Improving the Delivery of Prenatal Care and Outcomes of Pregnancy: A Randomized Trial of Nurse Home Visitation

PEDIATRICS ◽  
1986 ◽  
Vol 77 (1) ◽  
pp. 16-28 ◽  
Author(s):  
David L. Olds ◽  
Charles R. Henderson ◽  
Robert Tatelbaum ◽  
Robert Chamberlin
Keyword(s):  
Low Socioeconomic Status ◽  
Service Providers ◽  
Home Visitation ◽  
Community Services ◽  
Young Adolescents ◽  
Support Person ◽  
Developmental Problems ◽  
Nurse Home ◽  
Positive Effects ◽  
Wide Range

We evaluated a comprehensive program of prenatal and postpartum nurse home visitation. The program was designed to prevent a wide range of health and developmental problems in children born to primiparous women who were either teenagers, unmarried, or of low socioeconomic status. During pregnancy, women who were visited by nurses, compared with women randomly assigned to comparison groups, became aware of more community services; attended childbirth classes more frequently; made more extensive use of the nutritional supplementation program for women, infants, and children; made greater dietary improvements; reported that their babies' fathers became more interested in their pregnancies; were accompanied to the hospital by a support person during labor more frequently; reported talking more frequently to family members, friends, and service providers about their pregnancies and personal problems; and had fewer kidney infections. Positive effects of the program on birth weight and length of gestation were present for the offspring of young adolescents (<17 years of age) and smokers. In contrast to their comparison-group counterparts, young adolescents who were visited by nurses gave birth to newborns who were an average of 395 g heavier, and women who smoked and were visited by nurses exhibited a 75% reduction in the incidence of preterm delivery. (P ≤ .05 for all findings.

Preventing Child Abuse and Neglect: A Randomized Trial of Nurse Home Visitation

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 65-78 ◽  
Author(s):  
David L. Olds ◽  
Charles R. Henderson ◽  
Robert Chamberlin ◽  
Robert Tatelbaum
Keyword(s):  
Child Abuse ◽  
Emergency Room ◽  
Low Socioeconomic Status ◽  
Child Abuse And Neglect ◽  
Home Visitation ◽  
Developmental Problems ◽  
Care Giving ◽  
Wide Range ◽  
Abuse And Neglect ◽  
First Year Of Life

A program of prenatal and infancy home visitation by nurses was tested as a method of preventing a wide range of health and developmental problems in children born to primiparas who were either teenagers, unmarried, or of low socioeconomic status. Among the women at highest risk for care-giving dysfunction, those who were visited by a nurse had fewer instances of verified child abuse and neglect during the first 2 years of their children's lives (P = .07); they were observed in their homes to restrict and punish their children less frequently, and they provided more appropriate play materials; their babies were seen in the emergency room less frequently during the first year of life. During the second year of life, the babies of all nurse-visited women, regardless of the families' risk status, were seen in the emergency room fewer times, and they were seen by physicians less frequently for accidents and poisonings than comparison group babies (P ≤ .05 for all findings, except where indicated.) Treatment differences for child abuse and neglect and emergency room visits were more significant among women who had a lower sense of control over their lives.

Prevention of Intellectual Impairment in Children of Women Who Smoke Cigarettes During Pregnancy

PEDIATRICS ◽  
1994 ◽  
Vol 93 (2) ◽  
pp. 228-233 ◽  
Author(s):  
David L. Olds ◽  
Charles R. Henderson ◽  
Robert Tatelbaum
Keyword(s):  
New York ◽  
Home Visiting ◽  
Harmful Effect ◽  
Home Visitation ◽  
Intellectual Functioning ◽  
Positive Influence ◽  
Community Services ◽  
Smoking During Pregnancy ◽  
Nurse Home ◽  
Home Visiting Program

Objective. To analyze the influence of a comprehensive program of nurse home visitation on the intellectual functioning of children born to women who smoked cigarettes during pregnancy. Design. Randomized clinical trial. Treatment 1: sensory and developmental screening at ages 1 and 2 years; treatment 2: screening plus free transportation for prenatal and well-child care; treatment 3: screening, transportation, plus prenatal home visitation; treatment 4: screening, transportation, prenatal home visitation, plus postnatal home visitation through the children's second birthdays. Setting. Semirural community in Upstate New York. Participants. 400 families in which the mothers registered before the 30th week of pregnancy and had no previous live births. Eighty-five percent of the mothers were either teenagers, unmarried, or poor. Analysis was limited to whites, who constituted 89% of sample. Intervention. Nurse home visitation during pregnancy (treatments 3 and 4) or during pregnancy and the first 2 years of the child's life (treatment 4). During pregnancy, the nurses helped women improve their health-related behaviors, informal social support, and linkage with needed community services. Main findings. Children born to women who smoked 10 or more cigarettes per day at registration during pregnancy and who were assigned to treatments 3 and 4 had IQs (averaging across the 3rd and 4th years of life) that were 4.86 (95% CI: 0.47, 9.26) points higher after adjustment for covariates than did children born to women who smoked 10+ cigarettes per day and who were assigned to treatments 1 and 2. The positive influence of the home-visiting program on reducing the harmful effect of smoking appears to be due to prenatal visitation. Conclusion. Comprehensive prenatal home-visitation services can offset the impairment in intellectual functioning associated with substantial maternal smoking during pregnancy.

