (3) outside of the specified timeframe, (4) articles on male healthcare. The results of the literature review were synthesised into public health models of care: (1) primary care; (2) hospital-based and inter-conception care; (3) specific preconception care clinics; and, (4) community outreach. Fifteen evaluations of preconception care were identified. Community programmes demonstrated a significant impact on substance use, folic acid supplementation, diabetes optimization, and hyperphenylalaninemia. An ideal preconception visits entail risk screening, education, and intervention if indicated. Subsequently, four public health models were developed synthesizing preconception care delivery at a population level. Heterogeneity of risk factors, health systems and strategies of care reflect the lack of consensus about the best way to deliver preconception care. The proposed models aim to reflect differing aspects of preconception healthcare delivery.

  3. FOSTERING ADOLESCENTS' INTERPERSONAL BEHAVIOUR: AN ...

    African Journals Online (AJOL)

    Engr E. Egbochukwu

    skill training (SST) in fostering interpersonal behaviour among Nigerian adolescents. ..... communication problems (Akinade, 1988, Aremu, 1998, Ojekunle, 1999, .... Restructuring on the Enhancement of Self Esteem of Visually Impaired.

  4. Os desafios cotidianos dos trabalhadores em um abrigo para crianças e adolescentes (Daily challenges faced by the workers of a foster care institution for children and adolescents

    Directory of Open Access Journals (Sweden)

    Agueda Wendhausen

    2011-01-01

    Full Text Available Resumo: Num país com inúmeros problemas sociais como o Brasil, o abandono de crianças e adolescentes se constitui em problema preocupante, principalmente ao adentrarmos a realidade das chamadas casas de passagem, que lhes servem como abrigo temporário. O artigo é o recorte de um estudo junto a trabalhadores de um abrigo localizado no sul do país. Trata-se de um levantamento de problemas enfrentados por trabalhadores em seu cotidiano junto a crianças abrigadas. A abordagem metodológica foi qualitativa, utilizando-se para coleta dos dados a metodologia do Círculo de Cultura proposto por Paulo Freire. A análise se deu a partir dos “temas geradores” levantados. Emergiram dois temas principais: as necessidades dos trabalhadores em relação ao processo de trabalho e como se sentem em relação ao trabalho com as crianças. Os resultados apontam aspectos do abandono do Estado e do abandono familiar. Constatamos a necessidade da instituição de uma Política Social inclusiva para essa população, já que esse é um dilema enfrentado pelos Abrigos.Abstract: In a country with several social problems such as Brazil, the abandonment of children and adolescents is a matter of concern, especially considering the reality of so-called transition houses, which serve as temporary shelter. This article is an abridged version of a study performed with employees of a foster care institution located in the South region of Brazil. This is a survey of the problems faced in a daily basis by workers regarding the sheltered children. The methodological approach was qualitative, using for data collection the methodology of the Circle of Culture proposed by Paulo Freire. The analysis was based on the “generating issues” that were raised. Two main themes emerged: the needs of workers in relation to the work process and how they feel about working with children. The results reveal certain aspects of the abandonment of the state and of the children

  5. Hospice palliative care article publications: An analysis of the Web of Science database from 1993 to 2013

    Directory of Open Access Journals (Sweden)

    Hsiao-Ting Chang

    2016-01-01

    Conclusion: The number of hospice palliative care-related publications increased rapidly from 1993 to 2013 in the world and in Taiwan; however, the number of publications from Taiwan is still far below those published in several other countries. Further research is needed to identify and try to reduce the barriers to hospice palliative care research and publication in Taiwan.

  6. Double Crowding-Out Effects of Means-Tested Public Provision for Long-Term Care

    Directory of Open Access Journals (Sweden)

    Christophe Courbage

    2015-02-01

    Full Text Available Publicly provided long-term care (LTC insurance with means-tested benefits is suspected to crowd out either private saving or informal care. This contribution predicts crowding-out effects for both private saving and informal care for policy measures designed to relieve the public purse from LTC expenditure such as more stringent means testing and increased taxation of inheritance. These effects result from the interaction of a parent who decides on the amount of saving in retirement and a caregiver who decides on the effort devoted to informal care which lowers the probability of admission to a nursing home. Double crowding-out effects are also found to be the consequence of exogenous influences, notably a higher opportunity cost of caregiving.

  7. Primary care careers among recent graduates of research-intensive private and public medical schools.

    Science.gov (United States)

    Choi, Phillip A; Xu, Shuai; Ayanian, John Z

    2013-06-01

    Despite a growing need for primary care physicians in the United States, the proportion of medical school graduates pursuing primary care careers has declined over the past decade. To assess the association of medical school research funding with graduates matching in family medicine residencies and practicing primary care. Observational study of United States medical schools. One hundred twenty-one allopathic medical schools. The primary outcomes included the proportion of each school's graduates from 1999 to 2001 who were primary care physicians in 2008, and the proportion of each school's graduates who entered family medicine residencies during 2007 through 2009. The 25 medical schools with the highest levels of research funding from the National Institutes of Health in 2010 were designated as "research-intensive." Among research-intensive medical schools, the 16 private medical schools produced significantly fewer practicing primary care physicians (median 24.1% vs. 33.4%, p schools. In contrast, the nine research-intensive public medical schools produced comparable proportions of graduates pursuing primary care careers (median 36.1% vs. 36.3%, p = 0.87) and matching in family medicine residencies (median 7.4% vs. 10.0%, p = 0.37) relative to the other 66 public medical schools. To meet the health care needs of the US population, research-intensive private medical schools should play a more active role in promoting primary care careers for their students and graduates.

  8. Does public reporting measure up? Federalism, accountability and child-care policy in Canada.

    Science.gov (United States)

    Anderson, Lynell; Findlay, Tammy

    2010-01-01

    Governments in Canada have recently been exploring new accountability measures within intergovernmental relations. Public reporting has become the preferred mechanism in a range of policy areas, including early learning and child-care, and the authors assess its effectiveness as an accountability measure. The article is based on their experience with a community capacity-building project that considers the relationship between the public policy, funding and accountability mechanisms under the federal/provincial/territorial agreements related to child-care. The authors argue that in its current form, public reporting has not lived up to its promise of accountability to citizens. This evaluation is based on the standards that governments have set for themselves under the federal/provincial/territorial agreements, as well as guidelines set by the Public Sector Accounting Board, an independent body that develops accounting standards over time through consultation with governments.

  9. Fostering collective intelligence education

    Directory of Open Access Journals (Sweden)

    Jaime Meza

    2016-06-01

    Full Text Available New educational models are necessary to update learning environments to the digitally shared communication and information. Collective intelligence is an emerging field that already has a significant impact in many areas and will have great implications in education, not only from the side of new methodologies but also as a challenge for education. This paper proposes an approach to a collective intelligence model of teaching using Internet to combine two strategies: idea management and real time assessment in the class. A digital tool named Fabricius has been created supporting these two elements to foster the collaboration and engagement of students in the learning process. As a result of the research we propose a list of KPI trying to measure individual and collective performance. We are conscious that this is just a first approach to define which aspects of a class following a course can be qualified and quantified.

  10. Fostering Research and Publication in Academic Libraries

    Science.gov (United States)

    Sassen, Catherine; Wahl, Diane

    2014-01-01

    This study concerns administrative support provided to encourage the research and publishing activities of academic librarians working in Association of Research Libraries member libraries. Deans and directors of these libraries were asked to respond to an online survey concerning the support measures that their libraries provide, as well as their…

  11. Why public health services? Experiences from profit-driven health care reforms in Sweden.

    Science.gov (United States)

    Dahlgren, Göran

    2014-01-01

    Market-oriented health care reforms have been implemented in the tax-financed Swedish health care system from 1990 to 2013. The first phase of these reforms was the introduction of new public management systems, where public health centers and public hospitals were to act as private firms in an internal health care market. A second phase saw an increase of tax-financed private for-profit providers. A third phase can now be envisaged with increased private financing of essential health services. The main evidence-based effects of these markets and profit-driven reforms can be summarized as follows: efficiency is typically reduced but rarely increased; profit and tax evasion are a drain on resources for health care; geographical and social inequities are widened while the number of tax-financed providers increases; patients with major multi-health problems are often given lower priority than patients with minor health problems; opportunities to control the quality of care are reduced; tax-financed private for-profit providers facilitate increased private financing; and market forces and commercial interests undermine the power of democratic institutions. Policy options to promote further development of a nonprofit health care system are highlighted.

  12. Preventive care delivered within Public Dental Service after caries risk assessment of young adults

    DEFF Research Database (Denmark)

    Hänsel Petersson, G; Ericson, E; Twetman, S

    2016-01-01

    OBJECTIVES: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics...... adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention....

  13. Are primary care practitioners in Barbados following diabetes guidelines? - a chart audit with comparison between public and private care sectors

    Directory of Open Access Journals (Sweden)

    Carter Anne O

    2011-06-01

    Full Text Available Abstract Background Over 19% of the population ≥ 40 years of age in Barbados are diabetic. The quality of diabetes primary care is uncertain. Findings Charts of diabetic and hypertensive patients were randomly sampled at all public and 20 private sector primary care clinics. Charts of all diabetic patients ≥ 40 years of age were then selected. Processes of care, and quality targets for blood pressure (BP, fasting blood glucose (FBG and glycosylated haemoglobin (HbA1c were documented. 252 charts of diabetic patients (125 public and 127 private were audited. Patients had the following characteristics: mean age 64 years, female gender 61%, mean duration of diagnosis 9 years, and hypertension diagnosed 78%. Patients had an average of 4.7 clinic visits per year, 66% were prescribed metformin, 68% a sulphonylurea, 25% a statin, 21% insulin, 15% aspirin and 12% a glucosidase inhibitor. Public patients compared to private patients were more likely to be female (77% vs. 46%, p Conclusions Interventions such as body mass assessment, lifestyle advice, screening for retinopathy, monitoring blood glucose control, and achieving BP and glycaemic targets need improvement.

