ABSTRACTThis 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 ...

ABSTRACT: BACKGROUND: Disease management programs, especially those based on the Chronic Care Model (CCM), are increasingly common in the Netherlands. While disease management programs have been well-researched quantitatively and economically, less qualitative research has been done. The overall aim of the study is to explore how disease management programs are ...

Introduction and Aims. New strategies are required to reach subpopulations with high smoking rates. This study reports on an evaluation of the Smoking Care intervention-a 2-year organisational capacity building strategy-for social and community service organisations (SCSOs) to provide smoking care to clients. Design and Methods. The Smoking Care intervention consisted ...

In spite of the economic development through the past six decades post-independence, nearly 70% of the Indian population still live in villages, and these people very often have limited access to the advanced health-care technology. In an attempt to render cost-effective gastrointestinal care to the rural dwellers, we have initiated ...

In this article, we describe a digital photo scrapbooking project as a standard of care for the parents of infants admitted in a neonatal intensive care unit (NICU). Photographs were taken from birth until discharge or expiry at special moments during the infant's hospitalization and used to create a digital ...

The Medicare Pioneer and Shared Savings Accountable Care Organization (ACO) programs offer health care provider organizations contracts with Medicare whereby the organizations assume financial risk and are rewarded for providing high-quality care at lower cost. ACO spending targets will be determined on the basis of baseline Medicare spending for assigned ...

In England, Local Authorities (LAs) contribute to the care home fees of two-thirds of care home residents aged 65+ who pass a means test. LAs typically pay fees below those faced by residents excluded from state support. Most proposals for reform of the means test would increase the proportion of ...

The patient-centered medical home (PCMH) approach continues to gather momentum in the United States and Canada as a broad approach to reform the delivery of the complete primary care system. The family health team (FHT) model implemented in Ontario, Canada, best mirrors the PCMH approach of the United States. The ...

Abstract The National Consensus Project for Quality Palliative Care (NCP) has put forth eight domains of clinical practice guidelines that address the multidisciplinary nature of palliative and end-of-life (EOL) care. Extant surveys to assess education needs of palliative and EOL workers, however, have been constructed for individual professions. Thus we ...

I have recently been involved in a project for the Older Person's Commissioner for Wales, exploring the views of health-care staff toward whistleblowing. This has included gathering data in a number of settings such as nursing homes and acute units for older people. We have also been asking final-year student ...

OBJECTIVE: /st>To identify a set of indicators for monitoring the quality of maternity care for low-risk women provided by primary care midwives and general practitioners (GPs) in the Netherlands. DESIGN: /st>A Project Group (midwives, GPs, policymakers and researchers) defined a long list of potential indicators based on the literature, national ...

This article presents the key findings from an extensive research project aiming to identify the determinants of poor sleep in care homes. A mixed methods study was conducted in 10 care homes in South East England. This included 2-week daily diaries completed by 145 older residents and interviews with 50 ...

This project, based in Newfoundland and Labrador's Central Regional Health Authority, is the first application of an 80/20 staffing model to a long-term care facility in Canada. The model allows nurse participants to spend 20% of their paid time pursuing a professional development activity instead of providing direct patient care. ...

This article describes two collaborative paired student-preceptor efforts. One project resulted in the implementation of a hospital-wide oral care protocol, and the second enhanced the admission assessment process for adult patients at risk for respiratory compromise after sedation and/or receipt of narcotic analgesia. Recommendations for staff development are addressed.

: Health care reform under the "Patient Protection and Affordable Care Act" (PPACA) will lead to changes in reimbursement. Although this legislation provides a mechanism for uninsured Americans to obtain coverage, it excludes undocumented immigrants (UDI). Reimbursement for UDIs comes from the disproportionate share hospital (DSH) program and was previously ...

Abstract Background: People with intellectual disabilities (ID) experience many barriers in accessing quality health care for serious and terminal illness, including delayed diagnosis, as signs and symptoms of illness are misinterpreted There is growing evidence that palliative care services are underused by people with ID. Methods: A 3-year project aimed ...

Abstract Early entry to HIV care and receipt of antiretroviral therapy improve the health of the individual and decrease the risk of transmission in the community. To increase the limited information on prospective decisions to enter care and how these decisions relate to beliefs about HIV medications, we analyzed interview ...