The Effects of Technology Supports on Community Grocery Shopping Skills for Students With Intellectual and Developmental Disabilities: A Meta-Analysis

2021 ◽  
pp. 016264342198997
Author(s):  
Sojung Jung ◽  
Ciara Ousley ◽  
David McNaughton ◽  
Pamela Wolfe
Keyword(s):  
Developmental Disabilities ◽  
Positive Impact ◽  
Single Case ◽  
Effect Sizes ◽  
Future Research ◽  
Intellectual And Developmental Disabilities ◽  
Positive Effects ◽  
Analytic Review ◽  
Wide Range ◽  
The Impact

In this meta-analytic review, we investigated the effects of technology supports on the acquisition of shopping skills for students with intellectual and developmental disabilities (IDD) between the ages of 5 and 24. Nineteen single-case experimental research studies, presented in 15 research articles, met the current study’s inclusion criteria and the What Works Clearinghouse (WWC) standards. An analysis of potential moderators was conducted, and we calculated effect sizes using Tau-U to examine the impact of age, diagnosis, and type of technology on the reported outcomes for the 56 participants. The results from the included studies provide evidence that a wide range of technology interventions had a positive impact on shopping performance. These positive effects were seen for individuals across a wide range of ages and disability types, and for a wide variety of shopping skills. The strongest effect sizes were observed for technologies that provided visual supports rather than just auditory support. We provide an interpretation of the findings, implications of the results, and recommended areas for future research.

scholarly journals Enhanced Bilosomal Properties Resulted in Optimum Pharmacological Effects by Increased Acidification Pathways

Pharmaceutics ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1184
Author(s):  
Armin Mooranian ◽  
Thomas Foster ◽  
Corina M Ionescu ◽  
Daniel Walker ◽  
Melissa Jones ◽  
...  
Keyword(s):  
Bile Acids ◽  
Biological Effects ◽  
Cellular Respiration ◽  
Full Potential ◽  
Protective Effects ◽  
Pharmacological Effects ◽  
Β Cells ◽  
Positive Effects ◽  
Wide Range ◽  
Anti Inflammatory

Introduction: Recent studies in our laboratory have shown that some bile acids, such as chenodeoxycholic acid (CDCA), can exert cellular protective effects when encapsulated with viable β-cells via anti-inflammatory and anti-oxidative stress mechanisms. However, to explore their full potential, formulating such bile acids (that are intrinsically lipophilic) can be challenging, particularly if larger doses are required for optimal pharmacological effects. One promising approach is the development of nano gels. Accordingly, this study aimed to examine biological effects of various concentrations of CDCA using various solubilising nano gel systems on encapsulated β-cells. Methods: Using our established cellular encapsulation system, the Ionic Gelation Vibrational Jet Flow technology, a wide range of CDCA β-cell capsules were produced and examined for morphological, biological, and inflammatory profiles. Results and Conclusion: Capsules’ morphology and topographic characteristics remained similar, regardless of CDCA or nano gel concentrations. The best pharmacological, anti-inflammatory, and cellular respiration, metabolism, and energy production effects were observed at high CDCA and nano gel concentrations, suggesting dose-dependent cellular protective and positive effects of CDCA when incorporated with high loading nano gel.