  14. The duty to care in an influenza pandemic: a qualitative study of Canadian public perspectives.

    Science.gov (United States)

    Bensimon, Cécile M; Smith, Maxwell J; Pisartchik, Dmitri; Sahni, Sachin; Upshur, Ross E G

    2012-12-01

    Ever since the emergence of SARS, when we were reminded that the nature of health care practitioners' duty to care is greatly contested, it has remained a polarizing issue. Discussions on the nature and limits of health care practitioners' duty to care during disasters and public health emergencies abounds the literature, ripe with arguments seeking to ground its foundations. However, to date there has been little public engagement on this issue. This study involved three Townhall meetings held between February 2008 and May 2010 in three urban settings in Canada in order to probe lay citizens' views about ethical issues related to pandemic influenza, including issues surrounding the duty to care. Participants included Canadian residents aged 18 and over who were fluent in English. Data were collected through day-long facilitated group discussions using case scenarios and focus group guides. Participant's views were organized according to several themes, including the following main themes (and respective sub-themes): 1. Legitimate limits; a) competing obligations; and b) appeal to personal choice; and 2. Legitimate expectations; a) reciprocity; and b) enforcement and planning. Our findings show that participants moved away from categorical notions of the duty to care towards more equivocal and often normative views throughout deliberations. Our analysis contributes a better understanding of the constitutive nature of the duty to care, defined in part by taking account of public views. This broadened understanding can further inform the articulation of acceptable norms of duty to care and policy development efforts. What is more, it illustrates the urgent need for policy-makers and regulators to get clarity on obligations, responsibilities, and accountability in the execution of HCPs' duty to care during times of universal vulnerability. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Public policy and medical tourism: ethical implications for the Egyptian health care system.

    Science.gov (United States)

    Haley, Bob

    2011-01-01

    Egypt's medical tourism industry has been experiencing tremendous growth. However, Egypt continues to lack the necessary investment in its public health system to effectively care for its population. Current policy and the emergence of medical tourism have led to unequal health care access, resulting in high a prevalence of infectious diseases and lack of resources for its most vulnerable populations. As a new Egyptian government emerges, it is important for policymakers to understand the critical issues and ethical concerns of existing health policy. This understanding may be used to propose new policy that more effectively allocates to care for Egypt's population.

  16. System impact research - increasing public health and health care system performance.

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Interventions directed to system features of public health and health care should increase health and welfare of patients and population. To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and equality of services. SIR creates the

  17. System impact research – increasing public health and health care system performance

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Abstract Background Interventions directed to system features of public health and health care should increase health and welfare of patients and population. Aims To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). Methods The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. Results The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. Conclusions System Impact Research – creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population.Key messagesThe new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features.SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency

  18. Quality Tuberculosis Care in Indonesia: Using Patient Pathway Analysis to Optimize Public-Private Collaboration.

    Science.gov (United States)

    Surya, Asik; Setyaningsih, Budiarti; Suryani Nasution, Helmi; Gita Parwati, Cicilia; Yuzwar, Yullita E; Osberg, Mike; Hanson, Christy L; Hymoff, Aaron; Mingkwan, Pia; Makayova, Julia; Gebhard, Agnes; Waworuntu, Wiendra

    2017-11-06

    Tuberculosis (TB) is the fourth leading cause of death in Indonesia. In 2015, the World Health Organization estimated that nearly two-thirds of the TB patients in Indonesia had not been notified, and the status of their care remained unknown. As such, Indonesia is home to nearly 20% of the world's "missing" TB patients. Understanding where patients go for care may enable strategic planning of services to better reach them. A patient pathway analysis (PPA) was conducted to assess the alignment between patient care seeking and the availability of TB diagnostic and treatment services at the national and subnational level in Indonesia. The PPA results revealed that only 20% of patients encountered diagnostic capacity at the location where they first sought care. Most initial care seeking occurred in the private sector and case notification lagged behind diagnostic confirmation in the public sector. The PPA results emphasize the role that the private sector plays in TB patient care seeking and suggested a need for differentiated approaches, by province, to respond to variances in care-seeking patterns and the capacities of public and private providers. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  19. Quality comparisons between privately and publicly managed health care centres in a suburban area of Stockholm, Sweden.

    Science.gov (United States)

    Hansagi, H; Calltorp, J; Andréasson, S

    1993-03-01

    As in many other countries, the health care system in Sweden is currently undergoing rapid changes. Within a framework of public financing, the delivery of health care is to an increasing extent being transferred to various entrepreneurs; private, public or cooperatives. A privately run, but publicly financed, health care centre was evaluated with regard to quality and costs. Quality was defined in terms of the central guidelines for Swedish primary health care: first level responsibility, accessibility, a holistic view of the patient, and continuity of care and safety. The services offered by the private health care centre were evaluated by different methods--questionnaires, health care utilization data and economic analyses--and found to be of similar quality but produced at a lower cost than by three publicly managed health care centres.

  20. Advance care planning with individuals experiencing homelessness: Literature review and recommendations for public health practice.

    Science.gov (United States)

    Hubbell, Sarah A

    2017-09-01

    Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet health care needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to communicate end-of-life preferences. This paper includes a narrative literature review of advance care planning interventions and qualitative investigations into end-of-life concerns among people experiencing homelessness. Trials of clinician-guided interventions with homeless individuals demonstrated effectiveness in achieving advance directive completion and surrogate decision-maker designation. End-of-life concerns among homeless persons included fears of dying alone, dying unnoticed, or remaining unidentified after death. Research participants also reported concerns regarding burial and notification of family members. Public health practitioners should facilitate advance care planning for people who are homeless by providing opportunities for education and discussion on care options and advance directives. © 2017 Wiley Periodicals, Inc.

  1. Fostering clinical engagement and medical leadership and aligning cultural values: an evaluation of a general practice specialty trainee integrated training placement in a primary care trust.

    Science.gov (United States)

    Ruston, Annmarie; Tavabie, Abdol

    2010-01-01

    To report on the extent to which a general practice specialty trainee integrated training placement (ITP) developed the leadership skills and knowledge of general practice specialty trainees (GPSTRs) and on the potential of the ITP to improve clinical engagement. A case study method was used in a Kent primary care trust (PCT). Sources of data included face-to-face and telephone interviews (three GPSTRs, three PCT clinical supervisors, three general practitioner (GP) clinical supervisors and three Deanery/PCT managers), reflective diaries, documentary sources and observation. Interview data were transcribed and analysed using the constant comparative method. All respondents were positive about the value and success of the ITP in developing the leadership skills of the GPSTRs covering three dimensions: leadership of self, leadership of teams and leadership of organisations within systems. The ITP had enabled GP trainees to understand the context for change, to develop skills to set the direction for change and to collect and apply evidence to decision making. The ITP was described as an effective means of breaking down cultural barriers between general practice and the PCT and as having the potential for improving clinical engagement. The ITP provided a model to enable the effective exchange of knowledge and understanding of differing cultures between GPSTRs, general practice and the PCT. It provided a sound basis for effective, dispersed clinical engagement and leadership.

  2. Difficulties in accessing and availing of public health care systems among rural population in Chittoor District, Andhra Pradesh

    OpenAIRE

    Geetha Lakshmi Sreerama; Sai Varun Matavalum; Paraiveedu Arumugam Chandresekharan; Veronica Thunga

    2015-01-01

    Context: Despite policies to make health care accessible to all, it is not universally accessible. Frequent evaluation of barriers to accessibility of health care services paves path for improvement. Hence, present study is undertaken to evaluate the factors and public health policies influencing health care access to rural people in Chittoor District, Andhra Pradesh, which can be interpolated for other regions. Aims: To assess knowledge, perceptions, availing of public health care services, ...

