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1
Stewart, Rebecca. "Children adopted from care : teacher constructions of need and support." Thesis, Cardiff University, 2017. http://orca.cf.ac.uk/105025/.
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Evidence of the impact of Adverse Childhood Experiences (ACEs) and attachment theory (Bowlby, 1969) suggest that children who have been adopted from care are at higher risk of difficulties that may impact their ability to access education. In the UK, despite recent improvements, much of the support available to Looked After Children (LAC) is no longer available once children have been adopted. This research therefore sought to investigate teachers� perceptions on whether adopted children have difficulty accessing education, their understanding of the possible impact of ACEs and whether comparisons are made between adopted and LAC. Support systems for adopted children were also explored. Data was gathered in England and Wales through nine interviews with primary school teachers of adopted children and a questionnaire completed by 84 teachers. Descriptive statistics and a thematic analysis of the data revealed that many of the adopted children experienced some difficulties that impacted on their ability to access education to varying extents. Some received in-school support, however, few teachers accessed support from outside agencies. Training for teachers was limited and barriers to training are outlined. Teachers� perceptions on the need for support systems varied, as did their constructions of their role in support.
2
Harris, Rita. "Professionals' beliefs about contact between children in alternative care and their birth parents." Thesis, n.p, 1999. http://ethos.bl.uk/.
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Roberts, Michelle Eileen. "Post adoption contact with birth parents in foster care adoptions /." View online, 2009. http://repository.eiu.edu/theses/docs/32211131592056.pdf.
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Braun, Shawnee Dove. "Gay fathers with children adopted from foster care understanding their experiences and predicting adoption outcomes /." Diss., Restricted to subscribing institutions, 2006. http://proquest.umi.com/pqdweb?did=1280150331&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Wretham, Alexandra. "Do children adopted from British Foster Care show difficulties in executive functioning and social communication?" Thesis, King's College London (University of London), 2015. https://kclpure.kcl.ac.uk/portal/en/theses/do-children-adopted-from-british-foster-care-show-difficulties-in-executive-functioning-and-social-communication(06a1b50e-98fc-4ed9-91f8-689bdcab693b).html.
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Background: Early life stress and maltreatment has been observed to impact on cognitive development. Executive functioning (EF) processes begin to develop from early infancy and there is emerging evidence that early life maltreatment might influence their development. Children who have been removed from the family home and are in care or adopted are particularly likely to have experienced maltreatment and early life disruption. Objectives: This systematic review aimed to extract and synthesis data relating to whether looked after (LAC), adopted and post-institutionalised (PI) children show deficits on tests of EF. A secondary aim was to compare across these sub-groups and identify similarities or differences in EF abilities. Methods: A systematic search of three electronic databases was completed: Ovid, Web of Knowledge and the Cochrane library. Of the 895 records that were screened, 30 studies were identified to meet the selection criteria and included in this review. Results: The majority of studies examined EF in PI children (n = 24). In this population parental reported EF difficulties were consistently observed and associated with duration of institutionalisation. Poorer performance was also observed on several laboratory tasks of EF. LAC and adopted studies eluded to potential EF problems, however comparisons were difficult due to the limited number of studies and range of tasks used. Comparisons across populations were not possible due to the use of differing tasks and small number of identified studies. Conclusion: This review provides evidence for the impact of environmental and social factors on EF development. It suggests that PI children may be more likely to exhibit EF difficulties, particularly if they are removed from institutions at older ages. Furthermore the current evidence for LAC and adopted children, taken alongside the known impact of childhood maltreatment, suggests that these populations may be at higher risk for exhibiting EF difficulties.
6
Memarnia, Nina. "Listening to the experience of birth mothers whose children have been taken into care or adopted." Thesis, University of Hertfordshire, 2014. http://hdl.handle.net/2299/14555.
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The literature consistently reports a lack of support for birth mothers following their child being taken into care or adopted (Logan, 1996; Schofield, 2009; Schofield, 2010). This is despite consistent evidence of the long-term consequences that the removal of children has upon their mental health (Condon, 1986; Wells, 1993; Logan, 1996). O’Leary-Wiley & Baden (2005) write, ‘Birth parents are the least studied, understood, and served members of the adoption triad.’ The aim of the study was to explore: the experience of separation, sense of identity following separation, experience of contact and experience of support through the process. Semi-structured interviews were conducted with seven mothers who were recruited from birth mother support groups. The transcripts of the interviews were analysed using Interpretative Phenomenological Analysis (IPA). Four main themes emerged across the participants’ accounts: ‘No one in my corner’, ‘Disconnecting from emotion’, ‘Renegotiating identity’ and ‘The children are gone, but still here’. The findings contribute to our understanding of the experiences of birth mothers and are discussed within a range of psychological theories. Implications for clinical psychology are considered.
7
Sallot, Coleen Michelle. "Utilizing Play to Help Adopted Children Form Healthy Attachments." Miami University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=miami1619193153362829.
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Paczkowski, Emilie Ann. "Long-term adjustment of parents adopting from foster care the influence of parent and child factors on perceived positive and negative family impact /." Diss., Restricted to subscribing institutions, 2009. http://proquest.umi.com/pqdweb?did=1930279301&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Clifton, John. "The perspectives and experiences of birth fathers of children adopted from care in relation to their children's adoption." Thesis, University of East Anglia, 2012. https://ueaeprints.uea.ac.uk/38812/.
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Nielsen, Kate Marie. "Children's attachment trajectories after the transition to adoptive placement a longitudinal study of children with prenatal substance exposure adopted from foster care /." Diss., Restricted to subscribing institutions, 2007. http://proquest.umi.com/pqdweb?did=1472128201&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Manaseri, Holly M. "Complex care perspectives from mothers of children with medical needs /." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2009. http://wwwlib.umi.com/cr/syr/main.
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Rasnake, L. Kaye. "Anxiety reduction with children receiving medical care : cognitive developmental considerations /." The Ohio State University, 1987. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487325740719711.