The role of organizational culture in the knowledge management process

2015 ◽  
Vol 19 (3) ◽  
pp. 433-455 ◽  
Author(s):  
Christina Ling-hsing Chang ◽  
Tung-Ching Lin
Keyword(s):  
Organizational Culture ◽  
Knowledge Management ◽  
Customer Service ◽  
Survey Methodology ◽  
Cultural Dimensions ◽  
Content Type ◽  
Knowledge Resources ◽  
Positive Effects ◽  
Wide Range ◽  
The Individual

Purpose – The purpose of the study is to focus on the enhancement of knowledge management (KM) performance and the relationship between organizational culture and KM process intention of individuals because of the diversity of organizational cultures (which include results-oriented, tightly controlled, job-oriented, closed system and professional-oriented cultures). Knowledge is a primary resource in organizations. If firms are able to effectively manage their knowledge resources, then a wide range of benefits can be reaped such as improved corporate efficiency, effectiveness, innovation and customer service. Design/methodology/approach – The survey methodology, which has the ability to enhance generalization of results (Dooley, 2001), was used to collect the data utilized in the testing of the research hypotheses. Findings – Results- and job-oriented cultures have positive effects on employee intention in the KM process (creation, storage, transfer and application), whereas a tightly controlled culture has negative effects. Research limitations/implications – However, it would have been better to use a longitudinal study to collect useful long-term data to understand how the KM process would be influenced when organizational culture dimensions are changed through/by management. This is the first limitation of this study. According to Mason and Pauleen (2003), KM culture is a powerful predictor of individual knowledge-sharing behavior, which is not included in this study. Thus, this is the second limitation of this paper. Moreover, national culture could be an important issue in the KM process (Jacks et al., 2012), which is the third limitation of this paper for not comprising it. Practical implications – In researchers’ point of view, results- and job-oriented cultures have positive effects, whereas a tightly controlled culture has a negative effect on the KM process intention of the individual. These findings provide evidences that challenge the perspective of Kayworth and Leidner (2003) on this issue. As for practitioners, management has a direction to modify their organizational culture to improve the performance of KM process. Social implications – Both behavioral and value perspectives of the organizational cultural dimensions (results-oriented, tightly control, job-oriented, sociability, solidarity, need for achievement and democracy) should be examined to ascertain their effects firstly on KM culture and then on the KM process intention of the individual. It is hoped that the current study will spawn future investigations that lead to the development of an integrated model which includes organizational culture, KM culture and the KM process intention of the individual. Originality/value – The results-oriented, loosely controlled and job-oriented cultures will improve the effectiveness of the KM process and will also increase employees’ satisfaction and willingness to stay with the organization.

The Registered Dietitian in Primary Care: The Hamilton Experience

2007 ◽  
Vol 68 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Wendy Gamblen ◽  
Sherri Schamehorn ◽  
Anne Marie Crustolo ◽  
Tracy Hussey ◽  
Nick Kates ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Interdisciplinary Collaboration ◽  
Community Services ◽  
Care Providers ◽  
Clinical Role ◽  
Nutrition Services ◽  
Wide Range ◽  
Canadian Health ◽  
Shared Care Model

The Hamilton Health Service Organization Nutrition Program integrates nine registered dietitians (RDs) into the offices of 80 family physicians (FPs) at 50 sites in Hamilton, Ontario. The program is based on a shared care model, in which FPs and RDs work collaboratively to provide nutrition services aimed at prevention, treatment, and management of nutrition-related problems. In addition to their clinical role, dietitians in the program are involved in health promotion, disease prevention and early intervention strategies, interdisciplinary collaboration, building links with community services, and research. The RDs’ specialized knowledge, skills, and experience allow them to provide a wide range of services that complement and augment those of the FP. This model is consistent with Canadian health care reform recommendations and offers significant benefits for both health care providers and consumers.

Effects of nurse home visitation on cigarette smoking, pregnancy outcomes and breastfeeding: A randomized controlled trial

Midwifery ◽  
2014 ◽  
Vol 30 (6) ◽  
pp. 688-695 ◽  
Author(s):  
Jamila Mejdoubi ◽  
Silvia C.C.M. van den Heijkant ◽  
Frank J.M. van Leerdam ◽  
Matty Crone ◽  
Alfons Crijnen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cigarette Smoking ◽  
Pregnancy Outcomes ◽  
Controlled Trial ◽  
Home Visitation ◽  
Nurse Home ◽  
Randomized Controlled

scholarly journals Long-term Effects of Prenatal and Infancy Nurse Home Visitation on the Life Course of Youths

2010 ◽  
Vol 164 (1) ◽  
Author(s):  
John Eckenrode ◽  
Mary Campa ◽  
Dennis W. Luckey ◽  
Charles R. Henderson ◽  
Robert Cole ◽  
...  
Keyword(s):  
Life Course ◽  
Home Visitation ◽  
Long Term Effects ◽  
Nurse Home ◽  
The Life Course

scholarly journals Management of workplace health & safety risks in new disability care arrangements

2014 ◽  
Vol 9 ◽  
Author(s):  
Sofia Stavropoulos
Keyword(s):  
Support Services ◽  
Service Providers ◽  
Health And Safety ◽  
Community Services ◽  
Online Information ◽  
Training Models ◽  
E Learning ◽  
Direct Guidance ◽  
The Individual ◽  
Types Of Information

