The impact of intravenous acetaminophen pricing on opioid utilization and outcomes for children with appendicitis

Family violence (also referred to as Domestic Violence and Intimate Partner Violence) describes violence that occurs within an intimate relationship, whether a current or former partner. Children can experience a range of abuses (emotional, physical, sexual and neglect) within the context of family violence, and harm is cumulative and may present as complex trauma. This paper is based on a practice presentation delivered at the International Childhood Trauma Conference in Melbourne (Australia) in June 2016. The purpose of this paper is to increase awareness of the impacts for children who have experienced family violence, to enhance understanding of the mechanisms that contribute to their trauma presentation, and to highlight the specific practice issues and considerations in providing therapeutic support to this client population, with the ultimate aim of improving diagnostic and treatment outcomes for children impacted by family violence. Sufficient safety and stability are required for children to experience therapeutic change, and if family violence is current, the initial response needs to be protective. Identification of family violence should prompt practitioners to use trauma-informed assessment and trauma-focused evidence-based treatments within a family therapy and systems framework. Family violence is complex and there are many barriers to treatment and practice considerations. Expansion of practitioner knowledge and skills in family violence trauma will enhance outcomes for children who have experienced family violence.

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The impact of poverty on educational outcomes for children

Paediatrics & Child Health ◽

10.1093/pch/12.8.701 ◽

2007 ◽

Vol 12 (8) ◽

pp. 701-706 ◽

Cited By ~ 55

Author(s):

HB Ferguson ◽

S Bovaird ◽

MP Mueller

Keyword(s):

Educational Outcomes ◽

Outcomes For Children ◽

The Impact

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Interventions and practice models for improving health and psychosocial outcomes of children and young people in out-of-home care: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2019-031362 ◽

2019 ◽

Vol 9 (9) ◽

pp. e031362

Author(s):

Emma Galvin ◽

Renée O'donnell ◽

Helen Skouteris ◽

Nick Halfpenny ◽

Aya Mousa

Keyword(s):

Systematic Review ◽

Young People ◽

Home Care ◽

Psychosocial Outcomes ◽

Children And Young People ◽

Out Of Home Care ◽

Practice Models ◽

Outcomes For Children ◽

The Impact ◽

Improve Health

IntroductionChildren and young people placed in out-of-home care (OoHC) are often affected by a history of trauma and adverse childhood experiences. Trauma in early childhood can impact on children’s health and psychosocial development, whereas early interventions can improve children’s development and placement stability. Although several interventions and practice models have been developed to improve health and psychosocial outcomes for children and young people in OoHC, there remains a lack of rigorous research examining the impact of these interventions in OoHC settings, as there are no systematic reviews examining the impact these interventions and practice models have on the children and young people they serve. We aim to conduct a comprehensive systematic review to examine the effectiveness of interventions and practice models for improving health and psychosocial outcomes in children and young people living in OoHC and to identify relevant knowledge gaps.Methods and analysisMajor electronic databases including Medline, Medline in-process and other non-indexed citations, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Sociological Abstracts and all Evidence-Based Medicine Reviews incorporating: Cochrane Database of Systematic Reviews, American College of PhysiciansJournal Club, Database of Abstracts of Reviews of Effects,Cochrane Central Register of Controlled Trials, CochraneMethodology Register, Health Technology Assessment and National Health Service Economic Evaluation Database, will be systematically searched for any studies published between 2008 and 2018 of interventions and practice models developed to improve health and psychosocial outcomes for children and young people in OoHC. Two independent reviewers will assess titles and abstracts for eligibility according to prespecified selection criteria and will perform data extraction and quality appraisal. Meta-analyses and/or metaregression will be conducted where appropriate.Ethics and disseminationThis study will not collect primary data and formal ethical approval is therefore not required. Findings from this systematic review will be disseminated in a peer-reviewed publication and conference presentations.PROSPERO registration numberCRD42019115082.

