scholarly journals Can adoption at an early age protect children at risk from depression in adulthood? A Swedish national cohort study

2018 ◽  
Vol 2 (1) ◽  
pp. e000353
Author(s):  
Anders Hjern ◽  
Jesus Palacios ◽  
Bo Vinnerljung
Keyword(s):  
Foster Care ◽  
General Population ◽  
Psychiatric Care ◽  
Cox Regression ◽  
Adoptive Parents ◽  
Early Age ◽  
Children In Foster Care ◽  
Majority Population ◽  
Antidepressive Medication

ObjectiveOur aim was to investigate whether the risk of depression in adulthood in children raised by substitute parents from an early age differ by care arrangements.MethodsRegister study in Swedish national cohorts born 1972–1981, with three study groups of children raised in adoptive or foster homes with care starting before the age of 2 years and a comparison majority population group. Cox regression estimated HRs of prescribed antidepressive medication and specialised psychiatric care with a diagnosis of depression in adulthood during 2006–2012.ResultsCompared with the general population, long-term foster care carried the highest age-adjusted and sex-adjusted HR for both antidepressive medication, 2.07 (95% CI 1.87 to 2.28), and psychiatric care for depression, 2.85 (95% CI 2.42 to 3.35), in adulthood. Adults raised by adoptive parents were far more similar to the general population with HR of 1.19 (95% CI 1.00 to 1.43) for domestic and 1.13 (95% CI 1.08 to 1.18) for international adoption for antidepressive medication. Adjusting the analysis for school marks and income attenuated these risks more in the long-term foster care group.ConclusionThe study demonstrates the benefits of early adoption when substitute parents are provided for young children, and underlines the importance of improved educational support for children in foster care.

Long-Term Clinical Outcome in Elderly Patients Undergoing Mitral Valve Repair

2020 ◽  
Author(s):  
Julia Götte ◽  
Armin Zittermann ◽  
Kavous Hakim-Meibodi ◽  
Masatoshi Hata ◽  
Rene Schramm ◽  
...  
Keyword(s):  
Mitral Valve ◽  
General Population ◽  
Elderly Patients ◽  
Cox Regression ◽  
Functional Class ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Cox Regression Analysis

Abstract Background Long-term data on patients over 75 years undergoing mitral valve (MV) repair are scarce. At our high-volume institution, we, therefore, aimed to evaluate mortality, stroke risk, and reoperation rates in these patients. Methods We investigated clinical outcomes in 372 patients undergoing MV repair with (n = 115) or without (n = 257) tricuspid valve repair. The primary endpoint was the probability of survival up to a maximum follow-up of 9 years. Secondary clinical endpoints were stroke and reoperation of the MV during follow-up. Univariate and multivariable Cox regression analysis was performed to assess independent predictors of mortality. Mortality was also compared with the age- and sex-adjusted general population. Results During a median follow-up period of 37 months (range: 0.1–108 months), 90 patients died. The following parameters were independently associated with mortality: double valve repair (hazard ratio, confidence interval [HR, 95% CI]: 2.15, 1.37–3.36), advanced age (HR: 1.07, CI: 1.01–1.14 per year), diabetes (HR: 1.97, CI: 1.13–3.43), preoperative New York Heart Association (NYHA) functional class (HR: 1.41, CI: 1.01–1.97 per class), and operative creatininemax levels (HR: 1.32, CI: 1.13–1.55 per mg/dL). The risk of stroke in the isolated MV and double valve repair groups at postoperative year 5 was 5.0 and 4.1%, respectively (p = 0.65). The corresponding values for the risk of reoperation were 4.0 and 7.0%, respectively (p = 0.36). Nine-year survival was comparable with the general population (53.2 vs. 53.1%). Conclusion Various independent risk factors for mortality in elderly MV repair patients could be identified, but overall survival rates were similar to those of the general population. Consequently, our data indicates that repairing the MV in elderly patients represents a suitable and safe surgical approach.