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Jimenez-Etcheverria, Pamela. "A comparison of psychological adjustment and cognitive functioning between adopted and institution-reared children in Chile." Thesis, University of Cambridge, 2018. https://www.repository.cam.ac.uk/handle/1810/277429.
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Many studies have shown that adopted children show higher levels of psychological adjustment than children living in institutions. However, there is little research comparing the behaviour and cognitive abilities of adopted and institution-reared children in Latin America, despite the large number of children living in institutional care. The aim of this thesis was to examine differences in the socio-emotional and cognitive functioning of adopted and institution-reared children in Chile, and to identify factors associated with the psychological adjustment and cognitive ability of adopted children. Data were obtained from 52 adopted children and their parents, and a comparison group of 50 children living in institutions. All adoptions were national and the children were aged between 4-9 years. Children’s psychological problems and attachment difficulties were assessed using the Strengths and Difficulties Questionnaire and the Relationship Problems Questionnaire, respectively, completed by adoptive parents or caregivers and teachers. Cognitive functioning was assessed using the Wechsler Intelligence Scale for Children-Third Edition (WISC-III). The Structured Child Assessment of Relationships in Families was used to assess children’s perceptions of family relationships. Adoptive mothers and fathers were individually administered a standardised interview designed to assess parenting quality and questionnaire assessments of anxiety, depression, marital quality and parenting stress. Observational assessments of mother-child interaction were also carried out. Adopted children showed significantly higher levels of socio-emotional and cognitive functioning than institution-reared children, with the majority of adopted children scoring within the normal range and the majority of institutionalised children showed clinical levels of emotional and behavioural problems. The mean IQ score of adopted children was 23 points higher than that of the institutionalised group. Factors associated with more positive outcomes among the adopted children were a younger age at adoption and lower levels of maternal and paternal stress. Although a selection effect cannot be ruled out, with higher functioning children more likely to be adopted, the results point to a beneficial effect of adoption on the psychological development and wellbeing of institutionalised children in Chile.
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Lei, Xiaoyan. "Public and private transfers essays on transfers to children and parents /." Diss., Restricted to subscribing institutions, 2007. http://proquest.umi.com/pqdweb?did=1467890571&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Colm, Matilda, and Lina Eriksson. "Adoptivbarn och BVC : Adoptivbarns kontakter med BVC i Uppsala län." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-267110.
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Att adoptera och att bli adopterad kan vara en påfrestande livserfarenhet så stöd och hjälp frånbarnhälsovården, socialtjänsten, sjukvården och barnpsykiatrin kan bli nödvändig. Föreliggandestudie är en registerstudie och omfattar 50 221 barn, varav 440 adopterade, som är födda mellan1994-2007 och folkbokförda i Uppsala län. Syftet med studien är att undersöka om det finnsnågra skillnader i kontakten med BVC för adoptivbarn jämfört med biologiska barn vad gällerantal mottagningsbesök, antal hembesök, MPR vaccinationer, skickade remisser till barnläkare,psykolog, ortoptist, audiolog och logoped samt om barnen genomfört syn-, hörsel ochspråkscreening och utfallet på dessa screeningar. Logistiska- och linjära regressionsanlysergjordes och en del korrigerades för ålder. Adoptivbarnen fick både färre hembesök och färremottagningsbesök. Det var också lägre andel adoptivbarn som blev vaccinerade mot MPR. Vadgäller remisser skickades för adoptivbarnen högre andel remisser till BHV-psykolog, ortoptistoch till logoped. De biologiska barnen genomförde synscreening i högre grad. Adoptivbarnenfick i högre grad utfall på syn- och hörselscreening. Adoptivbarnen får i lägre utsträckning änbiologiska barn ta del av viktiga komponenter i svensk barnhälsovård vilket kan leda till sämrehälsa för gruppen på lång sikt. Vården behöver bli mer jämlik för adoptivbarnen och för attkomma till insikt om varför dessa skillnader finns behövs fler studier på området.<br>To adopt and to be adopted can be a distressing experience of life, and support from child healthcare, social services, health care and child psychiatry may be necessary. This study is aregister study and covers 50,221 children, of which 440 are adopted, born between 1994-2007 and registered in Uppsala län. The purpose of the study is to investigate if there areany differences in the contact with child health care for adopted children compared withbiological children as regards to the number of clinic visits, number of home visits, children whoare vaccinated with MMR, referrals to pediatricians, psychologists, orthoptist and speechtherapist and if the children perform the visual-, auditory-, and language screening and theoutcome of these screenings. Logistic- and linear regression analyzes were made and some werecorrected for age. The adoptees had both significantly fewer home visits and office visits than thebiological children. There were also a lower proportion of adopted children who were vaccinatedagainst MMR. The adopted children had significantly more referrals sent to the BHVpsychologist,the orthoptist and the speech therapist. Adopted children take a lesser part inimportant childcare components than biological children. This could lead to a worse health forthis group in the long term. The healthcare need to be more equal amongst children, and to getcloser to the cause of these differences more studies is needed.
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Marti-Morales, Madeline. "Care coordination, family-centered care and functional ability in children with special health care needs in the United States." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/870.
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Children with special health care needs (CSHCN) generally have physical, mental, or emotional conditions that require a broader range and greater quantity of health and related services compared to typical children. Care coordination (CC) and family-centered care (FCC) are necessary in the quality of health care for CSHCN. A gap exists in the literature regarding the impact of CC and FCC on children's functional ability (FA). Previous researchers have focused on met and unmet health care needs, but not on health outcomes or functionality. The purpose of this study was to determine if there was an association between CC, FCC, and FA in CSHCN. The design of this study was a secondary analysis of data from the 2005--2006 National Survey of CSHCN. The study was guided by an adapted socioecological multilevel conceptual framework. Statistical methods included univariate, bivariate, and multiple logistic regression analysis. Results indicated that CC was associated with FA in CSHCN. CSHCN that did not receive CC had a 53% increased risk (OR =1.53, 95%CI 1.21--1.94, p < 0.001) for a limitation in FA compared to CSHCN that received CC, controlling for age, gender, number of conditions, household poverty level, parental educational level, and health insurance. FCC was not associated with a limitation in FA in CSHCN ( p = 0.61). Findings from this study were consistent with the socioecological multilevel framework and the literature on care coordination. This study contributed to positive social change by providing information that can be used by public health officials, health care providers and policy makers in developing policies to assure that care coordination is provided to CSHCN and their families in order to improve their health outcomes and functionality.
