scholarly journals Child Protection and Child Outcomes: Measuring the Effects of Foster Care

2007 ◽  
Vol 97 (5) ◽  
pp. 1583-1610 ◽  
Author(s):  
Joseph J Doyle
Keyword(s):  
Foster Care ◽  
Juvenile Delinquency ◽  
Child Protection ◽  
Instrumental Variable ◽  
Child Outcomes ◽  
Causal Effects ◽  
Older Children ◽  
Teen Motherhood ◽  
Long Term Outcomes

Little is known about the effects of placing children who are abused or neglected into foster care. This paper uses the placement tendency of child protection investigators as an instrumental variable to identify causal effects of foster care on long-term outcomes—including juvenile delinquency, teen motherhood, and employment—among children in Illinois where a rotational assignment process effectively randomizes families to investigators. Large marginal treatment effect estimates suggest caution in the interpretation, but the results suggest that children on the margin of placement tend to have better outcomes when they remain at home, especially older children. (JEL H75, I38, J13)

“Essential” services, risk, and child protection in the time of COVID-19: An opportunity to prioritize chronic need

2020 ◽  
Vol 2 (3) ◽  
pp. 208-223
Author(s):  
Johanna Caldwell ◽  
Ashleigh Delaye ◽  
Tonino Esposito ◽  
Tara Petti ◽  
Tara Black ◽  
...  
Keyword(s):  
Child Protection ◽  
Risk Mitigation ◽  
Children And Families ◽  
Long Term Outcomes ◽  
Public Health Response ◽  
Child Protection Workers ◽  
Health Response ◽  
Vulnerable Families ◽  
Essential Services

In many North American jurisdictions, socioeconomically vulnerable families are more likely to be involved with child protection systems and experience ongoing challenges. The current public health response to the COVID-19 pandemic is having a disproportionate impact on these families via unemployment, “essential” work, isolation, and closures of childcare and schools, with negative implications for children’s developmental wellbeing. Experts warn that while child protection referrals have gone down, children who are at risk of maltreatment are less exposed to typical reporters (e.g., school professionals). At the same time, physical distancing measures are prompting many human service settings to shift toward virtual intervention with children and families. In this commentary, we suggest that a focus on short-term risk in the response to COVID-19 may obscure support for children’s long-term outcomes. We propose two policy considerations: (1) in the immediate term, that child protection workers be deemed “essential”; and (2) in the longer term, that permanent, universal basic income guarantees be implemented to support a baseline of predictability both in families’ material wellbeing and in fiscal budgets in the case of a future crisis. As we write, it is impossible to predict the longevity of these closures nor the extent of their impact on children and families. However, the present article mirrors commentary following previous crises noting the importance of going beyond immediate health risk mitigation to consider wellbeing with regard to children’s development and families’ socioeconomic needs in the long term.

A Comparison of Ventriculoperitoneal and Ventriculoatrial Shunts in a Population of 544 Consecutive Pediatric Patients

Neurosurgery ◽  
2019 ◽  
Vol 87 (1) ◽  
pp. 80-85 ◽  
Author(s):  
George N Rymarczuk ◽  
Robert F Keating ◽  
Daniel J Coughlin ◽  
Daniel Felbaum ◽  
John S Myseros ◽  
...  
Keyword(s):  
Overall Survival ◽  
Pediatric Patients ◽  
Older Children ◽  
Long Term Outcomes ◽  
Single Institution ◽  
First Line ◽  
Pediatric Hydrocephalus ◽  
Csf Shunting ◽  
Similar Survival

Abstract BACKGROUND Although ventriculoperitoneal shunts (VPS) remain the first-line option in most instances of pediatric hydrocephalus, the long-term efficacy of ventriculoatrial shunts (VAS) remains unknown. OBJECTIVE To characterize the long-term outcomes and adverse occurrences associated with both VPS and VAS at our institution. METHODS The authors retrospectively analyzed all cerebrospinal fluid (CSF) shunting procedures performed over a 13-yr period at a single institution. A total of 544 pediatric shunt patients were followed for at least 90 d (VPS: 5.9 yr; VAS: 5.3 yr). RESULTS A total of 54% of VPS and 60% of VAS required at least 1 revision. VPS demonstrated superior survival overall; however, if electively scheduled VAS lengthening procedures are not considered true “failures,” no statistical difference is noted in overall survival (P = .08). VPS demonstrated significantly greater survival in patients less than 7 yr of age (P = .001), but showed no difference in older children (P = .4). VAS had a significantly lower rate of infection (P < .05) and proximal failure (P < .001). CONCLUSION VAS can be a useful alternative to VPS when the abdomen is unsuitable, particularly in older children. Although VPS demonstrates superior overall survival, it should be understood that elective VAS lengthening procedures are often necessary, especially in younger patients. If elective lengthening procedures are not considered true failures, then the devices show similar survival.