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Health Status of Children Enrolled in a Family Navigator Program to Eliminate Intergenerational Poverty

Clinical Pediatrics ◽

10.1177/0009922819832026 ◽

2019 ◽

Vol 58 (6) ◽

pp. 647-655

Author(s):

Samantha Schilling ◽

Shaundreal Jamison ◽

Charles Wood ◽

Eliana Perrin ◽

Coby Jansen Austin ◽

...

Keyword(s):

North Carolina ◽

Child Health ◽

Medical Records ◽

Adverse Childhood Experiences ◽

Correlation Coefficients ◽

Parent Perception ◽

Childhood Experiences ◽

Adverse Childhood ◽

Outcomes For Children ◽

The Impact

In 2014, Family Success Alliance (FSA) was formed as a place-based initiative to build a pipeline of programs to reduce the impact of poverty on outcomes for children living in Orange County, North Carolina. In this study, FSA parents’ perception of child health, parent and child adverse childhood experiences (ACEs), and resilience were obtained by parent interview. Receipt of recommended health services were abstracted from primary care medical records of FSA children. Correlation coefficients investigated relationships among health, ACEs, and resilience. Among 87 parent-child dyads, 65% were Spanish speaking. At least 1 of the 7 ACEs measured was reported in 37% of children and 70% of parents. Parent perceptions of child health were lower than national averages. Routine preventive services included the following: autism screening at 18 months (15%) and 24 months (31%); ≥4 fluoride varnish applications (10%); lead screening (66%); and receipt of immunizations (94%). Parent perception of child health was moderately correlated with resilience.

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What is the Impact of Public Care on Children's Welfare? A Review of Research Findings from England and Wales and their Policy Implications

Journal of Social Policy ◽

10.1017/s0047279409003110 ◽

2009 ◽

Vol 38 (3) ◽

pp. 439-456 ◽

Cited By ~ 34

Author(s):

DONALD FORRESTER ◽

KEITH GOODMAN ◽

CHRISTINE COCKER ◽

CHARLOTTE BINNIE ◽

GRAHAM JENSCH

Keyword(s):

Child Welfare ◽

Policy Implications ◽

Public Care ◽

England And Wales ◽

Number Of Children ◽

Outcomes For Children ◽

Children In Care ◽

The Impact ◽

Over Time ◽

Specific Impact

AbstractThe outcomes for children in public care are generally considered to be poor. This has contributed to a focus on reducing the number of children in care: a goal that is made explicit in the provisions of the current Children and Young Persons Bill. Yet while children in care do less well than most children on a range of measures, such comparisons do not disentangle the extent to which these difficulties pre-dated care and the specific impact of care on child welfare. This article explores the specific impact of care through a review of British research since 1991 that provides data on changes in child welfare over time for children in care. Only 12 studies were identified, indicating a lack of research in this important area. The studies consistently found that children entering care tended to have serious problems but that in general their welfare improved over time. This finding is consistent with the international literature. It has important policy implications. Most significantly it suggests that attempts to reduce the use of public care are misguided, and may place more children at risk of serious harm. Instead, it is argued that England and Wales should move toward a Scandinavian system of public care, in which care is seen as a form of family support and is provided for more rather than fewer children and families.

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Community Connectors (CCx): the strategies employed by peer to peer connectors to foster relationships with early years caregivers to improve universal early child health and development

BMC Health Services Research ◽

10.1186/s12913-021-06184-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

C. F. Mills ◽

E. Lowrie ◽

K. Kinloch ◽

E. Hall

Keyword(s):