ABSTRACT: Despite the prevalence of women caring for stroke survivors, relatively little research has focused specifically on the experience and needs of informal female caregivers of stroke survivors. Therefore, the purpose of this study was to describe the experience of female caregivers who care for an adult family member who ...

Individual health care quality measures that have been shown to improve outcome can be combined together into what are called care bundles, with the expectation that this set of practices produces further improvements in outcome. Prevention of surgical site infection is the focus of several quality measures put forward by ...

Participation in horticulture and arts may improve wellbeing in those with mental and physical illness. To conduct an in-depth exploration of the views and experience of participants of a primary-care-based horticultural and participatory arts rehabilitation project (Sydenham Garden). Qualitative interview study of a primary-care-based horticultural and participatory arts rehabilitation project ...

Sarah Waller CBE, RGN, FRSA, programme director at The King's Fund's Enhancing the Healing Environment (EHE) programme, examines the work undertaken to date, and still ongoing, to improve the care environment for people living with dementia. At a time when estates and facilities budgets are tight, she argues that, as ...

Advances in genomic technologies and methods of assisted reproduction have opened up new possibilities for testing and screening of prospective parents, their fertilized eggs, their fetuses, and their newborn babies.

This project investigated New Zealanders' views about palliative care and local hospice services. A representative population-based sample of 1011 New Zealanders completed an online survey. The age, gender, and geographic region of the 1011 participants were broadly representative of the New Zealand population. Varying awareness of hospice services and palliative ...

Pre-hospital emergency care (PHEC) in the military has undergone major changes during the last 10 years of warfighting in the land environment. Providing this care in the maritime environment presents several unique challenges. This paper examines the clinical capabilities required of a PHEC team in the maritime environment and how ...

BACKGROUND: stroke is a leading cause of death and disability globally. The economic costs of stroke are high but not often fully quantified. This paper estimates the economic burden of stroke and transient ischaemic attack (TIA) in Ireland in 2007. METHODS: a prevalence-based approach using a societal perspective is adopted. ...

Despite recent and exponential improvements in diagnostic-therapeutic pathways, an existing "GAP" has been revealed between the "real world care" and the "optimal care" of patients with chronic heart failure (CHF). We present the T.O.S.CA. Project (Trattamento Ormonale dello Scompenso CArdiaco), an Italian multicenter initiative involving different health care professionals and ...

UK architecture firm, BMJ Architects, is well-known as a specialist in healthcare work, completing projects all over the UK--from whole hospital campuses to cancer care centres. The practice recently completed the design of a 3.5 million sterling pounds expansion to the existing Emergency Department at Glasgow Royal Infirmary (GRI), making ...

Division of labor among the workers of insect societies is a conspicuous feature of their biology. Social tasks are commonly shared among age groups but not between larvae and adults with completely different morphologies, as in bees, wasps, ants, and beetles (i.e., Holometabola). A unique yet hardly studied holometabolous group ...

A number of elements contribute to a healing ICU environment. The layout of a critical care unit helps create an environment that supports caregiving, which helps alleviate a host of work-related stresses. A quieter environment, one that includes family and friends, dotted with windows and natural light, creates a space ...

Abstract Disaster plans, during the actual disaster, often do not function as conceived and designed. Disaster or emergency situations may not present as anticipated in planning sessions confounding the intent of disaster planners. Systems that are created and shelved awaiting the disaster may be dysfunctional when needed due to problems ...

Shock is a clinical disorder that challenges caregivers in the neonatal intensive care unit. The predominant cause of shock in neonates is sepsis. This article provides an overview of the current treatment of septic shock with particular emphasis on newer vasoactive drugs (milrinone, levosimendan and vasopressin) to support cardiovascular dysfunction.

This article attempts to capture the dynamics of return reproductive tourism to the Middle East, based on ethnographic research undertaken at four different Middle Eastern locales (Egypt, Lebanon, United Arab Emirates and Arab America). Across the Middle Eastern diaspora, which is now vast, due to the disruptions of war and ...

Ten steps are required to develop an ACO that can thrive in the emerging healthcare environment: Assess readiness for accountable care. Assemble the right project team. Create a legal and organizational framework for an ACO. Form the right leadership team. Strategically align human capital. Ensure minimal operational requirements are met. ...

Media reporting of 'fertility tourism' tends to portray those who travel as a cohesive group, marked by their desperation and/or selfishness and propensity towards morally questionable behaviour. However, to date little has been known about the profile of those leaving the UK for treatment. This paper discusses the first UK-based ...