17
Teng, Yu-wai Alice. "Children health center." Hong Kong : University of Hong Kong, 1996. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25948568.
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Woodman, Kimberly K. Creasey Gary L. "An examination of the nature of attachment, identity, and adjustment in adolescents adopted from the child welfare system." Normal, Ill. : Illinois State University, 2005. http://proquest.umi.com/pqdweb?index=0&did=1221659101&SrchMode=1&sid=1&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1177270146&clientId=43838.
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Thesis (Ph. D.)--Illinois State University, 2005.<br>Title from title page screen, viewed on April 22, 2007. Dissertation Committee: Gary L. Creasey (chair), Jeanne A. Howard, Susan L. Smith, Adena B. Meyers, Alvin E. House. Includes bibliographical references (leaves 141-154) and abstract. Also available in print.
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Chung, Yuk-lan Ida. "A systematic review on integrated care pathway for children who need surgical intervention /." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36396886.
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Rein, David Bruce. "Modeling the health care utilization of children in Medicaid." Diss., Available online, Georgia Institute of Technology, 2004:, 2003. http://etd.gatech.edu/theses/available/etd-06072004-131339/unrestricted/rein%5Fdavid%5Fb%5F200405%5Fphd.pdf.
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Long, Webb E. "The value of the medical home for children without special health care needs." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12490.
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Thesis (M.S.)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.<br>Objective: Although the medical home is promoted for all children by the AAP and the Affordable Care Act, its impact on the majority of the pediatric population - children without special health care needs- is unknown. We examined whether the medical home is associated with beneficial health care utilization and health promoting behaviors in this population, and whether the effect of the medical home is influenced by cumulative social risk.
Methods: This was a secondary data analysis of the 2003 National Survey of Children's Health (NSCH). Data were available for 102,353 children, 82% of whom did not have special health care needs. We operationalized the medical home per the NSCH design. Logistic regression for complex sample surveys was used to model each outcome with the medical home, controlling for sociodemographics.
Results: Overall, a slight minority of children had a medical home, including 46.6% of those without special health care needs. Among those children, the medical home was significantly associated with decreased emergency department (aOR 0.73, 95% Cl 0.67- 0.79) and PCP sick-visits (aOR 0.85, 95% Cl 0.79-0.91), and with increased preventive care visits (aOR 1.59, 95% Cl 1.48-1.72). It was also associated with anticipatory guidance outcomes such as being read to (aOR 1.28, 95% Cl 1.03-1.58), helmet use (aOR 1.27, 95% Cl1.12-1.44), and decreased screen time (aOR 1.12, 95% Cl1.03- 1.21 ). There was no consistent trend in association between the medical home and the various outcomes across social risk strata.
Conclusions: For children without special health care needs, the medical home is associated with beneficial health and anticipatory guidance outcomes. These findings support the AAP and Affordable Care Act recommendations to extend the medical home to all children.
22
Chia, Jean. "How Often Do Care Plans Address Patient/Family-Stated Goals for Children with Medical Complexity?" University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1563876729636912.
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Ma, Hoi-ling Helen, and 馬海菱. "Appropriateness and feasibility of medical preparatory play in preparing children for anaesthetic procedure." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44626022.
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Chung, Yuk-lan Ida, and 鍾玉蘭. "A systematic review on integrated care pathway for children who need surgical intervention." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45011758.
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Silverstein, Jason Bryan. "Without Power, Without Glory: Palliative Care for Children the Nation’s Best Hospital Couldn’t Cure." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:33493557.
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Based on ethnographic fieldwork and drawing on anthropological, clinical, and social science literature, Without Power, Without Glory examines the work of a palliative care team of physicians, social workers, and nurses who cared for children and families who faced catastrophe and could not be cured in an institution whose professional identity, metrics for success, and global advertising campaigns are centered on cure.
This dissertation details the social construction of pediatric palliative care, which is often wrongly seen as both synonymous with hospice and clouded by the team’s close relationships with patients and families. Since the palliative care team often follows patients for many years, it also captures the way that children age out of innocence and into suspicion, especially with regards to pain medication for chronic illnesses. As a consult service that operates at a financial loss for the hospital, this dissertation reports on the palliative care team’s struggle to advocate for patients and families in the face of bureaucratic indifference. Though the hospital aggressively recruits children with complex illnesses for financial gain, it documents how comfort is pitted against technical care, which means the palliative care team and especially chaplaincy services are often excluded or not even hired. Finally, Without Power, Without Glory explores truth and lie in the disclosure of prognosis to families and shows how the responsibility to foresee is often diffused from the medical team onto children who are said to speak through tests.<br>Anthropology
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Paukert, Judy Lynn. "Faculty use of teaching strategies in ambulatory pediatric primary care settings /." Digital version accessible at:, 1999. http://wwwlib.umi.com/cr/utexas/main.
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Amoah, Abigail. "Factors contributing to primary care givers' delay in presenting children with chronic kidney disease for medical care in Ghana." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/24979.