  3. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Directory of Open Access Journals (Sweden)

    Lene Bjørn Jensen

    2018-05-01

    Full Text Available The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO. Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  4. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Science.gov (United States)

    Bjørn Jensen, Lene; Lukic, Irena; Gulis, Gabriel

    2018-05-07

    The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO). Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state) with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  5. Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol

    Directory of Open Access Journals (Sweden)

    Fayers Peter

    2010-09-01

    Full Text Available Abstract Background A public health response is essential to meet the multidimensional needs of patients and families affected by HIV disease in sub-Saharan Africa. In order to appraise curret provision of HIV care and support in East Africa, and to provide evidence-based direction to future care programming, and Public Health Evaluation was commissioned by the PEPFAR programme of the US Government. Methods/Design This paper described the 2-Phase international mixed methods study protocol utilising longitudinal outcome measurement, surveys, patient and family qualitative interviews and focus groups, staff qualitative interviews, health economics and document analysis. Aim 1 To describe the nature and scope of HIV care and support in two African countries, including the types of facilities available, clients seen, and availability of specific components of care [Study Phase 1]. Aim 2 To determine patient health outcomes over time and principle cost drivers [Study Phase 2]. The study objectives are as follows. 1 To undertake a cross-sectional survey of service configuration and activity by sampling 10% of the facilities being funded by PEPFAR to provide HIV care and support in Kenya and Uganda (Phase 1 in order to describe care currently provided, including pharmacy drug reviews to determine availability and supply of essential drugs in HIV management. 2 To conduct patient focus group discussions at each of these (Phase 1 to determine care received. 3 To undertake a longitudinal prospective study of 1200 patients who are newly diagnosed with HIV or patients with HIV who present with a new problem attending PEPFAR care and support services. Data collection includes self-reported quality of life, core palliative outcomes and components of care received (Phase 2. 4 To conduct qualitative interviews with staff, patients and carers in order to explore and understand service issues and care provision in more depth (Phase 2. 5 To undertake document

  6. Dementia and Migration: Family Care Patterns Merging With Public Care Services.

    Science.gov (United States)

    Sagbakken, Mette; Spilker, Ragnhild Storstein; Ingebretsen, Reidun

    2018-01-01

    This article focuses on cognitive impairment and dementia in the context of transnational migration. Based on data from focus group discussions and interviews, we conclude that to adjust to the needs of care within ethnic-minority communities, it is important to consider not only the availability of household and kin members but also the present understanding of obligation and reciprocity underlying the perception of care. Another important issue to realize is that caregivers, women in particular, might feel obliged to conform to a traditional caregiver role, but without the support from a wider extended family, and in the context of other pressing roles and duties. Consequently, health personnel should be wary of stereotyping and generalizing groups through "othering" ideologies and rather try to explore, understand, and adjust to the present and often fluctuating set of needs, as well as be aware of how and by whom these needs are articulated.

  7. Foster Youth and Social Support: The First RCT of Independent Living Services

    Science.gov (United States)

    Greeson, Johanna K. P.; Garcia, Antonio R.; Kim, Minseop; Courtney, Mark E.

    2015-01-01

    Objective: Conduct secondary data analysis to evaluate the effectiveness of Massachusetts' Adolescent Outreach Program for Youths in Intensive Foster Care (Outreach) for increasing social support (SS) among enrolled youth. Participants: 194 youth in intensive foster care under the guardianship of the Massachusetts Department of Children and…

  8. Tuition Assistance Programs for Foster Youth Pursuing Postsecondary Education. 50-State Review

    Science.gov (United States)

    Parker, Emily; Sarubbi, Molly

    2017-01-01

    Many students have concerns about the affordability of college, which may interfere with their potential success. However, foster care alumni have unique needs when making the transition into postsecondary enrollment. Compared to completion rates for the general population, postsecondary education outcomes for youth with foster care experience lag…

  9. Understanding Foster Youth Outcomes: Is Propensity Scoring Better than Traditional Methods?

    Science.gov (United States)

    Berzin, Stephanie Cosner

    2010-01-01

    Objectives: This study seeks to examine the relationship between foster care and outcomes using multiple comparison methods to account for factors that put foster youth at risk independent of care. Methods: Using the National Longitudinal Survey of Youth 1997, matching, propensity scoring, and comparisons to the general population are used to…

  10. Using Vector and Extended Boolean Matching in an Expert System for Selecting Foster Homes.

    Science.gov (United States)

    Fox, Edward A.; Winett, Sheila G.

    1990-01-01

    Describes FOCES (Foster Care Expert System), a prototype expert system for choosing foster care placements for children which integrates information retrieval techniques with artificial intelligence. The use of prototypes and queries in Prolog routines, extended Boolean matching, and vector correlation are explained, as well as evaluation by…

  11. A child brought up in foster family [Dziecko wychowywane w rodzinie zastępczej

    Directory of Open Access Journals (Sweden)

    Danuta WOSIK-KAWALA

    2017-11-01

    Full Text Available In a situation when a family does not care about the child and does not fulfil its educational duties to its child, and even where the support given does not result in an improvement of the situation, then the child may be placed in foster care. This leads to the child’s coexistence in two families: the biological one and foster one. In accordance with the law in force in Poland on family support and the foster care system of 20 September 2012, foster care becomes a supplement to parental care-giving and does not replace it. This article is an attempt to show the complexity of the issues concerning the upbringing of a child in two families. Particular attention is paid to the difficult situation of the child, who periodically, by the court’s decision is sent to foster care and functions in a new unrelated family, while maintaining contact with their biological parents, with whom they share a legal bond. This situation raises a number of difficulties experienced by the child – dilemmas and problems with identification and belonging to the foster or biological family. The temporary nature of foster care, its subsidiary character, causes that nowadays the goal of foster families is not to establish ties with the child similar to those resulting from a parent-like attitude but to support, help in the care and upbringing of the child. The article also highlights the resulting threats to the proper functioning of the child

  12. Top-cited publications on point-of-care ultrasound: The evolution of research trends.

    Science.gov (United States)

    Liao, Shao-Feng; Chen, Pai-Jung; Chaou, Chung-Hsien; Lee, Ching-Hsing

    2018-01-06

    Point-of-care ultrasound (POCUS) has been a rapidly growing and broadly used modality in recent decades. The purpose of this study was to determine how POCUS is incorporated into clinical medicine by analyzing trends of use in the published literature. POCUS-related publications were retrieved from the Web of Science (WoS) database. The search results were ranked according to the number of times an article was cited during three time frames and average annual number of citations. Of the top 100 most cited publications in the four rankings, information regarding the publication journal, publication year, first author's nationality, field of POCUS application, and number of times the article was cited was recorded for trend analysis. A total of 7860 POCUS-related publications were retrieved, and publications related to POCUS increased from 8 in 1990 to 754 in 2016. The top 148 cited publications from the four ranking groups were included in this study. Trauma was the leading application field in which POCUS was studied prior to 2001. After 2004, thorax, cardiovascular, and procedure-guidance were the leading fields in POCUS research. >79% (118/148) of the top-cited publications were conducted by authors in the United States, Italy, and France. The majority of publications were published in critical care medicine and emergency medicine journals. In recent years, publications relating to POCUS have increased. POCUS-related research has mainly been performed in thorax, cardiovascular, and procedure-guidance ultrasonography fields, replacing trauma as the major field in which POCUS was previously studied. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. A comparison between antenatal care quality in public and private sector in rural Hebei, China.

    Science.gov (United States)

    Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H M M T; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W

    2013-04-01

    To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. The quality of ANC in Hebei was poorer than required by China's national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities.

  14. Dementia care in public health in Brazil and the world: A systematic review

    Directory of Open Access Journals (Sweden)

    Bianca Bolzan Cieto

    Full Text Available ABSTRACT OBJECTIVE: This study aimed to identify in the recent scientific literature, information on health care provided to people with dementia, dementia costs and its resource implications for public health. METHODS: This was a systematic review of the literature in which the articles were consulted from the databases PubMed/MEDLINE, LILACS and SciELO. The review sample consisted of 45 articles. RESULTS: Examination of the studies identified the current scenario of dementia in relation to public health and public policy in Brazil and the world. The analyzed studies revealed key information on aspects of dementia in the world. There was consensus on the high prevalence of the syndrome and on the significant cost of health care and public policy for assisting the elderly with dementia. CONCLUSION: The importance of planning and implementing new public policies was recognized, since these are essential for the organization and management of health services and directly influence the country's ability to provide health care for people with dementia.

  15. A comparison between antenatal care quality in public and private sector in rural Hebei, China

    Science.gov (United States)

    Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H.M.M.T.; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W.

    2013-01-01

    Aim To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. Methods We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Results Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. Conclusion The quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities. PMID:23630142

  16. Changes in the relationship between nursing home financial performance and quality of care under public reporting.

    Science.gov (United States)

    Park, Jeongyoung; Werner, Rachel M

    2011-07-01

    The relationship between financial performance and quality of care in nursing homes is not well defined and prior work has been mixed. The recent focus on improving the quality of nursing homes through market-based incentives such as public reporting may have changed this relationship, as public reporting provides nursing homes with increased incentives to engage in quality-based competition. If quality improvement activities require substantial production costs, nursing home profitability may become a more important predictor of quality under public reporting. This study explores the relationship between financial performance and quality of care and test whether this relationship changes under public reporting. Using a 10-year (fiscal years 1997-2006) panel data set of 9444 skilled nursing facilities in the US, this study employs a facility fixed-effects with and without instrumental variables approach to test the effect of finances on quality improvement and correct for potential endogeneity. The results show that better financial performance, as reflected by the 1-year lagged total profit margin, is modestly associated with higher quality but only after public reporting is initiated. These findings have important policy implications as federal and state governments use market-based incentives to increase demand for high-quality care and induce providers to compete based on quality. Copyright © 2010 John Wiley & Sons, Ltd.

  17. Fostering employee involvement.

    Science.gov (United States)

    Beecher, G P

    1997-11-01

    Every year, the ODA's Economics of Practice Committee, with the help of an independent consulting firm, carries out the Cost of Practice Monitor which tracks the various costs of running a dental practice in Ontario. This article is the result of a joint ODA-Arthur Andersen initiative to provide members with detailed information from the Monitor. Over the next year, there will be a series of articles published under the heading "Best practises for Ontario's Dental Practices." The article featured in this issue focuses on wage expenses in dental practices and how to foster employee involvement as a means of addressing cost-productivity issues. Furthermore, information relating to wage expenses may be used by practitioners to benchmark their practice against the average Ontario dental practice. Appendix C was developed for this purpose. Through benchmarking, the practitioner may gain insight into ways of evaluating their practice and in addressing issues that could improve the management of the practice. For a long time, concepts of best business practises were applied only to manufacturing organizations or large multi-national corporations but experience has demonstrated that these activities are universal to all organizations, including service companies, schools, government and not-for-profit organizations.

