The medical evaluation of the internationally adopted child

2021 ◽  
Vol 45 (2) ◽  
pp. 228-234
Author(s):  
Randi Sperling ◽  
Danielle Steinberg ◽  
Zachary Belnavis
Keyword(s):  
Medical Information ◽  
Community Support ◽  
Anticipatory Guidance ◽  
Health Issues ◽  
Developmental Assessment ◽  
Adopted Child ◽  
Medical Evaluation ◽  
Behavioural Surveillance ◽  
Internationally Adopted

Children who have been internationally adopted often have complex health issues and unique challenges. 1 The paediatric office provides a medical home by offering continuity of care, links to community support, and appropriate evaluation and treatment. During the pre-adoption evaluation, biographical and medical information provided by the child’s country of origin is reviewed. Additionally, soon after the child’s adoption, a complete medical history and physical examination should be completed. Although laboratory work may have been performed previously, studies should be repeated to ensure reliability. Developmental assessment and review of vaccinations should be completed as well. Anticipatory guidance should be provided regarding medical concerns, effects of institutionalisation and the possibility of attachment issues. Follow-up care ensures optimal medical, developmental and behavioural surveillance in this patient population.

Fifth Edition: the New Standard

2000 ◽  
Vol 5 (6) ◽  
pp. 1-7
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage ◽  
Leon H. Ensalada
Keyword(s):  
Musculoskeletal System ◽  
Medical Information ◽  
Objective Assessment ◽  
Scientific Data ◽  
Practical Application ◽  
Fourth Edition ◽  
Appropriate Use ◽  
Medical Evaluation ◽  
Single Set

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is available and includes numerous changes that will affect both evaluators who and systems that use the AMA Guides. The Fifth Edition is nearly twice the size of its predecessor (613 pages vs 339 pages) and contains three additional chapters (the musculoskeletal system now is split into three chapters and the cardiovascular system into two). Table 1 shows how chapters in the Fifth Edition were reorganized from the Fourth Edition. In addition, each of the chapters is presented in a consistent format, as shown in Table 2. This article and subsequent issues of The Guides Newsletter will examine these changes, and the present discussion focuses on major revisions, particularly those in the first two chapters. (See Table 3 for a summary of the revisions to the musculoskeletal and pain chapters.) Chapter 1, Philosophy, Purpose, and Appropriate Use of the AMA Guides, emphasizes objective assessment necessitating a medical evaluation. Most impairment percentages in the Fifth Edition are unchanged from the Fourth because the majority of ratings currently are accepted, there is limited scientific data to support changes, and ratings should not be changed arbitrarily. Chapter 2, Practical Application of the AMA Guides, describes how to use the AMA Guides for consistent and reliable acquisition, analysis, communication, and utilization of medical information through a single set of standards.

J 5 — A Data Processing System for Medical Information

1967 ◽  
Vol 06 (01) ◽  
pp. 1-6
Author(s):  
P. Hall ◽  
Ch. Mellner ◽  
T. Danielsson
Keyword(s):  
Medical Records ◽  
Medical Information ◽  
Health Care Systems ◽  
Processing System ◽  
Linear Pattern ◽  
Flexible Form ◽  
Care Systems ◽  
Pattern Recognition Analysis ◽  
Numeric Information

A system for medical information has been developed. The system is a general and flexible one which without reprogramming or new programs can accept any alphabetic and/or numeric information. Coded concepts and natural language can be read, stored, decoded and written out. Medical records or parts of records (diagnosis, operations, therapy, laboratory tests, symptoms etc.) can be retrieved and selected. The system can process simple statistics but even make linear pattern recognition analysis.The system described has been used for in-patients, outpatients and individuals in health examinations.The use of computers in hospitals, health examinations or health care systems is a problem of storing information in a general and flexible form. This problem has been solved, and now it is possible to add new routines like booking and follow-up-systems.

scholarly journals P005 Rheumatology virtual clinics during COVID-19: are our patients satisfied?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Fajer A Altamimi ◽  
Una Martin
Keyword(s):  
Medical Information ◽  
Worker Safety ◽  
University Hospital ◽  
Free Text ◽  
Risk Of Infection ◽  
Further Training ◽  
Return Envelope ◽  
The Right ◽  
Reduced Risk