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Chronic kidney disease (CKD) in children has become a public health problem in Ghana. The researcher observed that the primary care givers of these children present them late for medical care. This ignited the researcher to conduct this study to identify factors that contribute to primary care givers' delay in seeking early medical care for children with CKD. The purpose of the study was to explore and describe the factors that contribute to primary care givers' delay in presenting children who suffer from CKD for medical care in Ghana. A descriptive qualitative design was used to answer the research question: What factors contribute to primary care givers' delay in presenting children with CKD for medical care in Ghana? Convenience sampling was used to recruit ten primary care givers of children admitted for CKD at the Paediatric Renal Unit of Komfo Anokye Teaching Hospital in Kumasi, Ghana, to participate in the study. Semi-structured interviews and field notes were used to collect data. The thematic data analysis approach of Colaizzi (1978) was used, and the ecological model of Schneider (2017) assisted in organising themes and subthemes. The themes which emerged are: intrapersonal-related factors contributing to delay; interpersonal-related factors contributing to delay; community-related factors contributing to delay; and political-related factors contributing to delay. These were directly related to the research question. A fifth theme which emerged serendipitously is the perceived need for community awareness about CKD. The findings revealed that intrapersonal, interpersonal, community and political level factors influence primary care givers' decisions in seeking medical care for their children. At intrapersonal level factors that played a role were personal attitudes and beliefs; primary care givers' beliefs in traditional medicine as a cure for CKD; their lack of knowledge on CKD and its management; primary care givers' financial constraints; and their beliefs in ancestral spiritual powers for healing. At interpersonal level factors included primary care givers' lack of family support and marital conflicts. At community level factors included primary care givers' delayed referral from the local health facility; incorrect advice received from family and neighbours on management; mismanagement of the disease at the local health facility; and misdiagnosis by neighbours. At political level the distance of the primary care givers' homes from the hospital can contribute to delays. One of the recommendations of the study is development and implementation of a national referral policy for CKD patients to guide health practitioners at the districts. Early referral for appropriate treatment of children with CKD can slow progression of the disease and prevent early mortality. Awareness campaigns need to be developed and implemented by the Ghana Kidney Association to provide health educational programmes for health professionals and communities. Further research using a larger sample or quantitative research methods is also recommended, to gain a better understanding of the factors contributing to delays in presentation of children with CKD in Ghana.
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Cline, Virginia Depp. "POST-TRAUMATIC STRESS DISORDER (PTSD) IN CHILDREN FOLLOWING ACUTE INJURIES REQUIRING EMERGENCY MEDICAL CARE." UKnowledge, 2007. http://uknowledge.uky.edu/gradschool_diss/481.
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Unfortunately, one rite of passage of childhood is often serious injury that carries psychological impact along with the obvious physical repercussions. Prior studies have found conflicting results for protective/risk factors, thus this study attempted to explore PTSD in a sample of children ages seven to thirteen years of age with moderate to severe injuries. In this study (N = 32), 31.3% of children experiencing such a sudden injury requiring hospitalization at the University of Kentucky Childrens Hospital demonstrated significant indications of post-traumatic stress disorder (PTSD) following the injury. Several pre, peri, and post-trauma variables from during the childs hospitalization to the follow-up period four to five weeks later were correlated with this outcome including age, ethnicity, acute stress disorder (ASD) with or without dissociation criteria being met, prior medical experience, parents score on the BSI-18 while the child is still in this hospital, chronic illness status, gender, number of coping strategies reported by the child while in the hospital, the number of negative coping strategies reported, the amount of pain reported, and several follow-up variables (parents BSI-18 score, number of coping strategies reported, number of negative and positive coping strategies reported, injury threat, and total number of impairments reported by the child and by the parent). Negative coping did not significantly change from the in-hospital period to the follow-up period. Surprisingly, the STEPP, a current screener described and supported by some past research, was not successful in identifying these at-risk children; however, a new screening prototype was developed including age, acute stress disorder (ASD), and pain that did successfully predict 80% of those with PTSD and 85% of those without later PTSD. A follow-up screener consisting solely of parental items (parental symptoms on the BSI-18 and parental rating of child impairments) was also created and found to sensitively predict 90% of those children with PTSD. Implications from these findings along with study strengths and weaknesses were highlighted.
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Spradling, Rebecca Lynne Allen. "Development and coordination of a health care services program for foster children in a shelter care population." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2096.
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The purpose of this project is to support health promotion of children entering foster care, ensure that children receive all health care services needed, prevent the trauma of duplication of immunizations, and reduce disruption of health care as children move through the foster care system.
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Mitchell, Barbara E. "Physical health of maltreated children shortly after entry into foster care : assessment and prediction of documented medical problems and caregiver reported health status /." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2002. http://wwwlib.umi.com/cr/ucsd/fullcit?p3044789.
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Seligman, Laura D. "The Effects Of Anxiety and Depression on Children's Utilization of Medical Health Care Services." Thesis, Virginia Tech, 1996. http://hdl.handle.net/10919/36820.
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The current study was designed to examine the relationship between childhood anxiety and depression and
children's rate of medical care utilization. Additionally, the model examined
considered family and parental factors (family conflict, parental anxiety,
parental depression, and parental somatization) as well as children's level of
negative affectivity and demographic variables (ageand sex). A hierarchical
regression analysis was used to examine the effects of each of these variables
on rate of physician utilization and to control for the effects of demographic
factors, parent/family variables and negative affectivity while examining
childhood anxiety and depression. Results revealed that parental anxiety and
depression and family conflict contribute significantly to the explanation of
children's health care utilization. Additionally, child anxiety also explained
number of physician visits but only when considered in the absence of child depression.<br>Master of Science
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Dewan, Tammie Joanne. "Characterizing the experience of accessing medical care for children with rare and undiagnosed complex conditions." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/61241.
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There is increasing awareness of rare disease as a distinct entity. Advances in diagnostic testing have identified over 7000 individual rare diseases affecting millions of patients worldwide, many of them children due to the frequent genetic etiology of these conditions. A medical system that is often based on disease-specific expertise and treatment must adapt to meet the needs of those with rare conditions. However, there is little known about the unique experiences of parents of children with very rare or undiagnosed diseases in accessing medical care. An in-depth look into their circumstances will identify areas for improvement and improve the family experience of care.