  18. Reforms are needed to increase public funding and curb demand for private care in Israel's health system.

    Science.gov (United States)

    Chernichovsky, Dov

    2013-04-01

    Historically, the Israeli health care system has been considered a high-performance system, providing universal, affordable, high-quality care to all residents. However, a decline in the ratio of physicians to population that reached a modern low in 2006, an approximate ten-percentage-point decline in the share of publicly financed health care between 1995 and 2009, and legislative mandates that favored private insurance have altered Israel's health care system for the worse. Many Israelis now purchase private health insurance to supplement the state-sponsored universal care coverage, and they end up spending more out of pocket even for services covered by the entitlement. Additionally, many publicly paid physicians moonlight at private facilities to earn more money. In this article I recommend that Israel increase public funding for health care and adopt reforms to address the rising demand for privately funded care and the problem of publicly paid physicians who moonlight at private facilities.

  19. A wall of information? Exploring the public health component of maternity care in England.

    Science.gov (United States)

    Sanders, Julia; Hunter, Billie; Warren, Lucie

    2016-03-01

    midwives have traditionally had an important role in providing public health messages to women. The range and diversity of the public health remit within maternity services has expanded rapidly over the past decade and maternity support workers as well as midwives are now engaged in public health work in many areas. Given these changes a review of current practice was indicated. to identify student midwives׳, midwives׳ and midwifery support workers׳ current knowledge of and involvement in the public health agenda in England. descriptive qualitative study using online discussion forums. England, United Kingdom undergraduate student midwives, midwives and maternity support workers employed by the National Health Service in England and University employed Leads for Midwifery Education. key themes identified were: the scope of the midwives׳ public health role, training and support for public health role, barriers and facilitators, specific client groups, specialist referral services. Student midwives, midwives and maternity support workers view engagement with, and delivery of, public health initiatives as an integral component of their roles, but are on occasions frustrated by constraints of time, training and public engagement. the National Health Service in England aims to engage pregnant women and new mothers in a diverse range of population based and individualised, public health initiatives. Currently, there are high levels of involvement in the public health agenda from the maternity workforce across a wide range of activities. However, midwives and maternity support workers are restricted by barriers of time, training and resources. These barriers will need addressing for optimal maternity care engagement in public health to be realised. policy makers, commissioners and National Health Service providers need to provide clear guidance on the expectations of the public health remit of midwives and maternity support workers and ensure that such expectations

  20. Payments and quality of care in private for-profit and public hospitals in Greece.

    Science.gov (United States)

    Kondilis, Elias; Gavana, Magda; Giannakopoulos, Stathis; Smyrnakis, Emmanouil; Dombros, Nikolaos; Benos, Alexis

    2011-09-23

    Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public sector hospitals is available. The aim of the present study was to describe and compare the operation and performance of private for-profit (PFP) and public hospitals in Greece, focusing on differences in nurse staffing rates, average lengths of stay (ALoS), and Social Health Insurance (SHI) payments for hospital care per patient discharged. Five different datasets were prepared and analyzed, two of which were derived from information provided by the National Statistical Service (NSS) of Greece and the other three from data held by the three largest SHI schemes in the country. All data referred to the 3-year period from 2001 to 2003. PFP hospitals in Greece are smaller than public hospitals, with lower patient occupancy, and have lower staffing rates of all types of nurses and highly qualified nurses compared with public hospitals. Calculation of ALoS using NSS data yielded mixed results, whereas calculations of ALoS and SHI payments using SHI data gave results clearly favoring the public hospital sector in terms of cost-efficiency; in all years examined, over all specialties and all SHI schemes included in our study, unweighted ALoS and SHI payments for hospital care per discharge were higher for PFP facilities. In a mixed healthcare system, such as that in Greece, significant performance differences were observed between PFP and public hospitals. Close monitoring of healthcare provision by hospital ownership type will be essential to permit evidence-based decisions on the future of the public/private mix in terms of healthcare provision.

  1. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    Science.gov (United States)

    2012-01-01

    Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form) for reporting violent incidents, the DCS (demand/control/support) model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors. PMID:22551645

  2. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    Directory of Open Access Journals (Sweden)

    Magnavita Nicola

    2012-05-01

    Full Text Available Abstract Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form for reporting violent incidents, the DCS (demand/control/support model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors.

  3. Attachment Theory, Foster Parents and Diversity Tolerance

    OpenAIRE

    Kenny, Michael; Fleming, Ted

    2009-01-01

    relevance to attachment within the biological and foster family. Yet every foster parent has a childhood attachment history that influences their interpersonal relationships in adulthood. The primary concern of the foster parent and their supports is with the foster child. But as a result the foster parent may distract or block reflection on their own attachment history. This presentation will focus on attachment theory and the adult, with particular reference to the foster parent. The pre...

  4. Public health care providers and market competition: the case of Finnish occupational health services.

    Science.gov (United States)

    Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu

    2011-02-01

    As reforms in publicly funded health systems rely heavily on competition, it is important to know if and how public providers react to competition. In many European countries, it is empirically difficult to study public providers in different markets, but in Finnish occupational health services, both public and private for-profit and non-profit providers co-exist. We studied possible differences in public providers' performance (price, intensity of services, service mix-curative medical services/prevention, productivity and revenues) according to the competitiveness of the market. The Finnish Institute of Occupational Health (FIOH) collected data on clients, services and personnel for 1992, 1995, 1997, 2000 and 2004 from occupational health services (OHS) providers. Employers defray the costs of OHS and apply for reimbursement from the Social Insurance Institution (SII). The SII data was merged with FIOH's questionnaire. The unbalanced panel consisted of about 230 public providers, totalling 1,164 observations. Local markets were constructed from several municipalities based on commuting practices and regional collaboration. Competitiveness of the market was measured by the number of providers and by the Herfindahl index. The effect of competition was studied by ordinary least square regression analysis and panel models. The more competitive the environment was for a public provider the higher were intensity, productivity and the share of medical care. Fixed panel models showed that these differences were not due to differences and changes in the competitiveness of the market. Instead, in more competitive markets public providers had higher unit prices and higher revenues.

  5. Lived experiences of student nurses caring for intellectually disabled people in a public psychiatric institution

    Directory of Open Access Journals (Sweden)

    Annie Temane

    2016-06-01

    Full Text Available Background: Caring for intellectually disabled people can be demanding for student nurses who are novices in the nursing profession. To ensure that quality nursing care is provided, student nurses should have an understanding of and a positive attitude towards intellectually disabled people. Nursing intellectually disabled people can be a challenge for the student nurses. Therefore, student nurses need to be able to deal with challenges of caring for intellectually disabled people. Objective: This article aims to explore and describe experiences of student nurses caring for intellectually disabled people in a public psychiatric institution. Design and method: A qualitative, exploratory, descriptive and contextual research design was used. Data were collected through individual in-depth phenomenological interviews, naïve sketches and field notes. Thematic analysis was utilised to analyse the collected data. Results were contextualised within the literature and measures to ensure trustworthiness were adhered to. Ethical principals were also applied throughout the research process. Results: Five themes emerged from the data. Student nurses experienced a profoundly unsettling impact on their whole being when caring for intellectually disabled people; they developed a sense of compassion and a new way of looking at life, and experienced a need for certain physical, mental and spiritual needs to be met. Conclusion: From the results, it is evident that student nurses were challenged in caring for intellectually disabled people. However, they developed a sense of awareness that intellectually disabled people have a need to be cared for like any other person. Keywords: experiences, student nurses, caring, intellectually disabled people, public psychiatric institution

  6. Domestic violence against women, public policies and community health workers in Brazilian Primary Health Care.

    Science.gov (United States)

    Signorelli, Marcos Claudio; Taft, Angela; Pereira, Pedro Paulo Gomes

    2018-01-01

    Domestic violence creates multiple harms for women's health and is a 'wicked problem' for health professionals and public health systems. Brazil recently approved public policies to manage and care for women victims of domestic violence. Facing these policies, this study aimed to explore how domestic violence against women is usually managed in Brazilian primary health care, by investigating a basic health unit and its family health strategy. We adopted qualitative ethnographic research methods with thematic analysis of emergent categories, interrogating data with gender theory and emergent Brazilian collective health theory. Field research was conducted in a local basic health unit and the territory for which it is responsible, in Southern Brazil. The study revealed: 1) a yawning gap between public health policies for domestic violence against women at the federal level and its practical application at local/decentralized levels, which can leave both professionals and women unsafe; 2) the key role of local community health workers, paraprofessional health promotion agents, who aim to promote dialogue between women experiencing violence, health care professionals and the health care system.

  7. Public and patient involvement in needs assessment and social innovation: a people-centred approach to care and research for congenital disorders of glycosylation.