Assessing the Health Status of Children Entering Foster Care

PEDIATRICS ◽  
1994 ◽  
Vol 93 (4) ◽  
pp. 594-601 ◽  
Author(s):  
Robin Chernoff ◽  
Terri Combs-Orme ◽  
Christina Risley-Curtiss ◽  
Alice Heisler
Keyword(s):  
Mental Health ◽  
Foster Care ◽  
Care Delivery ◽  
Cross Sectional ◽  
Children In Foster Care ◽  
High Prevalence ◽  
Complete Health ◽  
History Of ◽  
Short Time

Objective. Most research on health problems of children in foster care has been cross-sectional, resulting in overselection of children who have been in care long-term and underrepresentation of children who are in care for a short time. Methodology. This paper reports on the health of a large cohort of children who had complete health examinations at the time of entry into foster care in a middle-size city during a 2-year period. Results. Results indicate that >90% of the children had an abnormality in atleast one body system, 25% failed the vision screen, and 15% failed the hearing screen. The children were also lighter and shorter than the norm. Mental health screening revealed that 75% had a family history of mental illness or drug or alcohol abuse. Of children older than 3 years of age, 15% admitted to or were suspect for suicidal ideation and 7% for homicidal ideation. Of the children younger than 5 years of age, 23% had abnormal or suspect results on developmental screening examinations. At the time of entry into foster care, 12% of the children required an antibiotic. More than half needed urgent or nonurgent referrals for medical services and, for children >3 years of age, more than half needed urgent or nonurgent referrals for dental and mental health services. Just 12% of the children required only routine follow-up care. Conclusions. The high prevalence and broad range of health needs of children at the time they enter foster care necessitate the design and implementation of better models of health care delivery for children in foster care.

Foster Care and Adoption: Carer/Parent Hours Over and Above ‘Ordinary Parenting’

2011 ◽  
Vol 36 (2) ◽  
pp. 56-65 ◽  
Author(s):  
Catherine Forbes ◽  
Cas O'Neill ◽  
Cathy Humphreys ◽  
Susan Tregeagle ◽  
Elizabeth Cox
Keyword(s):  
Foster Care ◽  
Long Term Care ◽  
Adoptive Parents ◽  
First Year ◽  
Term Care ◽  
Home Based ◽  
Time Required ◽  
Time And Energy ◽  
Home Based Care

Caring for children in home-based care is seen as requiring considerably more time and energy from caregivers than is the case for most other children who are not in care. This article reports on a study that quantified the amount of time, over and above ‘ordinary parenting’, spent by 26 foster carers and prospective adoptive parents of children during a 9-month period in a program offering long-term care. The findings provide information that is potentially useful, not only in the debate about the decline in carer numbers, but also for agencies when they are recruiting, training and assessing prospective carers. Carers in the study spent an average of 55 minutes per day (or approximately 6 hours 22 minutes per 7-day week) on activities over and above the ordinary care of children. Carer time was highest for cases in the first year of placement when the average time was close to 2 hours per day. The tasks that took the greatest carer time, on average, were access visits, meeting with caseworkers, school- and tutoring-related matters, counselling and medical appointments, and organising respite care. Not surprisingly, more time was spent on children with challenging health and behavioural issues. Despite these differences in the average level of time required for each individual situation, the study also demonstrates that most carers experience days that are substantially taken up with their care responsibilities.

scholarly journals “STUDENTS FOR CHILDREN”: A VOLUNTEER PROGRAMME-MODEL FOR UNIVERSITIES FOR THE SUPPORT OF CHILDREN IN FOSTER CARE

2020 ◽  
Vol 11 (4.2) ◽  
pp. 1-12
Author(s):  
Gabriella Kulcsár ◽  
Judit Zeller ◽  
Beáta Korinek
Keyword(s):  
Foster Care ◽  
Social Interactions ◽  
Child Protection ◽  
Psychological Effects ◽  
Volunteer Work ◽  
Children In Foster Care ◽  
Elective Course ◽  
The University ◽  
University Settings

Foster care institutions are badly understaffed and operate on the lowest expected standards in terms of human resources in Hungary. In many cases, child protection personnel working with children in foster care do not have the necessary qualifications, and even those that do are often so overloaded with tasks that they cannot routinely engage in meaningful social interactions with the children. This paper introduces a unique and easily adaptable model of volunteer ,,work in university settings that aims to improve the situation of children in foster care. The Students for Children Volunteer Programme was founded in 2010 in the Faculty of Law at the University of Pécs, Hungary, and is now part of the curriculum there both as an elective course and as a cross-faculty programme. From the outset, the primary goal of this initiative has been to improve the situation of children in foster care through student mentoring by empowering them to manage everyday challenges and develop meaningful perspectives on their futures. Other equally important objectives are to enhance students’ social sensitivity and skills and to shape their thinking through this challenging work. Since its inception, the programme has been operating with unbroken success and, over the years, nearly 400 volunteers have completed the programme. The long-term plan is that through this model a country-wide network of similar volunteer programmes can be developed to improve the situation of children in need. Although aspects of the Students for Children programme still need to be refined, our experience with it shows that it has invaluable social, educational, and psychological effects on both the children and the future law professionals.