Abstract Background/Aims  Telemedicine can be broadly defined as the use of telecommunication technologies to provide medical information and services. It can be audio, visual, or text. Its use has increased dramatically during the COVID-19 pandemic to ensure patient and healthcare worker safety. Any healthcare professional can engage with it. It carries benefits like reduced stress and expense of traveling, maintenance of social distancing, and reduced risk of infection. There are some potential drawbacks such as lack of physical examination, liability and technological issues. Methods  A questionnaire was sent to 200 patients, selected from different virtual clinics (new and review, doctor and ANP led) run between March and May 2020 in the rheumatology department of University Hospital Waterford. We formulated 14 questions to cover the following aspects: demography, the purpose of the consult, punctuality, feedback, medico-legal concerns, and free text for comments. A self-addressed return envelope was included. Results  83 responses were received. 2 were excluded. The ratio of females to male respondents was 59: 41, with the majority over 60 years old. The main appointment type was review 67 (83%). 80% of patients were called either before or at the time of their scheduled appointment. The vast majority (98.8%) of our patients had confidence in our data protection and trusted our system to maintain their confidentiality. 95% stated that they felt comfortable, were given enough time to explain their health problem and felt free from stress. The respondents who preferred attending the clinic in person (17 in total) compared to the virtual were mostly follow up patients- 12 vs. 5 new. Conclusion  Patient satisfaction among those surveyed was high, despite having to introduce the service abruptly during the COVID-19 pandemic. There are many improvements we can adopt to improve our service and even maintain after the pandemic as a way of communicating with our stable patients. As we are covering a large geographical catchment, we can continue to implement the virtual clinic for some appointments. We should prioritize our efforts on identifying the right patient and the type of service we can offer, further training of staff, and increasing awareness of the patients as to how to get the most out of a virtual appointment. Disclosure  F.A. Altamimi: None. U. Martin: None. C. Sheehy: None.

scholarly journals Grandparent Resilience: Improving Self-Efficacy in Grandparents Raising Grandchildren

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 510-510
Author(s):  
Aimee Fox ◽  
Nathaniel Riggs ◽  
Loriena Yancura ◽  
Christine Fruhauf
Keyword(s):  
Self Efficacy ◽  
Emotional Health ◽  
Well Being ◽  
Individual Variability ◽  
Health Issues ◽  
Grandparents Raising Grandchildren ◽  
Post Intervention ◽  
Paired Samples ◽  
Post Test

Abstract Grandparents often protect against childhood trauma and promote resilience through their nurturance, love, and support when raising grandchildren. Despite the beneficial role grandparents have on their grandchildren, grandparents may experience challenges of their own, including physical, mental, and emotional health issues, lack of resources, and social isolation. Few interventions exist to help grandparents successfully adapt to the challenges they face as primary parenting figures. The purpose of this study was to test preliminary efficacy of a strengths-based intervention for grandparents raising grandchildren aimed at increasing self-care behaviors, managing emotions, and connecting to community resources. Grandparents (N = 137) providing primary care to grandchildren were recruited to participate in a single-group, pre- and post-test design, 6-week intervention. Self-efficacy was assessed at baseline, post-intervention, and at a 6-month follow-up. To evaluate who the intervention might be most beneficial for, grandparents’ service knowledge, perceived support from others, and length of care provided, measured at baseline, were analyzed for moderating effects. Results of paired-samples t-tests reveal significant increases in self-efficacy (p = .013) from baseline to post-test, which were maintained at the 6-month follow-up (p = .010). Hierarchical multiple regression showed interaction effects of the hypothesized moderators were not significant, indicating improvements in self-efficacy regardless of individual variability at baseline. As demonstrated, interventions can be effective at increasing self-efficacy in grandparents raising grandchildren and strengths-based approaches have the potential to provide universal benefits to grandparents, thus improving functioning in grandfamilies and promoting the health and well-being of grandparents and their grandchildren.

scholarly journals Empowerment among adult patients with type 2 diabetes: age differentials in relation to person-centred primary care, community resources, social support and other life-contextual circumstances

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Simonsen ◽  
Anne M. Koponen ◽  
Sakari Suominen
Keyword(s):  
Social Support ◽  
Community Health ◽  
Age Groups ◽  
Community Support ◽  
Community Resources ◽  
Age Group ◽  
Health Issues ◽  
Younger Adults

Abstract Background Rising prevalence of type 2 diabetes (T2D), also among younger adults, constitutes a growing public health challenge. According to the person-centred Chronic Care Model, proactive care and self-management support in combination with community resources enhance quality of healthcare and health outcomes for patients with T2D. However, research is scarce concerning the importance of person-centred care and community resources for such outcomes as empowerment, and the relative impact of various patient support sources for empowerment is not known. Moreover, little is known about the association of age with these variables in this patient-group. This study, carried out among patients with T2D, examined in three age-groups (27–54, 55–64 and 65–75 years) whether person-centred care and diabetes-related social support, including community support and possibilities to influence community health issues, are associated with patient empowerment, when considering possible confounding factors, such as other quality of care indicators and psychosocial wellbeing. We also explored age differentials in empowerment and in the proposed correlates of empowerment. Method Individuals from a register-based sample with T2D participated in a cross-sectional survey (participation 56%, n = 2866). Data were analysed by descriptive statistics and multivariate logistic regression analyses. Results Respondents in the youngest age-group were more likely to have low empowerment scores, less continuity of care, and lower wellbeing than the other age-groups, and to perceive less social support, but a higher level of person-centred care than the oldest group. Community support, including possibilities to influence community health issues, was independently and consistently associated with high empowerment in all three age-groups, as was person-centred care in the two older age-groups. Community support was the social support variable with the strongest association with empowerment across age-groups. Moreover, vitality was positively and diabetes-related distress negatively associated with high empowerment in all age-groups, whereas continuity of care, i.e. having a family/regular nurse, was independently associated in the youngest age-group only. Conclusion Person-centred care and community support, including possibilities to influence community health issues, supports empowerment among adults with T2D. Findings suggest that age is related to most correlates of empowerment, and that younger adults with T2D have specific healthcare needs.