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    de Freitas, Cláudia; Dos Reis, Vanessa; Silva, Susana; Videira, Paula A; Morava, Eva; Jaeken, Jaak

    2017-09-26

    Public and patient involvement in the design of people-centred care and research is vital for communities whose needs are underserved, as are people with rare diseases. Innovations devised collectively by patients, caregivers, professionals and other members of the public can foster transformative change toward more responsive services and research. However, attempts to involve lay and professional stakeholders in devising community-framed strategies to address the unmet needs of rare diseases are lacking. In this study, we engaged with the community of Congenital Disorders of Glycosylation (CDG) to assess its needs and elicit social innovations to promote people-centred care and research. Drawing on a qualitative study, we conducted three think tanks in France with a total of 48 participants, including patients/family members (n = 18), health care professionals (n = 7), researchers (n = 7) and people combining several of these roles (n = 16). Participants came from 20 countries across five continents. They were selected from the registry of the Second World Conference on CDG through heterogeneity and simple random sampling. Inductive and deductive approaches were employed to conduct interpretational analysis using open, axial and selective coding, and the constant-comparison method to facilitate the emergence of categories and core themes. The CDG community has unmet needs for information, quality health care, psychosocial support and representation in decision-making concerned with care and research. According to participants, these needs can be addressed through a range of social innovations, including peer-support communities, web-based information resources and a CDG expertise platform. This is one of the few studies to engage lay and professional experts in needs assessment and innovation for CDG at a global level. Implementing the innovations proposed by the CDG community is likely to have ethical, legal and social implications associated with the

  8. Understanding the Barriers to College Access for Former Foster Youth at the Los Angeles Community College District

    Science.gov (United States)

    Sousa, John Chaves

    2013-01-01

    Generally referred to as aged-out youth, approximately 20,000 former foster youth leave foster care each year, with very few enrolling into the community college system. Many enroll into a college system without a clear understanding of the system. Unable to maneuver, most former foster youth will drop out. The current exploratory, comparative…

  9. Implementing health care reform: implications for performance of public hospitals in central Ethiopia.

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    Manyazewal, Tsegahun; Matlakala, Mokgadi C

    2018-06-01

    Understanding the way health care reforms have succeeded or failed thus far would help policy makers cater continued reform efforts in the future and provides insight into possible levels of improvement in the health care system. This work aims to assess and describe the implications of health care reform on the performance of public hospitals in central Ethiopia. A facility-based, cross-sectional study was carried out in five public hospitals with different operational characteristics that have been implementing health care reform in central Ethiopia. The reform documents were reviewed to assess the nature and targets of the reform for interpretive analysis. Adopting dimensions of health system performance as the theoretical framework, a self-administered questionnaire was developed. Consenting health care professionals who have been involved in the reform from inception to implementation filled the questionnaire. Cronbach's alpha was measured to ensure internal consistency of the instrument. Descriptive statistics, weighted median score, χ 2 , and Mann-Whitney U and Kruskal-Wallis tests were used for data analysis. s Despite implementation of the reform, the health care system in public hospitals was still fragmented as confirmed by 50% of respondents. Limited effects were reported in favour of quality (48%), access (50%), efficiency (51%), sustainability (53%), and equity (61%) of care, while poor effects were reported in patient-provider (41%) and provider-management (32%) interactions. Though there was substantial gain in infrastructure and workspace, stewardship of health care resources was less benefited. The predominant hindrances of the reform were the working environment (adjusted Odds Ratio (aOR) = 2.27, 95% confidence interval (CI): 1.15-4.47), financial resources (aOR = 3.54, 95%CI = 1.97-6.33), management (aOR = 2.27, 95% CI = 1.15-4.47), and information technology system (aOR = 3.15, 95% CI = 1.57-6.32). s The Ethiopian

  10. Health care issues in Croatian elections 2005-2010: series of public opinion surveys.

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    Radin, Dagmar; Dzakula, Aleksandar; Benkovic, Vanesa

    2011-10-15

    To compare the results of a series of public opinion surveys on experiences with the health care sector in Croatia conducted in the time of elections and to analyze whether political party affiliation had any influence on issues of priority ranking. The surveys were conducted during 2005, 2007, and 2009. They were administered through a Computer Assisted Telephone Interviewing method to representative samples of Croatian population and were statistically weighted according to sex, age, level of education, and political party affiliation. The random sampling of the person within the household was done using the table of random numbers. Health and health care system was the most important issue (58%) during the 2007 parliamentary election and the second most important issue during the 2005 and 2009 elections (46% and 28%). In the 2007 election, health care was viewed as most important by women, respondents with lower education levels, and respondents with lower income. In 2005, the most important health care issues were corruption and lack of funding (45% and 43%, respectively), in 2007 poor organization and lack of funding (43% and 42%, respectively), and in 2009 lack of funding and corruption (51% and 45%, respectively). Health and health care system were consistently among the top two issues in all elections from 2005 to 2009. The top three most important health care sector issues were corruption, poor organization, and lack of funding. This indicates that political parties should include solutions to these issues in their health care policymaking.

  11. Health care issues in Croatian elections 2005-2009: series of public opinion surveys

    Science.gov (United States)

    Radin, Dagmar; Džakula, Aleksandar; Benković, Vanesa

    2011-01-01

    Aim To compare the results of a series of public opinion surveys on experiences with the health care sector in Croatia conducted in the time of elections and to analyze whether political party affiliation had any influence on issues of priority ranking. Methods The surveys were conducted during 2005, 2007, and 2009. They were administered through a Computer Assisted Telephone Interviewing method to representative samples of Croatian population and were statistically weighted according to sex, age, level of education, and political party affiliation. The random sampling of the person within the household was done using the table of random numbers. Results Health and health care system was the most important issue (58%) during the 2007 parliamentary election and the second most important issue during the 2005 and 2009 elections (46% and 28%). In the 2007 election, health care was viewed as most important by women, respondents with lower education levels, and respondents with lower income. In 2005, the most important health care issues were corruption and lack of funding (45% and 43%, respectively), in 2007 poor organization and lack of funding (43% and 42%, respectively), and in 2009 lack of funding and corruption (51% and 45%, respectively). Conclusion Health and health care system were consistently among the top two issues in all elections from 2005 to 2009. The top three most important health care sector issues were corruption, poor organization, and lack of funding. This indicates that political parties should include solutions to these issues in their health care policymaking. PMID:21990075

  12. The Influence of Urinary Incontinence on Publicly Financed Home Care Services to Low-Income Elderly People.

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    Baker, Dorothy I.; Bice, Thomas W.

    1995-01-01

    A retrospective cohort design is used to estimate the effect of urinary incontinence (UI) on the public costs of home care services to elderly individuals. Multivariate analyses controlling for other individual, household, and supply characteristics demonstrate that those with UI generate significantly greater public costs for home care services.…

  13. Job satisfaction of primary health-care providers (public sector in urban setting

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    Pawan Kumar

    2013-01-01

    Full Text Available Introduction: Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. Materials and Methods: Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. Results: Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01. Age and education level of health care providers don′t show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. Conclusion: Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi.

  14. Microbiological contamination of mobile phones of clinicians in intensive care units and neonatal care units in public hospitals in Kuwait.

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    Heyba, Mohammed; Ismaiel, Mohammad; Alotaibi, Abdulrahman; Mahmoud, Mohamed; Baqer, Hussain; Safar, Ali; Al-Sweih, Noura; Al-Taiar, Abdullah

    2015-10-15

    The objective of this study was to explore the prevalence of microbiological contamination of mobile phones that belong to clinicians in intensive care units (ICUs), pediatric intensive care units (PICUs), and neonatal care units (NCUs) in all public secondary care hospitals in Kuwait. The study also aimed to describe mobile phones disinfection practices as well as factors associated with mobile phone contamination. This is a cross-sectional study that included all clinicians with mobile phones in ICUs, PICUs, and NCUs in all secondary care hospitals in Kuwait. Samples for culture were collected from mobile phones and transported for microbiological identification using standard laboratory methods. Self-administered questionnaire was used to gather data on mobile phones disinfection practices. Out of 213 mobile phones, 157 (73.7 %, 95 % CI [67.2-79.5 %]) were colonized. Coagulase-negative staphylococci followed by Micrococcus were predominantly isolated from the mobile phones; 62.9 % and 28.6 % of all mobile phones, respectively. Methicillin-resistant Staphylococcus aureus (MRSA) and Gram-negative bacteria were identified in 1.4 % and 7.0 % of the mobile phones, respectively. Sixty-eight clinicians (33.5 %) reported that they disinfected their mobile phones, with the majority disinfecting their mobile phones only when they get dirty. The only factor that was significantly associated with mobile phone contamination was whether a clinician has ever disinfected his/her mobile phone; adjusted odds ratio 2.42 (95 % CI [1.08-5.41], p-value = 0.031). The prevalence of mobile phone contamination is high in ICUs, PICUs, and NCUs in public secondary care hospitals in Kuwait. Although some of the isolated organisms can be considered non-pathogenic, various reports described their potential harm particularly among patients in ICU and NCU settings. Isolation of MRSA and Gram-negative bacteria from mobile phones of clinicians treating patients in high-risk healthcare

  15. A comparison of private and public sector intensive care unit infrastructure in South Africa.

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    Mahomed, S; Sturm, A W; Moodley, P

    2017-11-27

    Intensive care units (ICUs) are designed to care for patients who are often at increased risk of acquiring healthcare-associated infections. The structure of ICUs should be optimally designed to facilitate the care of these critically ill patients, and minimise their risk of infection. National regulations (R158) were developed to govern the building and registration of private hospitals, and until recently equivalent regulations were not available for public hospitals. To assess and compare the compliance of ICUs in the private and public sectors with the R158 regulations. A cross-sectional study design was used to assess the infrastructure of 25 private sector and 6 public sector ICUs in eThekwini Health District, KwaZulu-Natal Province, South Africa. We used the R158 checklist, which was developed by the KwaZulu-Natal Department of Health Private Licensing Unit and Infection Prevention and Control Unit. The aspects covered in the R158 checklist were categorised into the design, general safety and patient services of the ICUs. Most of the ICUs in both sectors met the general safety requirements. There were varying levels of compliance with the design criteria. Only 7 (28.0%) and 1 (16.7%) of the private and public ICUs, respectively, had sufficient space around the beds. Twenty-two private ICUs (88.0%) and 4 public ICUs (66.7%) had isolation rooms, but only some of these isolation rooms (15 private and 2 public) had appropriate mechanical ventilation. None of the ICUs had clinical hand-wash basins in the nurse stations and dirty utility rooms. The majority of the ICUs had the required number of oxygen and electric outlets at the bedside. None of the public ICUs met the light intensity requirement over the bed area. Adequate spacing in ICUs is an issue in many cases. Interventions need to be put in place to ensure that ICUs meet the relevant design standards. There is an urgent need to revise the R158 regulations to reflect current best practices, particularly

  16. Tuberculosis treatment managed by providers outside the Public Health Department: lessons for the Affordable Care Act.