scholarly journals A national study of the impact of outpatient mental health services for children in long-term foster care

2010 ◽  
Vol 15 (4) ◽  
pp. 467-479 ◽  
Author(s):  
Jennifer L. Bellamy ◽  
Geetha Gopalan ◽  
Dorian E. Traube
Keyword(s):  
Mental Health ◽  
Foster Care ◽  
Mental Health Services ◽  
Health Services ◽  
The United States ◽  
Internalizing Behavior ◽  
Outpatient Mental Health ◽  
Children In Foster Care ◽  
The Impact

Despite the tremendous mental health need evidenced by children in foster care and high rates of use of mental health services among children in foster care, little is known about the impact of outpatient mental health services on the behavioral health of this population. This study utilizes data from the National Survey of Child and Adolescent Well-being (NSCAW), the first nationally representative study of child welfare in the United States. A subsample of 439 children who have experienced long-term foster care were included in this study. These data were used to estimate the impact of outpatient mental health services on the externalizing and internalizing behavior problems of children in long-term foster care. A propensity score matching model was employed to produce a robust estimate of the treatment effect. Results indicate that children who have experienced long-term foster care do not benefit from the receipt of outpatient mental health services. Study results are discussed in the context of earlier research on the quality of mental health services for children in foster care.

Foreign children in foster care (on the example of Bialskie region)

2018 ◽  
Vol 570 (5) ◽  
pp. 55-61
Author(s):  
Maria Ruszkowska ◽  
Beata Wołosiuk
Keyword(s):  
Foster Care ◽  
Education Institution ◽  
Refugee Children ◽  
Educational Institutions ◽  
Unaccompanied Minors ◽  
Family Situation ◽  
Children In Foster Care ◽  
The Status ◽  
The Subject

This publication concerns refugee children who are not adequately cared for by adults and come to foster care in Poland. "Unaccompanied foreign child" means a child who does not have Polish nationality and is without a statutory representative, i.e. a parent or a guardian. The publication contains information obtained through interviews conducted with three educators who are long-term employees of care and educational institutions in the Bialskie region. The subject of interest was the situation of unaccompanied minors coming to care and education institutions. The analyses included family situation of these children (along with the status of their parents), length of their stay in foster care, types of emerging educational and upbringing difficulties and the possibility of implementing intercultural education in a care and education institution.

scholarly journals The Impact of Waist Circumference on Incident of Cardiovascular Death During 9 Years of Follow Up in General Population

2021 ◽  
Author(s):  
Man Li ◽  
Shu-xia Wang ◽  
Yong-kang Su ◽  
Jin Sun ◽  
An-hang Zhang ◽  
...  
Keyword(s):  
Waist Circumference ◽  
General Population ◽  
Regression Models ◽  
Prognostic Value ◽  
Cox Regression ◽  
Cardiovascular Death ◽  
Kaplan Meier ◽  
Increased Risk

Abstract Background: Risk assessment is essential for the primary prevention of cardiovascular death among general population. Although studies have shown that waist circumference (WC) is positively associated with an increased risk of cardiovascular death among the general population, few studies have investigated the prognostic value of WC during a long-term follow up and the risk threshold of WC remains controversial. We aimed to investigate whether higher level of WC measurements was able to predict mortality in general population.Methods: In this prospective cohort study, a total of 1521 consecutive subjects free of clinical cardiovascular disease were included. The end point was cardiovascular death. The Kaplan-Meier method was used to evaluate the cumulative risk of outcome at different WC levels, and compared by log-rank tests. Univariate and multivariable-adjusted Cox regression models were used to investigate the association between WC and outcomes.Results: During a median follow up of 9.2 years, there were 265 patients died. Kaplan-Meier survival estimates indicated that the patients with higher levels of WC (WC> 94cm) had a significantly increased risk of cardiovascular death (log-rank p＜0.001). After adjustment for potential confounders, multiple COX regression models showed that higher level of WC was an independent predictor in developing cardiovascular death (HR 3.02; 95% CI: 1.88–3.83; p＜0.001). We saw a significant increase of (area under the curve) AUC in ROC (receiver operating characteristic) curve after addition of WC to a clinical model, for long-term cardiovascular death the increase of AUC 0.766 vs 0.642 (95% CI: 0.787–0.846 p＜0.001). The addition of WC to established risk factors significantly improved risk prediction of cardiovascular death (net reclassification index, and integrated discrimination improvement, all p＜0.05).Conclusion: Higher level of WC is significantly associated with long-term cardiovascular death. WC may provide incremental prognostic value beyond traditional risks factors.

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