Early Stage ◽

Child Outcomes ◽

Study Data ◽

Early Years ◽

Sampling Frame ◽

Policy And Practice ◽

Development Platform ◽

Economically Deprived ◽

Outcomes For Children ◽

The Impact

AbstractBlackpool is one of the most deprived Local Authority (LA) areas in England; in April 2015 the Blackpool Better Start (BBS) Partnership was allocated £45 million over 10 years from the Big Lottery Fund (BLF) as one of five ‘A Better Start’ initiative areas in England. The aim of the ‘A Better Start’ initiative is to improve outcomes for children from conception to 3 years of age. Co-designed by professionals and the community, the Community Connector (CCx) programme employs residents to directly engage caregivers of children, in seven of Blackpool’s most socio-economically deprived wards. The CCx follow a socioecological framework which proposes that caregivers will be positively influenced to engage in early years activities because of connections to trained peers. Peer support models are commonly applied within targeted early years health settings (i.e., infant feeding support, literacy) yet their role to improve child outcomes at a universal level has received little attention. This paper focuses on caregiver-level evidence of the strategies employed by CCx - part of an early stage pilot study supported by Frontiers of Innovation, the Harvard Centre on the Developing Child’s Research and Development platform.The study collated attendance data from Children’s Centres, these are publically funded community centres providing information and activities for families with children 0–5 years of age. The study data included individual interactions between a CCx and caregiver over a 1 year period (1st April 2018 – 31st March 2019). A sampling frame was created from which a total of 22 interviews with caregivers were undertaken in early years community settings. The interview data was thematically analysed; the findings highlighted the mechanisms by which CCx served to mediate service and caregiver communication boundaries, negotiate access to spaces, and encouraged sustained engagement in longer term activities such as volunteering and training. Value was embedded by the CCx in their process of establishing and maintaining connections with caregivers through the ‘everyday’ conversations, their individualised approach and in demonstrating self-efficacy behaviours. Further research is required to review the impact of the CCx role in caregiver’s recall of early years information, nevertheless the study provided important learning for establishing formalised CCx programmes elsewhere, and has implications for community health and early years policy and practice.

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Applying What Evidence We Have: Support for Having Race Conversations in White U.S. Families

10.31234/osf.io/8dpru ◽

2021 ◽

Author(s):

Sylvia Perry ◽

Allison Skinner-Dorkenoo ◽

Jamie L Abaied ◽

Sara Waters

Keyword(s):

Racial Socialization ◽

Parental Socialization ◽

White Families ◽

Racial Biases ◽

Potential Benefits ◽

Outcomes For Children ◽

The Impact ◽

The U.S ◽

Parent Child

Popular press articles have advocated for parent-child conversations about race to prevent children from developing racial biases, yet empirical investigations of the impact of racial socialization in White families in the U.S. are scarce. Scott et al. (2020) warn that, given the lack of empirical evidence, parents might actually do more harm than good by talking to their children about race. In this comment, we draw upon the literature on (1) racial socialization, (2) parenting and parent-child discourse, and (3) the role of nonverbal communication in parental socialization to inform our understanding of parents’ ability to engage in race-related conversations in the absence of empirical guidance. We also highlight emerging evidence of the potential benefits of these conversations (even if parents are uncomfortable). In sum, the wealth of existing literature suggests that parents can successfully navigate challenging conversations with their children—which tends to result in better outcomes for children than avoiding those conversations. Thus, although we support Scott et al.’s call for researchers to develop more empirical research, we part with the authors’ assertion that White parents should wait to have these conversations with their children—we believe that the time to begin talking is now.

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The impact of the COVID-19 pandemic on child health

Journal of Laboratory Medicine ◽

10.1515/labmed-2021-0128 ◽

2021 ◽

Vol 45 (6) ◽

pp. 249-258

Author(s):

Ruud G. Nijman

Keyword(s):