scholarly journals Effect of physician prescribed information on hospital readmission and death after discharge among patients with health failure: A randomized controlled trial

2021 ◽  
Vol 27 (1) ◽  
pp. 146045822199640
Author(s):  
Faranak Kazemi Majd ◽  
Vahideh Zarea Gavgani ◽  
Ali Golmohammadi ◽  
Ali Jafari-Khounigh
Keyword(s):  
Randomized Controlled Trial ◽  
Hospital Readmission ◽  
Medical Information ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Long Term Follow Up ◽  
Oral Information

In order to understand if a physician prescribed medical information changes, the number of hospital readmission, and death among the heart failure patients. A 12-month randomized controlled trial was conducted (December 2013–2014). Totally, 120 patients were randomly allocated into two groups of intervention ( n = 60) and control ( n = 60). Accordingly, the control group was given the routine oral information by the nurse or physician, and the intervention group received the Information Prescription (IP) prescribed by the physician as well as the routine oral information. The data was collected via telephone interviews with the follow-up intervals of 6 and 12 months, and also for 1 year after the discharge. The patients with the median age of (IQR) 69.5 years old (19.8) death upon adjusting a Cox survival model, [RR = 0.67, 95%CI: 0.46–0.97]. Few patients died during 1 year in the intervention group compared to the controls (7 vs 15) [RR = 0.47, 95%CI: 0.20–1.06]. During a period of 6-month follow-up there was not statistically significant on death and readmission between two groups. Physician prescribed information was clinically and statistically effective on the reduction of death and hospital readmission rates among the HF patients in long term follow-up.

Health assessments for Indigenous Australians at Orange Aboriginal Medical Service: health problems identified and subsequent follow up

2016 ◽  
Vol 22 (3) ◽  
pp. 233 ◽  
Author(s):  
Tegan Dutton ◽  
Wendy Stevens ◽  
Jamie Newman
Keyword(s):  
Medical Service ◽  
Pap Smear ◽  
Aboriginal Health ◽  
Indigenous Australians ◽  
Adult Women ◽  
Health Issues ◽  
Retrospective Audit ◽  
Health Assessments ◽  
Clinical Records

This study aimed to document the types, management and follow up of health issues identified by all Aboriginal Health Assessments (AHA) performed at Orange Aboriginal Medical Service from 1 January 2011 to 31 December 2012. This was done with a retrospective audit of clinical records. In total, 1169 AHAs were performed: 41% child, 53% adult and 6% older person AHAs. Newly identified health issues were documented in 85% (984). Being overweight (41%; 476) and smoking (26%; 301) were the common risk factors identified. As a result of the AHA, most children who were not up-to-date with their vaccinations received catch-up immunisations; 11% (36) of adult women (n=314) received a Pap smear, although Pap smear status was unknown or not up-to-date for 61% (192); 27% (311) of cases were prescribed new medication; and 1239 referrals were made but only 40% were attended. At 6 months following the AHA, 26% (240) of cases with newly identified health issues were completely managed and followed up, whereas 25% (226) received no follow up. The AHAs are useful for identifying new health issues; however, follow up of the identified health issues should be improved. If AHAs are to improve health outcomes, appropriate management and follow up of the identified health issues are essential.

Effects of choral singing on salivary cortisol levels and self-reported stress in university students

2021 ◽  
Vol 13 (4) ◽  
Author(s):  
Gunnar Glauco De Cunto Carelli Taets ◽  
Ramon Werner Heringer Gutierrez ◽  
Leila Brito Bergold ◽  
Luana Silva Monteiro
Keyword(s):  
University Students ◽  
Salivary Cortisol ◽  
Health Issues ◽  
Group Approach ◽  
Choral Singing ◽  
Before And After ◽  
Quasi Experimental ◽  
Potential Impact ◽  
Cortisol Levels

Although mental disorders are common among university students, the majority of students with mental health issues do not seek out treatment during their academic life. The aim of this study was to evaluate the effects of a novel group approach- choir singing, and its potential impact on stress, via salivary cortisol levels and self-reported stress levels in university students during 4 sessions of choir singing. It was based on a quasi-experimental research conducted with 25 Brazilian university students. Each choir singing session lasted 60 minutes. A question was asked before and after the intervention: what is the level of your stress? Salivary cortisol was collected before and after the intervention. After the choir singing intervention, there was  a statistically significant reduction in self-reported stress (p<0.0001) and salivary cortisol levels (p<0.0001). This research suggests that choir singing can reduce the self-reported stress of university students after 4 weeks of follow-up with ∆= 45.83% and salivary cortisol levels in the first week with ∆= 3.57%.

The Immigrant, Refugee, or Internationally Adopted Child

2001 ◽  
Vol 22 (12) ◽  
pp. 419-429 ◽  
Author(s):  
Jerri Ann Jenista
Keyword(s):  
Adopted Child ◽  
Internationally Adopted
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