scholarly journals Clinical Features and Long-Term Follow-Up of Patients with Retinoblastoma in Turkish Children Older Than 5 Years of Age

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Zafer Cebeci ◽  
Samuray Tuncer ◽  
Rejin Kebudi
Keyword(s):  
Clinical Features ◽  
Treatment Options ◽  
Older Children ◽  
Long Term Outcomes ◽  
Turkish Children ◽  
Turkish Patient ◽  
Long Term Follow Up ◽  
Salvage Rate

Purpose. The diagnosis and management of retinoblastoma can be difficult in older children. This study reports the clinical features and long-term outcomes of such patients in a Turkish patient population. Methods. Medical records of 18 patients, between January 1992 and December 2017, were reviewed retrospectively. Results. Of 298 consecutive patients with retinoblastoma, 18 (6%) were at the age of 5 years and older. The median age at diagnosis was 9 years (range, 5–18 years). Misdiagnosis was noted in 8 patients (44.4%). Treatment options included enucleation in 16 patients (88.8%), adjuvant systemic chemotherapy in 3 (16.6%), intra-arterial chemotherapy in one (5.5%), and additional orbital irradiation in one (5.5%). After a median follow-up of 97 months (range, 6–252 months), all patients survived without any recurrence. Conclusions. Our series showed that 6% of patients with retinoblastoma were 5 years of age and older. Over a 15-year period, ocular salvage rate of 11.2% and survival rate of 100% were attained.

Abstract 17018: Amputation After Atherectomy: Studying Long-Term Outcomes Using an Instrumental Variable Method

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Niveditta Ramkumar ◽  
Jesse A Columbo ◽  
Pablo M Camblor ◽  
A. James O’Malley ◽  
Philip P Goodney
Keyword(s):  
Instrumental Variable ◽  
Primary Outcome ◽  
Cox Regression ◽  
Peripheral Vascular ◽  
Long Term Outcomes ◽  
Patient Demographics ◽  
Disease Characteristics ◽  
Instrumental Variable Method ◽  
Unmeasured Confounders

Introduction: Outcomes for atherectomy remain poorly characterized. Our objective was to use instrumental variable (IV) analysis to compare long-term amputation rates in patients receiving atherectomy versus other traditional peripheral vascular interventions (PVI) approaches. Methods: We queried the Medicare-linked Vascular Quality Initiative registry for patients undergoing PVI from 2010-2015. The exposure was treatment: atherectomy (+/- balloon angioplasty) versus other PVI types. The primary outcome was amputation. We used the proportion of atherectomy procedures of all PVIs performed at each hospital as an IV and compared the estimates from IV analysis to multivariable Cox regression and propensity-matched estimates. Results: In this cohort of 19693 patients, 2103 (10%) received atherectomy. Compared to patients receiving other PVI, patients receiving atherectomy were more likely to have a femoropopliteal artery (65% vs 48%, p<0.001) treated with worse disease severity (TASC B and greater: 77% vs 69%, p<0.001). The 5-year overall amputation rate was 31% (158 amputations per 1000 patients/year) in patients receiving atherectomy versus 24% (105 amputations per 1000 patients/year) for other PVIs (log-rank p<0.001). Without adjustment, patients undergoing atherectomy were 40% more likely to have an amputation (Figure 1). After adjusting for patient demographics, comorbidities, and disease characteristics, this effect was mitigated to 15% and 16% for multivariable Cox and propensity-matched approaches, respectively. However, after the IV adjusted analysis accounted for unmeasured confounders, patients receiving atherectomy versus non-atherectomy PVI were 78% more likely to have an amputation. Conclusions: Patients receiving atherectomy were more likely to have an amputation. Unmeasured confounders such as selection bias may play an important role in the long-term risk of amputation for patients undergoing atherectomy.

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.

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