The mechanism that facilitates the evolution of maternal care is ambiguous in egg-laying terrestrial vertebrates: does the ability of mothers to recognize their own eggs lead them under some circumstances to begin providing care or can maternal care evolve from simply being in close proximity to the eggs (e.g. through ...

Adrenal corticosterone secretion of newborn mice rapidly desensitizes to repeated maternal absence. The present study investigated the effects of novelty exposure, maternal care and genotype on this phenomenon. Maternal separation (MS) took place on postnatal days (pnd) 3-5. In Wistar rats, the degree of novelty in the MS-environment was varied ...

Éire, or in its English language form, Ireland, is a constitutional republic island state bordered by the Atlantic Ocean on its rugged north and rocky west coasts and the rough Irish Sea on the east. After a period of calm, financial promise, and prosperity, the so called Celtic tiger's roar ...

BACKGROUND: Access to surgical care and emergency obstetrical care is limited in low-income countries. The Solomon Islands is one of the poorest countries in the Pacific region. Access to surgical care in Solomon Islands is limited and severely affected by a country made up of islands. Surgical care is centralized ...

The spiritual dimensions of surgical palliative care encompass recognition of mortality (physician and patient); knowledge of moral and ethical dilemmas of medical decision making; respect for each individual and for all belief systems; responsibility to remain physically and psychologically present for the patient and family; and knowledge of when chaplains, ...

Palliation has been an essential, if not the primary, activity of surgery during much of its history. However, it has been only during the past decade that the modern principles and practices of palliative care developed in the nonsurgical specialties in the United States and abroad have been introduced to ...

In the surgical intensive care unit (SICU), the stress of having a critically ill loved one creates significant bereavement and emotional needs for family members. Surgical palliative care has expanded; clinicians do not just treat the patient, but now include the family within the scope of care. Understanding and treating ...

Burnout is a prevalent and important occupational hazard among surgical oncologists. The well-being or distress experienced can have a significant effect on clinicians and their families, the quality of care provided to patients, and the success of the health care organization. We aimed to measure the prevalence of burnout, psychiatric ...

A parturient with Fontan circulation required general anesthesia for urgent cesarean delivery and subsequent prolonged postoperative ventilation for newly-diagnosed pseudocholinesterase deficiency. Anesthetic management necessitated a thorough understanding of the hemodynamic principles of the Fontan circulation and physiologic adaptations during surgical delivery and recovery in the intensive care unit.

Objective To assess the degree and methods of involvement of United Kingdom-based specialists in restorative dentistry in cleft lip and palate services.Design Postal questionnaire.Setting The questionnaire was sent to specialists in restorative dentistry, periodontics, prosthodontics and endodontics as held by the General Dental Council (n = 709). The study was ...

PURPOSE: This review addresses and summarizes the key issues and unique specific intensive care treatment of adult patients from the trauma surgery perspective. MATERIALS AND METHODS: The cornerstones of successful surgical intensive care management are fluid resuscitation, transfusion protocol and extracorporeal organ replacement therapies. The injury-type specific complications and unique ...

This paper describes the relationship between John Ruskin [1819-1900] the Victorian artist, writer, and critic, and Alfred James Woodhouse [1824-1906], the dentist who cared for him from 1866 to 1883. Although Ruskin was perhaps not quite as eccentric as a recent television series has portrayed him, he was certainly not ...

Objective: The Division of Pediatric Neurosurgery of the University of Florida College of Medicine - Jacksonville developed a multidisciplinary clinic for the better management of pediatric patients with spinal defects. The purpose of this report is to assist neurosurgeons in those regions and countries where there are no spinal defects ...

The objective of this study was to identify leading practices to promote environmentally friendly and efficient efforts in the provision of surgical health care. Health care is the second leading contributor to waste in the United States. Despite widespread enthusiasm for "going green" in the US economy, little substantive information ...

In an effort to improve patient care, there has been a growing trend across the nation and the world to embed the principles of evidence-based dentistry into mainstream care delivery by private practicing dentists. Evidence-based dentistry is an essential tool that is used to improve the quality of care and ...

PURPOSE: To determine whether former pediatric residents trained using a model of integrated behavioral health (BH) care in their primary care continuity clinics felt more comfortable managing BH care and better prepared to collaborate with BH professionals than did peers from the same residency who trained in clinics with a ...