Purpose: The purpose of this study is to describe children’s dental disease status and functional health literacy of families enrolled in the Child Health Investment Partnership program in Roanoke Valley. Methods: This was a prospective cohort study of children (n=166) enrolled in the Child Health Investment Partnership of Roanoke Valley, Virginia (CHIP). The parents of the 166 children completed the Life Skills Progression (LSP) survey at enrollment between September 2004 and September 2008 to assess their functional health literacy levels. Their LSP scores were used to determine their subsequent health care literacy (HCL), personal health literacy (PHL), and dental-child utilization (LSP22) scores. Descriptive statistics were recorded and a paired t-test was used to determine a relationship between the three measures of functional health literacy at baseline and at their most recent literacy assessment. Dental disease status was determined by an epidemiological dental exam and evaluated using d1d2-3f criteria. This was a visual exam that measured the presence of frank (d2-3) and non-cavitated carious lesions (d1), as well as filled teeth. Results: Descriptive analysis of the cohort reveals: 58% of the children enrolled had no carious teeth at the dental screening exam. The average mean of LSP scores for all three scales: HCL, PHL, and LSP22 were significantly different from baseline: p<.0001, p<.0009, and p<.0001, respectively. Conclusion: An improvement of parental functional health literacy has been documented in a low-income pediatric dental population when preventative efforts and education is delivered within the context of a home-visitation health program. The population of high-risk children had low levels of dental disease.

En av de största utmaningarna, inom folkhälsan, under 2000-talet beskrivs vara, övervikt och fetma hos barn. Sen år 1990 är ökningen alarmerande och detta främst i låg- och medelinkomstländerna. I Sverige har det främst varit en ökning av övervikt och fetma bland barn i en mer utsatt socioekonomisk bakgrund. Familjen och de levnadsvanor som följer barnet i uppväxten beskrivs vara avgörande, för om barnet utvecklar övervikt eller fetma. Sjuksköterskor har goda möjligheter, att komma i kontakt med hela familjen för att rådgöra samt stötta. Syftet med studien är att beskriva sjuksköterskors erfarenheter av att möta barn med övervikt samt deras familjer. En litteraturstudie genomfördes. Elva vetenskapliga artiklar, varav 9 med kvalitativ forskningsansats och 2 med kvantitativ forskningsansats, granskades och analyserades. Fyra teman och nio subteman identifierades. Resultatet visar att yrkesverksamma sjuksköterskor möter svårigheter, till dessa hör att övervikt tolereras och accepteras på ett annat sätt än tidigare, liksom livsstilsförändringar som innebär att vi idag är mer stillasittande. De ansåg sig väl positionerade för att ta hand om barnen med övervikt och fetma, men upplevde en osäkerhet för samtalet kring och med barnet, samt dess familj. Bristande riktlinjer på arbetsplatsen bidrog till färre antal samtal, med berörda föräldrar. Sjuksköterskorna upplevde en osäkerhet i den egna professionen, där mer utbildning önskades, dels i hur kommunikationen med barn och deras föräldrar kunde förbättras men även i ämnet övervikt. För att öka tryggheten hos sjuksköterskorna behövs tydlig arbetsbeskrivning och riktlinjer, mer utbildning, främst i kommunikation med barn och familj, men även ett förbättrat samarbete med andra yrkeskategorier.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / This study was undertaken to find out the factors which contributed to the difference in attendance and non- attendance of preschool children at a child health conference. It was conducted in an urban-suburban community in southeastern Rhode Island which had a population in 1960, of 14, 750 of whom 10. 5 percent were under five years of age. The sample was limited to eighteen mothers whose infants had been admitted to the child health conference during a three year period. Of these eighteen mothers, nine met the criteria for regular attendance, and nine met the criteria for non- attendance. An interview schedule and a check list of child health conference services for preschool children were developed to collect the data. Mothers in each of the two attendance groups were interviewed in their own homes by the investigator. [TRUNCATED] / 2031-01-01