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    Melissa Ehman

    Full Text Available INTRODUCTION: Tuberculosis (TB requires at least six months of multidrug treatment and necessitates monitoring for response to treatment. Historically, public health departments (HDs have cared for most TB patients in the United States. The Affordable Care Act (ACA provides coverage for uninsured persons and may increase the proportion of TB patients cared for by private medical providers and other providers outside HDs (PMPs. We sought to determine whether there were differences in care provided by HDs and PMPs to inform public health planning under the ACA. METHODS: We conducted a retrospective, cross-sectional analysis of California TB registry data. We included adult TB patients with culture-positive, pulmonary TB reported in California during 2007-2011. We examined trends, described case characteristics, and created multivariate models measuring two standards of TB care in PMP- and HD-managed patients: documented culture conversion within 60 days, and use of directly observed therapy (DOT. RESULTS: The proportion of PMP-managed TB patients increased during 2007-2011 (p = 0.002. On univariable analysis (N = 4,606, older age, white, black or Asian/Pacific Islander race, and birth in the United States were significantly associated with PMP care (p<0.05. Younger age, Hispanic ethnicity, homelessness, drug or alcohol use, and cavitary and/or smear-positive TB disease, were associated with HD care. Multivariable analysis showed PMP care was associated with lack of documented culture conversion (adjusted relative risk [aRR] = 1.37, confidence interval [CI] 1.25-1.51 and lack of DOT (aRR = 8.56, CI 6.59-11.1. CONCLUSION: While HDs cared for TB cases with more social and clinical complexities, patients under PMP care were less likely to receive DOT and have documented culture conversion. This indicates a need for close collaboration between PMPs and HDs to ensure that optimal care is provided to all TB patients and TB transmission is

  17. A framework for current public mental health care practice in South Africa.

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    Janse Van Rensburg, A B

    2007-11-01

    One of the main aims of the new Mental Health Care Act, Act No. 17 of 2002 (MHCA) is to promote the human rights of people with mental disabilities in South Africa. However, the upholding of these rights seems to be subject to the availability of resources. Chapter 2 of the MHCA clarifies the responsibility of the State to provide infrastructure and systems. Chapters 5, 6 and 7 of the Act define and regulate the different categories of mental health care users, clarify the procedures around these categories and spell out mental health practitioners' roles and responsibilities in this regard. Also according to the National Health Act No. 61 of 2003, the State remains the key role player in mental health care provision, being responsible for adequate mental health infrastructure and resource allocation. Due to "limited resources" practitioners however often work in environments where staff ratios may be fractional of what should be expected and in units of which the physical structure and security is totally inadequate. The interface between professional responsibility of clinical workers versus the inadequacy of clinical interventions resulting from infrastructure and staffing constraints needs to be defined. This paper considered recent legislation currently relevant to mental health care practice in order to delineate the legal, ethical and labour framework in which public sector mental health practitioners operate as state employees. These included the Mental Health Care Act, No.17 of 2002; the National Health Act, No. 61 of 2003 and the proposed Traditional Health Practitioners Act, No. 35 of 2004. Formal legal review of and advice on this legislation as it pertains to public sector mental health practitioners as state employees, is necessary and should form the basis of the principles and standards for care endorsed by organized mental health care practitioner groups such as the South African Society of Psychiatrists (SASOP).

  18. Patients’ needs for care in public mental health: unity and diversity of self-assessed needs for care

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    Tanja eBellier-Teichmann

    2016-02-01

    Full Text Available Purpose. Needs assessment is recognized to be a key element of mental health care. Patients tend to present heterogeneous profiles of needs. However, there is no consensus in previous research about how patients’ needs are organized. This study investigates both general and specific dimensions of patients’ needs for care. Methods. Patients’ needs were assessed with ELADEB, an 18-domain self-report scale. The use of a self-assessment scale represents a unique way of obtaining patients’ perceptions. A patient-centered psychiatric practice facilitates empowerment as it is based on the patients’ personal motivations, needs and wants. 471 patients’ profiles were analyzed through exploratory factor analysis. Results. A four-factor bi-factor model, including one general factor and three specific factors of needs was most adequate. Specific factors were: (a ‘finances’ and ‘administrative tasks’; (b ‘transports’, ‘public places’, ‘self-care’, ‘housework’ and ‘food’; (c ‘family’, ‘children’, ‘intimate relationships’ and ‘friendship’.Conclusions. As revealed by the general factor, patients expressing urgent needs in some domains are also more susceptible to report urgent needs in several other domains. This general factor relates to high versus low utilizers of public mental healthcare. Patients also present specific needs in life domains, which are organized in three dimensions: management; functional disabilities; familial and interpersonal relationships. These dimensions relate to the different types of existing social support described in the literature.

  19. National Foster Care and Adoption Directory Search

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    Skip to main content U.S. Department of Health & Human Services Administration for Children & ... Menu Home Topics Family-Centered Practice Philosophy and Key Elements of Family-Centered Practice Family- ...

  20. Improved Diagnosis and Care for Rare Diseases through Implementation of Precision Public Health Framework.

    Science.gov (United States)

    Baynam, Gareth; Bowman, Faye; Lister, Karla; Walker, Caroline E; Pachter, Nicholas; Goldblatt, Jack; Boycott, Kym M; Gahl, William A; Kosaki, Kenjiro; Adachi, Takeya; Ishii, Ken; Mahede, Trinity; McKenzie, Fiona; Townshend, Sharron; Slee, Jennie; Kiraly-Borri, Cathy; Vasudevan, Anand; Hawkins, Anne; Broley, Stephanie; Schofield, Lyn; Verhoef, Hedwig; Groza, Tudor; Zankl, Andreas; Robinson, Peter N; Haendel, Melissa; Brudno, Michael; Mattick, John S; Dinger, Marcel E; Roscioli, Tony; Cowley, Mark J; Olry, Annie; Hanauer, Marc; Alkuraya, Fowzan S; Taruscio, Domenica; Posada de la Paz, Manuel; Lochmüller, Hanns; Bushby, Kate; Thompson, Rachel; Hedley, Victoria; Lasko, Paul; Mina, Kym; Beilby, John; Tifft, Cynthia; Davis, Mark; Laing, Nigel G; Julkowska, Daria; Le Cam, Yann; Terry, Sharon F; Kaufmann, Petra; Eerola, Iiro; Norstedt, Irene; Rath, Ana; Suematsu, Makoto; Groft, Stephen C; Austin, Christopher P; Draghia-Akli, Ruxandra; Weeramanthri, Tarun S; Molster, Caron; Dawkins, Hugh J S

    2017-01-01

    Public health relies on technologies to produce and analyse data, as well as effectively develop and implement policies and practices. An example is the public health practice of epidemiology, which relies on computational technology to monitor the health status of populations, identify disadvantaged or at risk population groups and thereby inform health policy and priority setting. Critical to achieving health improvements for the underserved population of people living with rare diseases is early diagnosis and best care. In the rare diseases field, the vast majority of diseases are caused by destructive but previously difficult to identify protein-coding gene mutations. The reduction in cost of genetic testing and advances in the clinical use of genome sequencing, data science and imaging are converging to provide more precise understandings of the 'person-time-place' triad. That is: who is affected (people); when the disease is occurring (time); and where the disease is occurring (place). Consequently we are witnessing a paradigm shift in public health policy and practice towards 'precision public health'.Patient and stakeholder engagement has informed the need for a national public health policy framework for rare diseases. The engagement approach in different countries has produced highly comparable outcomes and objectives. Knowledge and experience sharing across the international rare diseases networks and partnerships has informed the development of the Western Australian Rare Diseases Strategic Framework 2015-2018 (RD Framework) and Australian government health briefings on the need for a National plan.The RD Framework is guiding the translation of genomic and other technologies into the Western Australian health system, leading to greater precision in diagnostic pathways and care, and is an example of how a precision public health framework can improve health outcomes for the rare diseases population.Five vignettes are used to illustrate how policy

  1. Socioeconomic patterns in the use of public and private health services and equity in health care

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    Ortega Paloma

    2008-09-01

    Full Text Available Abstract Background Several studies in wealthy countries suggest that utilization of GP and hospital services, after adjusting for health care need, is equitable or pro-poor, whereas specialist care tends to favour the better off. Horizontal equity in these studies has not been evaluated appropriately, since the use of healthcare services is analysed without distinguishing between public and private services. The purpose of this study is to estimate the relation between socioeconomic position and health services use to determine whether the findings are compatible with the attainment of horizontal equity: equal use of public healthcare services for equal need. Methods Data from a sample of 18,837 Spanish subjects were analysed to calculate the percentage of use of public and private general practitioner (GP, specialist and hospital care according to three indicators of socioeconomic position: educational level, social class and income. The percentage ratio was used to estimate the magnitude of the relation between each measure of socioeconomic position and the use of each health service. Results After adjusting for age, sex and number of chronic diseases, a gradient was observed in the magnitude of the percentage ratio for public GP visits and hospitalisation: persons in the lowest socioeconomic position were 61–88% more likely to visit public GPs and 39–57% more likely to use public hospitalisation than those in the highest socioeconomic position. In general, the percentage ratio did not show significant socioeconomic differences in the use of public sector specialists. The magnitude of the percentage ratio in the use of the three private services also showed a socioeconomic gradient, but in exactly the opposite direction of the gradient observed in the public services. Conclusion These findings show inequity in GP visits and hospitalisations, favouring the lower socioeconomic groups, and equity in the use of the specialist physician. These