The objectives of this study were to analyze this parent experience particularly regarding their relationships and communication with physicians. In addition, the parent perspectives regarding the connections between themselves and health care providers, as well as between health care providers, will be explored. Participants were recruited through the TIDE-BC (Treatable Intellectual Disability Endeavor of British Columbia) Complex Diagnostic Clinic, as parents of children with: (1) “Complex intellectual disability,” defined as undiagnosed intellectual disability with other prominent features; and (2) Ongoing care from at least three health professionals. Semi-structured interviews with parents explored a number of topics including: their experience of their child’s illness and its impact on the family, accessing necessary medical care for their child, developing their own expertise and relating to physicians. Interviews were transcribed and analyzed using discourse analysis methodology.
Themes identified included the pervasive and multi-faceted nature of uncertainty and its contribution to changes in roles for parents, physicians and peers. A key gap identified was a lack of coordination of care and lost opportunity for collaboration amongst professionals and with the family. Addressing these unique experiences and moving towards non-categorical design of health care service models will better serve the needs of children with rare and undiagnosed conditions.<br>Medicine, Faculty of<br>Experimental Medicine, Division of<br>Medicine, Department of<br>Graduate
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McDonald, Kate. "Transitions to Adulthood for Children with Special Health Care Needs." Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/202697.
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Background: Every year in the United States approximately half a million youth with special health care needs (SHCN) turn 18. Little is known about how this population fares during the transition to adulthood. Purpose: To examine transitions to adulthood for young adults with SHCN. Methods: Using data from two national longitudinal surveys: the Panel Study of Income Dynamics and the Survey of Adult Transitions and Health, I built linear and logistic regression models to evaluate the relationship between having a history of SHCN during childhood and key transitional outcomes during young adulthood (e.g., mental health status, educational attainment, employment, financial independence and subjective indicators of adulthood). A second set of logistic models examined associations between hypothesized risk and protective factors during childhood (e.g. family financial burden, care in a medical home and access to adequate insurance) and physical health outcomes during young adulthood for youth with SHCN. Multivariate models were adjusted for key confounders. Results: The majority of youth with a history of SHCN were doing well during the transition to adulthood. That said, compared to young adults without a history of SHCN, young adults with a history of SHCN were in significantly worse mental health (adjusted OR of experiencing a non-specific psychological disorder 3.90, 95% CI 1.78-8.53) and had significantly lower odds of graduating from high school (adjusted OR 0.55, 95% CI 0.32-0.96), attending college (adjusted OR 0.61, 95% CI 0.38-0.96), and receiving financial assistance from their families (adjusted OR 0.56, 95% CI 0.38-0.83). Amongst young adults with a history of SHCN, family financial burden during childhood significantly decreased the odds of being in good physical health during the transition to adulthood. There was limited evidence that receipt of care in a medical home or access to adequate insurance during childhood increased the odds of being in good physical health for young adults with a history of SHCN. Conclusions: These findings have important policy implications for programs serving youth with SHCN. Specifically, mental health and educational services may need to be expanded and more emphasis placed on addressing the non-medical determinants of health, like family financial burden.
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Tatterton, Michael J. "Non-medical prescribing and advanced practice in children's hospices." Together for Short Lives, 2020. http://hdl.handle.net/10454/18256.
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No<br>In recent years, as the prevalence of prescribers has increased, there has been discord and confusion around exactly how to refer to prescribers who are not doctors (Nuttall and Rutt-Howard, 2020). Professional regulators continue to define prescribers by specific profession, using terms such as ‘nurse prescriber’ (Nursing and Midwifery Council, 2018a), ‘pharmacist prescriber’ (General Pharmaceutical Society, 2018) and ‘allied health professional prescriber’ (Health and Care Professions Council, 2016). However, there is a broader range of literature using the collective term of ‘non-medical prescribers’ (All Wales Medicines Strategy Group, 2017; Department of Health Northern Ireland, 2020; NHS England, 2020; Scottish Government, 2020), highlighting the multidisciplinary nature of contemporary prescribing practices across the UK, and the shared responsibility of prescribers for assuring safe and effective practice. Within this chapter, we refer to prescribers collectively, as non-medical prescribers.
Although this chapter has been written with the four countries of the UK in mind, it is important that you consider any country-specific, and profession-specific guidelines.
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Chouteau, Wendy A. "Use of a Portable Medical Summary to Provide Continuity across Systems of Care as Youth with Medical Complexity Transition to Adult Care." Xavier University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1524321320625958.
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Pirtle, Jody Marie. "Collaboration Among Families, Educators, and Medical Professionals to Create a Rural Medical Home for Children with Special Health Care Needs and Disabilities." Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/283632.
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Families of children with special health care needs (CSHCN) and disabilities who lived in rural communities faced a variety of economic, social, and environmental challenges. Bronfenbrenner (1979, 2005) in his Bioecological Theory of Human Development offered an insightful lens for understanding the nested environments in which these families interact. This model was used as the overarching framework for this dissertation. The three manuscripts contained in this dissertation have included analyses of the involvement and participation of families of CSHCN and disabilities in the creation of a medical home located in a rural southwestern border community. These studies were critical for the medical home professionals - family involvement was at the core of the medical home philosophy. The overarching purpose of this dissertation was to set the foundation for successful family participation and feedback in the medical home. Within the first manuscript, I used the Medical Home Family Index to discover families’ (a) perceptions of interactions with medical professionals and (b) ratings of the quality of care within the medical home. Families of CSHCN (N = 92) completed the Medical Home Family Index and descriptive statistics as well as Chi-Square analyses were completed. Significant associations between families’ home languages and the amount of time the CSHCN had been receiving services at the medical home and the families’ responses were found. No associations between the children’s ages and the families’ responses were found. Recommendations for medical home professionals to complete the partner index, the Medical Home Index, were included. The purpose of the second manuscript was to examine the support needs of families of CSHCN and disabilities. Relationships between the severity of the children’s special health care needs and disabilities and the potential services they required were explored. For this study, a small sample (N = 25) of families of CSHCN completed the Family Needs section of the Center for Medical Home Improvement Family Survey, an in-depth, five-part survey designed to have families report on the services and supports that their CSHCN actually received. Families of CSHCN identified the need for therapies to be provided within the community. Findings from this study supported the creation of a pilot program in which parents were active participants in an intensive summer program designed to address the language and communication needs of their children. The purposes of the third manuscript were to (a) conduct research in two settings - a rural medical home and the families’ natural environments, (b) identify families’ perceptions of a targeted summer language intervention program, and (c) determine what changes in young children’s communication skills could be measured when parents were active members in a targeted summer language intervention program. For the third study, fourteen children with language delays and their families participated. Children were assessed using the Battelle Developmental Inventory-2nd Edition or the Preschool Language Scale-4th Edition. Intervention was conducted within a pediatric medical home and families continued the intervention at home. For both test results, the treatment had a significant effect. All families indicated a strong desire to continue the program and families who were most concerned with their children’s language were most satisfied with the program. This pilot program model was an example of ways that interventions could be extended successfully beyond traditional settings.