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfilment of the requirements for the degree of Master of Science in Nursing Johannesburg, 2015 / Background: Despite the empirical evidence of the significance of weaning protocols in Intensive Care Units, variations still exist in the adoption of weaning protocols. Multidisciplinary teams hold the responsibility for the introduction and development of weaning protocols in PICU. Purpose: To explore and describe the opinions of multidisciplinary teams practicing in the paediatric and cardiothoracic ICU at an academic hospital in Johannesburg concerning weaning protocols from mechanical ventilation. Design: Qualitative descriptive. Method: Data was collected from multidisciplinary team comprising of registered nurses (n=8) and doctors (n=2) practicing in PICU and CTICU who were purposively selected using semi-structured interviews to obtain qualitative information on their opinions regarding weaning protocols. Data collected was analysed using a Braun and Clarke method of qualitative thematic analysis. Seven categories were identified in which three themes, which provided the fundamental structure of the findings for the discussion, emerged and included the following:  Unstructured weaning – the current practice.  Recognition of the need for weaning protocols.  Being not in favour of weaning. Results: The majority of the multidisciplinary team members recognise the need to develop weaning protocols in PICU for standardisation of practice. Currently there are no weaning protocols and a multidisciplinary approach was identified as an important strategy to develop the protocols. However, nurses practicing in PICU are not trained in Critical Care nursing which poses a challenge to the practice. Conclusion This study indicates that there is need for the development of weaning protocols in PICU. Although nurses are weaning patients in PICU, there are no standardised weaning protocols to guide the practice. The study therefore suggests the need to develop weaning protocols through multidisciplinary approach and training of nurses in critical care nursing to improve knowledge base and skills. Keywords: Mechanical ventilation, weaning, protocols, paediatric patients, opinions/perception and multidisciplinary team.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

BACKGROUND: Inflammatory bowel disease (IBD) is a group of conditions characterized by chronic inflammation of the gastrointestinal (GI) tract. A new diagnosis of IBD in children and adolescents can have significant psychosocial effects on both the patient and the family. Child and parental coping strategies play a crucial role in the adjustment to IBD, especially within the first year of the diagnosis. AIMS: The primary aim of the study was to assess the stability of coping measures over time in children and parents following a new pediatric IBD diagnosis. The study also aimed to assess the impact of parental coping on parental healthcare resource utilization for children with newly diagnosed IBD, as well as the impact of parental coping on anxiety, depression, and quality of life in children with newly diagnosed IBD. METHODS: This was a prospective, longitudinal cohort study at Boston Children’s Hospital (BCH) that focused on children and adolescents with newly diagnosed IBD, as well as their parents. Patients and their parents were approached at the time they enrolled in the study and then again about 12 months later as part of a one-year follow-up. At both time points, they were asked to fill out various questionnaires about psychological functioning and answer other questions about medical care. RESULTS: The study identified and encountered 465 IBD patients, of which 126 were eligible for recruitment. There were 70 patients and families who signed a consent form for enrollment, 55 who fully or partially completed the questionnaires at baseline, and only 5 who also completed the questionnaires at follow-up. Due to the limited number of participants who completed the questionnaires at follow-up, no definitive conclusions could be drawn about the stability of coping measures over time. Parental anxiety, parental depression, frequent parental stress, and difficult parental stress were all found to be positively correlated with healthcare utilization and negatively correlated with the child’s quality of life. Parental anxiety, frequent parental stress, and difficult parental stress were all found to be positively correlated with the child’s anxiety. Parental depression, frequent parental stress, and difficult parental stress were all found to be positively correlated with the child’s depression. CONCLUSION: Preliminary findings suggest that poor parental coping leads to decreased child quality of life and increased healthcare utilization, child anxiety, and child depression. A larger sample size is needed to accurately evaluate the stability of coping measures over time. The next steps for this study involve further examination of the impact of parental coping and enrollment of more patients and families.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01