  2. Building the national health information infrastructure for personal health, health care services, public health, and research

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    Detmer Don E

    2003-01-01

    Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin

  3. Human rights in patient care and public health-a common ground.

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    Peled-Raz, Maya

    2017-01-01

    Medical law and public health law have both served extensively as instruments of health protection and promotion-yet both are limited in their effect and scope and do not sufficiently cover nor supply a remedy to systematic, rather than anecdotal, mistreatments in the health care system. A possible solution to this deficiency may be found in the human rights in patient care legal approach. The concept of human rights in patient care is a reframing of international human rights law, as well as constitutional thought and tools, into a coherent approach aimed at the protection and furthering of both personal and communal health. It applies human rights discourse and human rights law onto the patient care setting while moving away from the narrow consumeristic view of health care delivery. By applying human rights in patient care approach, both national and international courts may and should serve as policy influencing instruments, protecting the rights of the most vulnerable and prejudiced against groups, which are want of a remedy through traditional patients' rights legal schemes.

  4. Public involvement in research within care homes: benefits and challenges in the APPROACH study.

    Science.gov (United States)

    Froggatt, Katherine; Goodman, Claire; Morbey, Hazel; Davies, Sue L; Masey, Helen; Dickinson, Angela; Martin, Wendy; Victor, Christina

    2016-12-01

    Public involvement in research (PIR) can improve research design and recruitment. Less is known about how PIR enhances the experience of participation and enriches the data collection process. In a study to evaluate how UK care homes and primary health-care services achieve integrated working to promote older people's health, PIR was integrated throughout the research processes. This paper aims to present one way in which PIR has been integrated into the design and delivery of a multisite research study based in care homes. A prospective case study design, with an embedded qualitative evaluation of PIR activity. Data collection was undertaken in six care homes in three sites in England. Six PIR members participated: all had prior personal or work experience in care homes. Qualitative data collection involved discussion groups, and site-specific meetings to review experiences of participation, benefits and challenges, and completion of structured fieldwork notes after each care home visit. PIR members supported recruitment, resident and staff interviews and participated in data interpretation. Benefits of PIR work were resident engagement that minimized distress and made best use of limited research resources. Challenges concerned communication and scheduling. Researcher support for PIR involvement was resource intensive. Clearly defined roles with identified training and support facilitated involvement in different aspects of the data collection process. This can also ensure that vulnerable older people who participate in research have a positive experience that reinforces the value of their views. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  5. Working toward financial sustainability of integrated behavioral health services in a public health care system.

    Science.gov (United States)

    Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

    2012-06-01

    The need, benefit, and desirability of behavioral health integration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains.

  6. Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

    Science.gov (United States)

    Eckelman, Matthew J; Sherman, Jodi

    2016-01-01

    The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%), greenhouse gas emissions (10%), smog formation (10%) criteria air pollutants (9%), stratospheric ozone depletion (1%), and carcinogenic and non-carcinogenic air toxics (1-2%). The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors) and demand side (NHE categories), as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.

  7. Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

    Directory of Open Access Journals (Sweden)

    Matthew J Eckelman

    Full Text Available The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA modeling using National Health Expenditures (NHE for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%, greenhouse gas emissions (10%, smog formation (10% criteria air pollutants (9%, stratospheric ozone depletion (1%, and carcinogenic and non-carcinogenic air toxics (1-2%. The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors and demand side (NHE categories, as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.

  8. Does public transportation improve the accessibility of primary dental care in São Paulo, Brazil?

    Science.gov (United States)

    Yuen, Aidan; Martins Rocha, Carla; Kruger, Estie; Tennant, Marc

    2018-06-01

    Advances in geospatial technologies have recognized the role of geographic distance as a barrier to healthcare accessibility. Frequent transportation is supposed to buffer issues with distance, while infrequent services impede the uptake of care. The role of public transportation on the accessibility of health care-including oral health care-is not well elucidated in the context of megacities, such as the municipality of São Paulo, Brazil. This study aimed to compare the supply of public transportation to primary dental clinics and the population between advantaged and disadvantaged areas in São Paulo city. A total of 4101 primary dental clinics in São Paulo city were identified and geocoded. Geographic coordinates were also retrieved for the 19 242 bus stops, 56 commuter rail stations and 64 rapid transit stations. Clinic locations and transport points were integrated with the city's 19 128 constituent census tracts-each containing sociodemographic data on the 11 252 204 residents-using Geographic Information Systems (GIS). Almost all clinics were located within 0.5 km of public transportation. Half of all clinics were within 0.5 km of high-frequency transport points, and three-quarters were within 1 km. Likewise, 99% of the population resided within 0.5 km of any public transportation. However, only 22% were within 0.5 km of high-frequency options, and half were within 1 km. Those within 0.5 km of high-frequency points had higher average monthly household incomes and lower illiteracy rates, with lower proportions of children and ethnic minorities, and higher proportions of older people. Clinics and populations in sociodemographically disadvantaged tracts have poorer public transportation links in São Paulo city. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. [Affordability and availability of drugs for treatment of chronic diseases in the public health care system].

    Science.gov (United States)

    Helfer, Ana Paula; Camargo, Aline Lins; Tavares, Noemia Urruth Leão; Kanavos, Panos; Bertoldi, Andréa Dâmaso

    2012-03-01

    To assess the affordability by workers of drugs used for treatment of chronic diseases, as well as the availability of the reference, similar, or generic forms of these drugs in the public health care system. We employed the methodology recommended by the World Health Organization (WHO) and Health Action International (HAI) for the standardized collection of information on selling prices in the private sector and availability in the public health care system of drugs in six cities in the state of Rio Grande do Sul, Brazil. Data were collected from November 2008 to January 2009. Affordability was estimated as the number of salary days required for a worker receiving the national minimum wage to buy, in a private pharmacy, the amount of medication required for one month of treatment. Availability was assessed by the presence of these drugs in public health care system facilities. Twenty-two public facilities and 30 private pharmacies were studied. Of 21 drugs used for the treatment of seven chronic disorders, only nine were available free of charge in the six cities. Mean availability ranged from 83.3% (São Leopoldo) to 97.6% (Caxias do Sul). Affordability ranged from 0.4 to 10.5 salary days for reference drugs, 0.2 to 8.4 salary days for similar drugs, and 0.3 to 3.8 salary days for generic drugs. The overall availability of the drugs surveyed was higher than the 80% recommended by WHO. However, some treatments were not available, or had limited availability in the public system. Concerning affordability, the number of salary days required to buy these drugs may affect the continuation of drug treatments for chronic diseases.

  10. A national analysis of dental waiting lists and point-in-time geographic access to subsidised dental care: can geographic access be improved by offering public dental care through private dental clinics?

    Science.gov (United States)

    Dudko, Yevgeni; Kruger, Estie; Tennant, Marc

    2017-01-01

    Australia is one of the least densely populated countries in the world, with a population concentrated on or around coastal areas. Up to 33% of the Australian population are likely to have untreated dental decay, while people with inadequate dentition (fewer than 21 teeth) account for up to 34% of Australian adults. Historically, inadequate access to public dental care has resulted in long waiting lists, received much media coverage and been the subject of a new federal and state initiative. The objective of this research was to gauge the potential for reducing the national dental waiting list through geographical advantage, which could arise from subcontracting the delivery of subsidised dental care to the existing network of private dental clinics across Australia. Eligible population data were collected from the Australian Bureau of Statistics website. Waiting list data from across Australia were collected from publicly available sources and confirmed through direct communication with each individual state or territory dental health body. Quantum geographic information system software was used to map distribution of the eligible population across Australia by statistical area, and to plot locations of government and private dental clinics. Catchment areas of 5 km for metropolitan clinics and 5 km and 50 km for rural clinics were defined. The number of people on the waiting list and those eligible for subsidised dental care covered by each of the catchment areas was calculated. Percentage of the eligible population and those on the waiting list that could benefit from the potential improvement in geographic access was ascertained for metropolitan and rural residents. Fifty three percent of people on the waiting list resided within metropolitan areas. Rural and remote residents made up 47% of the population waiting to receive care. The utilisation of both government and private dental clinics for the delivery of subsidised dental care to the eligible population

  11. Role of pharmacogenetics in public health and clinical health care: a SWOT analysis.

    Science.gov (United States)

    Kapoor, Ritika; Tan-Koi, Wei Chuen; Teo, Yik-Ying

    2016-12-01

    Pharmacogenomics has been lauded as an important innovation in clinical medicine as a result of advances in genomic science. As one of the cornerstones in precision medicine, the vision to determine the right medication in the right dosage for the right treatment with the use of genetic information has not exactly materialised, and few genetic tests have been implemented as the standard of care in health systems worldwide. Here we review the findings from a SWOT analysis to examine the strengths, weaknesses, opportunities and threats around the role of pharmacogenetics in public health and clinical health care, at the micro, meso and macro levels corresponding to the perspectives of the individuals (scientists, patients and physicians), the health-care institutions and the health systems, respectively.