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Cavota, João Joaquim Gunza. "Primary health care facilities for street children : a study of the street children's requirements in designing community hospitals in Angola." Master's thesis, University of Cape Town, 1997. http://hdl.handle.net/11427/28254.
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Summary in English.<br>Bibliography: pages 122-126.<br>This dissertation studies the delivery of health care to street children. ft investigates the existing street children's facilities and the health system in Ang of a in order to determine an appropriate type of health facilities for the special health needs of these children. The study was based on a review of bibliographic material on street children and related subjects. The findings from this review were tested through a series of interviews with professionals working with street children in Angola and with ~treet children randomly selected from shelters and on the streets in Luanda. The questionnaires were designed for evaluation of the street children's facilities, the health system and to determine street children's preferences and attitudes towards formal institutions in a context where th'e main cause of family disintegration was war. The study concluded that street children's health needs in Angola would be better catered for through independent primary health centres provided with partial in-patient services (temporary sf eeping and eating facilities for children under medical care). These centres would serve mainly children with no access to shelters and those living in shelters without health centres. The study formulates guidelines and presents a design example of the type offacifity proposed.
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Davidson, Deryn. "Integrating Biophilic Principles and Therapeutic Design Elements in Outdoor Spaces for Children at Tucson Medical Center." The University of Arizona, 2013. http://hdl.handle.net/10150/294837.
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As concern for the health and wellbeing of children grows in a society geared toward a more sedentary lifestyle, many doctors and therapists are pointing to the importance of access to, and time spent interacting with the natural world. The idea of using the restorative properties of nature in healing has been around since ancient times. There is currently a renaissance in the health care industry looking at the importance of incorporating gardens into the design of health care facilities once again. This project proposes to explore the importance for children in health care facilities to have access to the natural world while using the biophilia hypothesis as a framework for design. Furthermore, the benefits of outdoor areas for the families (particularly siblings) of child patients and the staff of the health care facilities was explored. Through the use of literature and case reviews, data was collected and synthesized to determine the elements best used to strengthen the designs for children’s therapeutic environments. Outcomes include three models of therapeutic environments including focus areas for the Tucson Medical Center campus in Tucson, Arizona.
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Yung, Wing-yan Ada, and 楊穎欣. "Clinical outcome and prognosis of childhood epilepsy (1996-2006)." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45153322.
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Inkelas, Moira. "Incentives in a specialty care carve-out." Santa Monica, CA : RAND Graduate School, 2001. http://catalog.hathitrust.org/api/volumes/oclc/47357973.html.
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Roy, Lonnie C. "Dallas Area Health Care Use: Study of Insured, Uninsured, and Medicaid Enrolled Children." Thesis, University of North Texas, 2000. https://digital.library.unt.edu/ark:/67531/metadc2553/.
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This research investigated physician and emergency room use among representative samples of children in the Dallas metropolitan area (N = 1606) and among patients who used Children's Medical Center of Dallas' First Care services (N = 612). Through telephone interviewing, caregivers to children under fifteen years of age were asked about an array of health service use behaviors, social-psychological issues related to acquiring health care for their children, and demographic characteristics as outlined by the Andersen & Newman model of health care service use. Children's use of physician services is best predicted by whether or not they have medical insurance, their level of income, and whether or not they have medical homes. Although having commercial managed care and fee-for-service Medicaid insurance consistently predicted increased physician use, neither independently reduced reliance on emergency rooms for non-emergent care. Managed care insurance and Medicaid did, however, significantly improve the odds that children would have medical homes, which significantly decreased emergency room use for non-emergent care. Further, increasing physician use and reducing reliance on hospital emergency rooms for non-emergent care will require ensuring that children have medical homeseither private physicians or community health centersat which they can readily and consistently receive sick and well care. Although some ethnic differences were observed, few of the broad array of factors in the Behavioral Model significantly predicted either physician or emergency room use. Moreover, educational levels and health beliefs rarely, and if significant negligibly, influenced physician and emergency room use. Health policy for children would best be served by focusing on programs that facilitate parent's ability to secure health insurance for their children and allocating children to medical homes where they can readily and consistently access sick and well care.
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Caicedo, Carmen. "Children with Special Health Care Needs: Comparison of the Effects of Home Care Setting, Prescribed Pediatric Extended Care Setting, and Long-Term Care Setting on Child and Family Health Outcomes and Health Care Service Use." FIU Digital Commons, 2013. http://digitalcommons.fiu.edu/etd/844.
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Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQL TM Generic Core Module for child health and functioning, PedsQL TM Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.
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鄧如慧 and Yu-wai Alice Teng. "Children health center." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31983054.
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PHELAN, KIERAN J. "TRENDS AND PATTERNS OF PLAYGROUND INJURIES IN UNITED STATES CHILDREN AND ADOLESCENTS." University of Cincinnati / OhioLINK, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1006198437.
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Yousef, Yousef Mohammed. "Medical professionals' oral health knowledge, attitudes & related practices performed for high caries-risk children." Diss., University of Iowa, 2011. https://ir.uiowa.edu/etd/2793.