The NDIS introduces changes to the level of control, choice and flexibility that persons with a disability can exercise over the services they require to support their individual needs. One of the main stays of NDIS is the ability for persons with a disability to utilise allocated funding how and with whom they choose to create a package of supports. Coinciding with the move towards the NDIS has been the introduction of the NSW WHS Act 2011. This Act introduces and broader new definitions relating to persons with responsibilities for ensuring health and safety at work. In some circumstances the individual person with a disability will be a direct employer, or an “other” in the workplace, and will take on responsibilities for health and safety for persons working in their home. For government organisations making funding decisions and allocating funds for the purchase of support services, there continues to be an obligation to ensure that services are conducted safely with risks to health adequately managed. NSW FACS can not “contract” out of their obligations. Instead we must work in partnership with all stakeholders to manage WHS risks as far as is reasonably practicable. Our role in government means we have the resources, experience, and must respond to the community expectation that we will support persons with a disability to understand and discharge their WHS obligations as far as is reasonably practicable. This is a way of operating presents the following questions: Do persons with disability understand the WHS obligations and risks associated with their care and supports? How to individuals with disability obtain sound advice and information on WHS risks that may be associated with their care arrangements? Can WHS information and resources that organisations like NSW Department of Family and Community Services (Ageing Disability and Home Care) have established be leverages to share with our “clients”? As Government partners in NDIS are we obligated to share our knowledge and information? What is the best way to bridge the gap in understanding and what types of information, tools and training can be made available on WHS for persons with a disability.A Joint WHS project currently underway within NSW FACS seeks to address the information and resources gap for all clients who participate in self directed funding arrangements (including NDIS). Our project will demonstrate how products and advice developed for internal staff use can be “reframed” and made accessible to persons with disability, their carers and individual service providers. The approach being applied within NSW FACS will potentially reduce costs in persons with disability being required to engage additional services to seek and develop WHS direct guidance and tools. The project being undertaken will deliver face to face training models, e-learning components and online information and tools to assist stakeholders in the NDIS and other Direct Funding Arrangements within NSW, to make informed decisions regarding WHS risk in the provision of care and support services. Guidance and information is provided on key risk areas utilising tested tools & WHS resources within the disability sector. E-learning solutions are made available to inform and train stakeholders of WHS obligations and potential risk management approaches. NSW FACS works with NGO stakeholders to ensure consistent advice and assistance is provided in the area of WHS obligations and performance expectations.

Does Prenatal and Infancy Nurse Home Visitation Have Enduring Effects on Qualities of Parental Caregiving and Child Health at 25 to 50 Months of Life?

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. 89-98 ◽  
Author(s):  
David L. Olds ◽  
Charles R. Henderson ◽  
Harriet Kitzman
Keyword(s):  
New York ◽  
Child Abuse ◽  
Comparison Group ◽  
Child Abuse And Neglect ◽  
Home Visitation ◽  
Health Department ◽  
Nurse Home ◽  
Upstate New York ◽  
Parental Caregiving ◽  
Abuse And Neglect

Objective. To examine, during the 3rd and 4th years of life, the health, development, rates of child maltreatment, and living conditions of children who had been enrolled in a randomized trial of nurse home visitation during pregnancy and first 2 years of their lives. Design. Prospective follow-up of families who had been randomly assigned to nurse-visited and comparison conditions. Setting. Study conducted in semirural community in upstate New York. Families dispersed among 14 other states during 2-year period after children's second birthdays. Participants. Four hundred women were recruited through a health department antepartum clinic and offices of private obstetricians and were registered before 30th week of pregnancy. All women had no previous live births and 85% were either teenaged (< 18 years at registration), unmarried, or from Hollingshead social classes IV or V. Analysis focused on whites, who comprised 89% of sample. Intervention. Nurse home visitation from pregnancy through second year of the child's life. Main Results. There were no treatment differences in the rates of child abuse and neglect or children's intellectual functioning from 25 to 48 months of age. Nurse-visited children, nevertheless, lived in homes with fewer hazards for children; they had 40% fewer injuries and ingestions and 45% fewer behavioral and parental coping problems noted in the physician record; and they made 35% fewer visits to the emergency department than did children in the comparison group. Nurse-visited mothers were observed to be more involved with and to punish their children to a greater extent than were mothers in the comparison group. The functional meaning of punishment differed between the nurse-visited and comparison families. Conclusions. The program does have enduring effects on certain aspects of parental caregiving, safety of the home, and children's use of the health care system, but it may be necessary to extend the length of the program for families at highest risk to produce lasting reductions in child abuse and neglect.

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