  12. The need to include obstetric nurses in prenatal care visits in the public health system

    Directory of Open Access Journals (Sweden)

    Selma Aparecida Lagrosa Garcia

    2010-06-01

    Full Text Available Objective: To investigate, with a qualitative approach, the role of Obstetric Nurses at the primary level of care given to women’s health as a vital component of the multidisciplinary team, which today is fundamental for providing care, prevention as well as health education and promotion, especially in programs whose activities are geared towards primary care of pregnant, parturient, and puerpera women. Methods: Brazilian laws and the determinations of Nursing Councils in reference to the activities of the obstetric nurse were researched, including the nurse’s responsibilities and limits. The bibliographic search was conducted in health-related journals, lay publications, and the Internet. Results: The conflicts between professional physicians and nurses were discussed. Conclusions: It was concluded that the activities of the nurse, conducting low-risk prenatal clinical visits in the basic healthcare network, has legal and ethical support and provides true benefit to the clients.

  13. Major publications in the critical care pharmacotherapy literature: January-December 2017.

    Science.gov (United States)

    Hammond, Drayton A; Baumgartner, Laura; Cooper, Craig; Donahey, Elisabeth; Harris, Serena A; Mercer, Jessica M; Morris, Mandy; Patel, Mona K; Plewa-Rusiecki, Angela M; Poore, Alia A; Szaniawski, Ryan; Horner, Deanna

    2018-06-01

    To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2017. The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 32 journals monthly for impactful articles and reviewed 115 during 2017. Two meta-analyses and eight original research trials were reviewed here from those included in the monthly CCPLU. Meta-analyses on early, goal-directed therapy for septic shock and statin therapy for acute respiratory distress syndrome were summarized. Original research trials that were included evaluate thrombolytic therapy in severe stroke, hyperoxia and hypertonic saline in septic shock, intraoperative ketamine for prevention of post-operative delirium, intravenous ketorolac dosing regimens for acute pain, angiotensin II for vasodilatory shock, dabigatran reversal with idarucizumab, bivalirudin versus heparin monotherapy for myocardial infarction, and balanced crystalloids versus saline fluid resuscitation. This clinical review provides perspectives on impactful critical care pharmacotherapy publications in 2017. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Physical activity counseling in primary care: Insights from public health and behavioral economics.

    Science.gov (United States)

    Shuval, Kerem; Leonard, Tammy; Drope, Jeffrey; Katz, David L; Patel, Alpa V; Maitin-Shepard, Melissa; Amir, On; Grinstein, Amir

    2017-05-06

    Physical inactivity has reached epidemic proportions in modern society. Abundant evidence points to a causal link between physical inactivity and increased risk for numerous noncommunicable diseases, such as some types of cancer and heart disease, as well as premature mortality. Yet, despite this overwhelming evidence, many individuals do not meet the recommended amount of physical activity required to achieve maximum health benefits. Because primary care physicians' advice is highly regarded, clinicians have the unique opportunity to play an important role in enabling patients to modify their behavior at the point of care with the goal of guiding patients to adopt and maintain an active lifestyle. In the current study, the authors evaluate pertinent literature from the fields of medicine/public health and economics/psychology to suggest a comprehensive approach to physical activity counseling at the primary care level. They first examine the public health approach to physical activity counseling, and then proceed to offer insights from behavioral economics, an emerging field that combines principles from psychology and economics. The application of key behavioral economics tools (eg, precommitment contracts, framing) to physical activity counseling in primary care is elaborated. CA Cancer J Clin 2017;67:233-244. © 2017 American Cancer Society. © 2017 American Cancer Society.

  15. Public Health Investment in Team Care: Increasing Access to Clinical Preventive Services in Los Angeles County

    Directory of Open Access Journals (Sweden)

    Tony Kuo

    2018-02-01

    Full Text Available As part of federal and local efforts to increase access to high quality, clinical preventive services (CPS in underserved populations, the Los Angeles County Department of Public Health (DPH partnered with six local health system and community organization partners to promote the use of team care for CPS delivery. Although these partners were at different stages of organizational capacity, post-program review suggests that each organization advanced team care in their clinical or community environments, potentially affecting >250,000 client visits per year. Despite existing infrastructure and DPH’s funding support of CPS integration, partner efforts faced several challenges. They included lack of sustainable funding for prevention services; limited access to community resources that support disease prevention; and difficulties in changing health-care provider behavior. Although team care can serve as a catalyst or vehicle for delivering CPS, downstream sustainability of this model of practice requires further state and national policy changes that prioritize prevention. Public health is well positioned to facilitate these policy discussions and to assist health system and community organizations in strengthening CPS integration.

  16. Advancing the business creed? The framing of decisions about public sector managed care.

    Science.gov (United States)

    Waitzkin, Howard; Yager, Joel; Santos, Richard

    2012-01-01

    Relatively little research has clarified how executives of for-profit healthcare organisations frame their own motivations and behaviour, or how government officials frame their interactions with executives. Because managed care has provided an organisational structure for health services in many countries, we focused our study on executives and government officials who were administering public sector managed care services. Emphasising theoretically the economic versus non-economic motivations that guide economic behaviour, we extended a long-term research project on public sector Medicaid managed care (MMC) in the United States. Our method involved in-depth, structured interviews with chief executive officers of managed care organisations, as well as high-ranking officials of state government. Data analysis involved iterative interpretation of interview data. We found that the rate of profit, which proved relatively low in the MMC programme, occupied a limited place in executives' self-described motivations and in state officials' descriptions of corporation-government interactions. Non-economic motivations included a strong orientation toward corporate social responsibility and a creed in which market processes advanced human wellbeing. Such patterns contradict some of the given wisdom about how corporate executives and government officials construct their reality. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  17. Collaboration across private and public sector primary health care services: benefits, costs and policy implications.

    Science.gov (United States)

    McDonald, Julie; Powell Davies, Gawaine; Jayasuriya, Rohan; Fort Harris, Mark

    2011-07-01

    Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations.

  18. How the biological children of foster parents accept their new foster siblings and fostering of their parents

    OpenAIRE

    Dvořáková, Kristýna

    2015-01-01

    The bachelor thesis discusses how the biological children of foster parents accept their new foster siblings and fostering of their parents from the view of the foster parents. The aim of this work is to find out if and how the biological children accept their new foster siblings, what are their relationships like, what are the problematic aspects of these relationships and how to prevent them.

  19. Mothers’ expectations of midwives’ care during labour in a public hospital in Gauteng

    Directory of Open Access Journals (Sweden)

    Malmsey Sengane

    2013-08-01

    Full Text Available Background: Mothers develop expectations regarding midwives’ care during labour and when these are not met mothers become dissatisfied and eventually have negative experiences of their labour. It is only when mothers’ voices are heard by midwives in the labour ward that efficient and quality care will be provided. To ensure mothers have a positive experience of labour, midwives should include mothers’ expectations when caring for them.Objective: The purpose of the study on which this article is based was to determine mothers’ expectations of midwives’ care during labour. To achieve this purpose the researcher sought to explore and describe mothers’ expectations of midwives’ care during labour in a specific public hospital in Gauteng.Method: A qualitative, exploratory, descriptive and contextual study design was used. Face-to-face, in-depth individual interviews were conducted with mothers about their expectations of midwives’ care during labour. Data were then analysed with an open descriptive method of coding (Tesch’s eight steps that is appropriate for qualitative research to identify categories. The data was also analysed by an independent coder. The categories were subsequently placed within a holistic health promotive nursing theory that encompasses body, mind and spirit.Results: The findings revealed the provision of comfort and support as the two main aspects that the mothers expected from the midwives’ care. The mothers expected midwives to improve their communication skills with them (mothers as well as with fathers or partners if they were available. The mothers expected midwives to facilitate bonding between mother, father and baby, and also encouraged the midwives to improve their (midwives’ knowledge, skills and morale. Conclusion: The results of this study should assist midwives in providing holistic quality care to mothers during labour, thus providing satisfaction and positive experiences of the mothers

  20. [The national public discourse on priority setting in health care in German print media].

    Science.gov (United States)

    Liesching, Florian; Meyer, Thorsten; Raspe, Heiner

    2012-01-01

    Germany's Central Ethics Committee of the Federal Chamber of Physicians (FCP) and other relevant national actors called for a public discourse on priority setting in health care. Politicians, members of a Federal Joint Committee and health insurance representatives, however, refused to promote or participate in the establishment of a public discussion. A change to that attitude only became apparent after former FCP President Hoppe's opening speech at the annual FCP assembly in Mainz in 2009. The present paper applies the Sociology of Knowledge Approach to Discourse, implemented through Qualitative Content Analysis and elements of Grounded Theory, to examine the development of the national public discourse in leading German print media. It creates a matrix that represents the discourse development between May 2009 and May 2010 and reflects central actors, their "communicative phenomena" and their interactions. Additionally, the matrix has been extended to cover the period until December 2011. Hoppe's arguments for priority setting in health care are faced with a wide opposition assuming opposing prerequisites and thus demanding alternative remedies. The lack of interaction between the different parties prevents any development of the speakers' positions. Incorrect accounts, reductions and left-outs in the media representation add to this effect. Consequently, the public discussion on priority setting is far from being an evolving rational discourse. Instead, it constitutes an exchange of preformed opposing positions. Copyright © 2012. Published by Elsevier GmbH.