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The past few decades have witnessed an increased focus on the importance of oral health on the social, psychological and developmental well-being in children. Although effective and advanced dental prevention measures and treatment options are increasingly available, dental decay remains one of the most common chronic childhood diseases in the United States and around the world. Recently, the World Health Organization Assembly called attention to the significant burden oral disease has maintained in all countries around the world. Additionally, multiple studies have described disparities in oral health with a disproportionate amount of dental disease concentrated in children with special health care needs, those that live with poor families or that live in isolated or rural communities. In response to this issue there has been renewed focus on combating access to oral health care issues. One approach that has been suggested is the utilization of non-dental health professionals in assessing oral health, performing basic preventive steps and referral of high-caries risk children for further care. These non-dental professionals are often in a better position to evaluate children at an early age, are more likely to see poor children early and to provide care for them on a continuing basis when compared to dentists. However, several barriers have been mentioned in the literature that prevent or deter these non-dental health professionals from taking on a more active role in this access to care issue. Of which has been a reported lack in oral care education and training for medical care professionals. Additionally, collectively few studies have specifically identified the importance of different suggested influencing factors.
In our present study, three main analyses were conducted. The first analysis assessed the oral-health knowledge, practices, and factors influencing the ability and willingness of Iowa pediatricians' to assess and refer high caries-risk children. In which, a 22-item survey was mailed to all licensed pediatricians in Iowa. Chi-square statistics and logistic regression models were used to analyze data. On questions regarding comfort levels when performing oral-health related practices on children under 3, physicians reported high levels of comfort with all specified issues. The majority of respondents routinely gave the name of a dentist to the caregiver when referring, where as only 4% made use of local care coordination services and only 9% actually made the dental appointment. Sixty-five percent referred all children 12 months or older to a dentist in accordance with AAPD and AAP guidelines. The ability to locate a dentist willing to accept Medicaid or uninsured children was noted as the major referral barrier. Bivariate and multivariate logistic regression analyses indicated that pediatricians who had higher frequency of seeing oral-health problems (p=0. 0.0488), greater mean total number of children seen per week (p=0.0431), and believed that children should have their 1st dental visit no later than 12 months of age (p=0.0196) were more likely to make frequent referrals to a dentist compared to their counterparts. The second analyses assessed Saudi medical interns' oral-health knowledge, and other factors influencing their ability and willingness to perform oral-health related practices for high caries-risk children. In which, a 15-item survey was emailed to all eligible graduating fifth year medical students at King Khalid University Hospital to address these areas of interest. Chi-square statistics and logistic regression models were used to analyze data. Similar to our first study physicians noted high levels of comfort with all specified oral health practices. However, students generally rated their medical training fair or poor in preparing them for oral-health assessments compared. Additionally, although 90% of respondents noted that the role of primary physicians in counseling/referring children with oral health was important; 60% did not agree with the AAPD and AAP guidelines that state that all children should be referred to a dentist by 12 months of age. Multivariate logistic regression analyses revealed several statistically significant variables that predict the likelihood of performing various oral-health related practices. The choice of public-health oriented future clinical goals, the level of oral-health knowledge, how interns rated their oral health training in medical school, and the average number of children seen per week, all - to varying degrees - proved important predicator variables for the likelihood of performing them once in practice. In our third study focus was placed on assessing the effectiveness of an electronic educational intervention on improving primary care practitioners' knowledge, willingness, and comfort levels in identifying children who are at high risk for developing dental caries. Following the educational program, a 16-item survey was emailed to all participants to address the areas of interest. Bivariate correlation and linear regression were used to analyze data. Respondents gave a higher percentage of correct responses to the knowledge questions post-intervention compared to pre-intervention with an average increase of 63%. Additionally, nearly all respondents agreed with the statement that all children 12 months and older should be seen by a dentist in accordance the AAP & AAPD. Furthermore, physicians noted improved levels of comfort with all specified oral health practices. Most notable, following the educational intervention, 91% of respondents rated them-selves as comfortable in counseling, compared to only 25.6% that did so before the educational program. The only exception on comfort issues pertained to performing emergency treatments on young children with a majority of interns (92%) still considering themselves as neutral or uncomfortable in doing so. Multiple linear regression analyses revealed several statistically significant variables that predict the likelihood of performing various oral-health related practices. Increased oral health knowledge, higher self-perceived comfort levels and seeing oral-health problems more frequently all proved important predicator variables for the likelihood of performing oral-health related services.
Collectively, these three analyses lead us to several main conclusions and future education recommendations. Educating medical practitioners and students about basic oral health recommendations and referral guidelines provides an excellent opportunity to alert medical professionals about the importance and timing of these dental referrals. Ultimately, earlier referrals by physicians can help improve dental utilization among high risk children, especially among lower income and rural families. Additionally, providing these medical professionals with experience opportunities in assessing the oral health of young children may improve both physician willingness and likelihood to perform various oral health practices for young children. Overall, increasing both knowledge and personal experience of training physicians' could lead to greater comfort levels in dealing with oral health issues affecting young children. Furthermore, establishing effective care coordinator services to assist in linking various health care professionals more directly; may also increase physician willingness to assess and refer high-caries-risk children by making the referral process easier for physician offices. This step helps in saving time and effort, two deterrents noted by physicians.
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Hughes, Suzanne Chung-A.-On. "Children's receipt of routine health care : the role of parental health beliefs /." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2002. http://wwwlib.umi.com/cr/ucsd/fullcit?p3071178.
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Brennan, Mary. "Establishing clinical networks to deliver optimal care for children and young people with Juvenile Idiopathic Arthritis : guidance for medical professionals." Thesis, University of Newcastle upon Tyne, 2016. http://hdl.handle.net/10443/3457.