Critical Care ◽

Emergency Care ◽

Clinical Signs ◽

Delayed Presentation ◽

Social Distancing ◽

Number Of Children ◽

Atypical Symptoms ◽

Outcomes For Children ◽

Cardinal Symptoms ◽

The Impact

Abstract Most Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections in children are mild or asymptomatic. Severe Coronavirus Disease 2019 (COVID-19) in children is infrequent. An estimated 0.3–1.3% of children with SARS-CoV-2 infection were admitted to hospital, and of these 13–23% needed critical care. SARS-CoV-2 related deaths were very rare in children, estimated at 2 per million. The vast majority of admitted children had one of shortness of breath, fever, and cough, but atypical symptoms are more common in children. Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) have been linked to SARS-CoV-2 infection. Cardinal symptoms include prolonged fever, clinical signs of inflammation, gastro-intestinal symptoms, and cardiac dysfunction. Twenty two to 80% of patients with MIS-C needed critical care; mortality of MIS-C is around 2%. Six to 24% of children with MIS-C had coronary artery dilatation or cardiac aneurysms. Equipoise still exists between first-line treatment with immunoglobulins and steroids. Outcomes for children with MIS-C are generally very good in those recognised early and started on appropriate treatment. Vaccination schemes for children are rapidly expanding, with the benefits of preventing severe COVID-19 disease and MIS-C and reducing community transmission outweighing the risks of adverse events of, amongst others, myocarditis temporally related to COVID-19 vaccination in children and young adults. The imposed social distancing measures reduced the overall number of children with acute illness or injury presenting to urgent and emergency care facilities worldwide. No clear signal was seen that large numbers of children had a delayed presentation to emergency care departments with a serious illness. The social distancing measures negatively impacted the mental health of children.

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The Impact of Dedicated Cardiac Intensive Care Units on Outcomes in Pediatric Cardiac Surgery: A Virtual Pediatric Systems Database Analysis

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1714718 ◽

2020 ◽

Author(s):

Dayanand N. Bagdure ◽

Jason W. Custer ◽

Cortney B. Foster ◽

William C. Blackwelder ◽

Vladimir Mishcherkin ◽

...

Keyword(s):

Cardiac Surgery ◽

Intensive Care ◽

Mortality Rate ◽

Intensive Care Units ◽

Risk Category ◽

Database Analysis ◽

Cardiac Intensive Care ◽

Outcomes For Children ◽

The Impact ◽

Risk Categories

AbstractCare of children undergoing cardiac surgery occurs in dedicated cardiac intensive care units (CICU) or mixed intensive care units. We analyzed data from Virtual Pediatric Systems (VPS, LLC) database (2009–2014) for children < 18 years of age undergoing cardiac surgery, classified according to Society of Thoracic Surgery–European Association of Cardiothoracic Surgery (STS-EACTS) risk category. We had 25,052 (52%) patients in 53 mixed units (mortality rate, 2.99%), and 22,762 (48%) patients in 19 dedicated CICUs (mortality rate, 2.62%). There was a direct relationship between STS-EACTS risk category and death rate in both units. By multivariable logistic and linear regression, there was no difference in mortality between mixed unit and CICU death rates within STS-EACTS risk categories. We found no difference in outcomes for children undergoing cardiac surgery based on the unit type (dedicated CICU or mixed unit).

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Children of Parents with a Mental Illness — The COPMI Project

Australian Journal of Guidance and Counselling ◽

10.1017/s1037291100004775 ◽

2003 ◽

Vol 13 (1) ◽

pp. 99-105

Author(s):

Elizabeth Fudge

Keyword(s):

Mental Health ◽

Mental Illness ◽

Health Outcomes ◽

Mental Health Problems ◽

Service Providers ◽

Good Practice ◽

Health Problems ◽

Mental Health Outcomes ◽

Outcomes For Children ◽

The Impact

When adults experience mental health problems, the effect on their family members can be immense. The impact on the person's children, both of the parent's behaviour and of their treatment, can be profound but is frequently overlooked by service providers for a range of reasons. The current national COPMI project has been initiated to promote better mental health outcomes for children of parents with a mental illness, especially by providing information and good practice guidance for services and people in the community who work with these families and their children.

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