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Background: Clinical networks are evolving across the United Kingdom (UK), as a means to address inequities in access to specialist care for children and young people with Juvenile Idiopathic Arthritis (JIA). There is recognition that establishing clinical networks, and educating and training health professionals has been challenging. This study therefore explored the experiences of those involved to understand this area further. The aim of this study was to produce an educational framework to guide medical professionals in this process. Methods: Focus groups and one-to-one interviews were used to explore experiences of health professionals, young people with JIA and their families. Participants were recruited from paediatric and adolescent rheumatology specialist centres, clinical networks and charities across the UK. Data was analysed using coding, memoing and mapping techniques to identify issues and features relating to the support required. The findings provided the content for an educational framework. Results: Seventy-two participants took part in 9 focus groups and 12 one-to-one interviews. Five tertiary centres and their networks were studied, 4 in England and 1 in Scotland. Networks were constantly evolving and no one network or ‘link’ within a network was the same. Different network structures gave rise to different roles and responsibilities, educational needs and training opportunities. Crucially professional and organisational boundaries have impeded the effective implementation of organisational change. Conclusions: This thesis has documented key issues and mapped out the support required for medical professionals establishing and maintaining clinical networks to deliver optimal care for children and young people with JIA. The support required is complex and context specific. There are many questions still to be answered. However, I hope my observations, theories and educational framework development provides the basis for future research and begins to facilitate change to improve care for children and young people with JIA.
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Johansson, Nina. "Social workers’ perspectives on a medical home model for children and adolescents in out of home care : An interview study." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-413383.
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Background: In Sweden, health outcomes for children placed in care have been disappointing. ‘Placed in care’ refers to social out of home care (OHC). Hälsofam is a medical home model for healthcare of children in OHC currently delivered in Uppsala. Aim: To explore how social workers perceive and experience the Hälsofam model. Methodology: A qualitative explorative study with ten semi-structured individual telephone interviews. The criteria for inclusion in the study sample were employees within the social service, working in a specialised case unit and having experience of referring children and/or adolescents to Hälsofam. Results: Working with Hälsofam has offered social workers a way into the health care sector, which is something that previously has been limited. The Hälsofam model has offered the social workers an active collaborative working situation, where focus has been given to organised work across the ‘silos’ of care services for these children. However, the findings raised the question of whether or not all children and adolescents have the same possibility to receive care from Hälsofam. Conclusion: The Hälsofam model appears to have had a positive impact on the interrelations between the social service and the health care sector. Social workers perceive it to facilitate necessary support for children and adolescents in OHC. Yet, findings show that personal views of the social worker and the societal situation in which they operate create limitations for providing care for every child and adolescent.<br>Bakgrund: I Sverige har hälsoutfallen för barn och ungdomar inom socialtjänstens placeringar utanför det egna hemmet varit bristande. Hälsofam är en organisatorisk modell inom hälso- och sjukvård för barn i placeringar utanför det egna hemmet i Uppsala. Syfte: Syftet med denna kvalitativa studie är att undersöka hur anställda inom Socialtjänsten har upplevt och erfarit Hälsofam-modellen. Metod: En kvalitativ explorativ studie med tio semi-strukturerade individuella telefonintervjuer användes. Kriterier för inkludering i studieurvalet var att personen skulle vara anställd inom Socialtjänsten, arbeta med denna typ av fall samt ha erfarenhet av att remittera barn och unga till Hälsofam. Resultat: Arbetet med Hälsofam har erbjudit anställa inom socialtjänsten en väg in till hälso- och sjukvården, vilket tidigare upplevts begränsat. Hälsofam har erbjudit anställda inom socialtjänsten ett aktivt samarbete, där fokus har lagts på organiserat interprofessionellt arbete. Frågan har också rests, huruvida alla barn och ungdomar har samma möjlighet till vård inom Hälsofam. Slutsats: Hälsofam-modellen har haft en positiv inverkan på det inbördes förhållandet mellan Socialtjänst och hälso- och sjukvårdssektorn. Anställda inom socialtjänsten upplever även att arbetet med att stödja de barn och unga som får vård utanför hemmet, har blivit lättare i och med Hälsofam. Resultatet visar dock att det personliga perspektivet hos den anställda samt den samhälleliga situationen där de arbetar, skapar begräsningar för att erbjuda vård till alla barn och unga.
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Garlington, Jennifer Erin, and Jennifer Erin Garlington. "Exploring Family Perceptions About Primary Care Management Following Diagnosis of Type 1 Diabetes in Preschool-Age Children." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/621004.
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Purpose: To describe family perceptions about pediatric primary care management following diagnosis of type 1 diabetes mellitus (T1DM) in preschool-aged children living in the Pacific Northwest region of the United States. Study Design and Method: Mothers of children diagnosed with T1DM before the fifth birthday and within the past two years were recruited anonymously through two regional support groups. Perceptions about pediatric primary care management following T1DM diagnosis were elicited through an anonymous 30-item online survey. Demographic characteristics of mother and child were obtained as well as information about five important domains of health care management for a young child with T1DM: (1) multidisciplinary, (2) holistic and compassionate, (3) accessible and communicative, (4) uses current standards and technology, and (5) actively promotes safe self-management. Results: Twenty-one biological mothers participated in this study, each on behalf of a child diagnosed with T1DM who fit inclusion criteria. Overall mothers held positive perceptions about care management by PCPs and endocrinologists within context of each of the five domains. Most mothers felt included in care planning, valued periodic well-child exams, and believed the child's providers were accessible, communicated effectively, and usually demonstrated consideration/compassion for the family. Although a majority of mothers at least somewhat agreed that the PCP used current standards and technology to care for the child, and functioned as the center of his/her health care coordination, these domains elicited a slightly greater number of responses indicating uncertainty or disagreement. Clinical Implications: Nurses and pediatric practitioners can use findings from this study to plan continued exploration into the perceptions and care management needs of families following diagnosis of a very young child with T1DM. The domains of care used to assess mothers' perceptions about care management-based on tenets of the Chronic Care Model (CCM) and Patient Centered Medical Home (PCMH)-can be used by pediatric PCPs and endocrinologists to dialogue with patients and staff about how care management may be improved for these families. Providing opportunities for feedback to the families of young children with T1DM should be encouraged so future research can examine relationships between care management variables and clinical outcomes.
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Luque, John S. "Breathing easier : ethnographic study of acute respiratory infection in children in rural Ecuador." [Tampa, Fla] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0001420.
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