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No description available.

Burgeoning numbers of child abuse and neglect reports throughout the developed world has prompted calls for preventive and early intervention measures to support and prepare families for parenting. Nurse home visiting is one form of service delivery gaining acceptance as an appropriate strategy. Although home visiting is not a new concept in service delivery, enthusiasm for home-visitation programmes has re-emerged not only in Australia in recent years, but in many other developed countries with initiatives being launched or recommended at state, national and international levels. This thesis presents a review of the tenets of home visiting and examines a home visiting intervention programme targeting children born into families with child abuse or neglect risk factors. A randomised controlled trial using a cohort of 181 families was undertaken to evaluate the impact of this home visiting programme. Mothers were recruited in the immediate postnatal period and allocated either into the home visiting programme or into a comparison group. The research design required self-identification into the study by providing positive responses to a range of risk factors. This procedure was shown to have utility in the context of recruitment to a research trial, in that respondents were willing to disclose sensitive personal issues using this form of screening as the basis for targeted intervention. The home visiting programme examined by this study was also shown to have social validity, with mothers willing to accept this form of intervention from the immediate postnatal period. High retention and satisfaction rates strengthened this conclusion. The ability of this study to evaluate the effectiveness of the home visiting intervention programme may have been compromised by a range of contextual factors influencing programme outcomes detailed in this thesis. Nonetheless, the study found that, for a group of families reporting risk factors for child abuse and neglect potential, provision of an intensive home visiting intervention using nurses, social workers, and parent aides was not effective in producing more favourable adjustment to the parenting role over time compared with nonintervention or clinic based service provision. The intervention programme group participants gained knowledge of child development and child management skills during the early postnatal weeks while the comparison group participants developed knowledge and skills later in the first year of their infant's lift. Early adaptation to the parenting role, parenting knowledge, and skill acquisition bodes well for parent-infant attachment and the children's long-term health and developmental outcomes. However, a 12-month assessment of maternal, family, and child development variables did not demonstrate maintenance of a positive intervention impact on parenting stress, parenting competence, or quality of the home environment. Finally, predictive analysis of fictors measured in the immediate postnatal period revealed an absence of any predictive value to demographic characteristics, which secondary prevention efforts typically target. These results not only demonstrate that there is a relationship between maternal, family and enviromnental factors identified in the immediate postnatal period, and adjustment to the parenting role, but also challenge demographic targeting for child abuse and neglect risk. Findings are discussed and placed within the context of previous research and reference is made to implications for future child health practice, development, and research. Recommendations arising from this discussion relate to both future research and community child health practice.

The purpose of this study was to determine whether participation in a Family Resource\Youth Services Center New and Expectant Parenting Series had an impact on maternal and child health knowledge of parents and their future behavior choices. The study had two components. First, a telephone survey was conducted with 40 past program participants asking them nine questions concerning behavior and lifestyle choices in regards to child safety, breast or bottle feeding, immunizations, car seat use, etc. Secondly, thirty participants were given a pretest and posttest questionnaire. As a control group, there were 25 Lamaze class participants, who also completed the pre-test and posttest questionnaires. The questionnaire was a 20 item multiple choice instrument (Learning About Parenting Survey or LAPS) which measured maternal and child health knowledge in such areas as family planning; informed parenting; maternal health; basic baby care; breast-feeding; bottle-feeding; first aid; child's health including immunizations, child safety; nutrition; child development and discipline. Analysis of covariance was performed using the LAPS raw scores from the posttests as the dependent variable, the pretest scores as the covariate and the treatment as the independent variable. The results showed no significant difference in parenting knowledge between the individuals enrolled in the Family Resource\Youth Services Center's New and Expectant Parenting Series and the comparison group who did not take the course.

Barnhälsovården i Sverige ska vara en resurs för alla familjer med barn upp till skolåldern. Syftet med studien var att undersöka hur adoptivföräldrar respektive biologiska föräldrar upplevde kontakten med barnhälsovården, vilka förväntningar de hade på barnhälsovården samt vilka olika insatser de blivit erbjudna. Dessutom undersöktes om föräldragrupperna hade olika behov när det gällde kontakten med barnhälsovården och hur de upplevde att deras behov uppfyllts. Studien är av kvalitativ design och intervjuer har genomförts både individuellt och i grupp med biologiska föräldrar och adoptivföräldrar. Resultatet visar att adoptivföräldrar förväntade sig och erbjöds färre insatser från barnhälsovården än biologiska föräldrar. En stor skillnad mellan grupperna var hur snart de träffade distriktssköterskan efter hemkomst med sitt barn, och hur ofta de besökte barnavårdscentralen. Biologiska föräldrar kunde bygga en förtroendefull relation med distriktssköterskan genom en tidig kontakt och täta besök i början. Adoptivföräldrarna saknade den möjligheten och upplevde dessutom att distriktssköterskan hade bristande kunskap om adoption och adoptivfamiljer. Tillsammans resulterade detta i att adoptivföräldrarna sällan sökte hjälp för annat än medicinska problem på barnavårdscentralen. Att adoptivföräldrarna erbjöds färre insatser skulle kunna bero på att barnhälsovårdens fokus låg på adoptivbarnets ålder vid hemkomst snarare än på familjens behov. / Child health services in Sweden are aimed at all families with children aged 0-6. The aim of this study was to investigate how adoptive parents and biological parents experience their contact with child health services, their expectations concerning the child health services and to what measures they had been invited. Furthermore it was investigated if the parent groups had different needs of the child health services and their experience of how these needs were supplied. The study has a qualitative design and individual interviews as well as group interviews have been conducted with biological parents and adoptive parents. The results show that adoptive parents expected and were offered less than biological parents from the child health services. There was a big difference between the parent groups in how soon they first met the district nurse after the family had returned home with their child, and how often they visited the child health centre. The biological parents could build a trusting relationship with the district nurse because they had an early start and frequent visits. The adoptive parents lacked this possibility and also felt that the district nurse lacked knowledge of adoption and adoptive families. Because of this the adoptive parents rarely sought help from the child health centre with other than medical problems. That the adoptive parents were offered less than biological parents were could depend on the focus of the child health services on the adoptive child´s age when the family returned home rather than on the needs of the family.

Bakgrund Sömn och matproblem är vanliga hos små barn. Bekymren kan vara stora och föräldrarna i behov av professionell hjälp. Barnavårdscentralerna har stor stöd- och hjälpfunktion men inte alltid resurser för detta. I Uppsala län finns en specialbarnavårdscentral som erbjuder råd och stöd vid dessa problem. Syfte med studien var att studera föräldrarnas bedömning av barnets sömn- eller matproblem före och efter kontakt med Special-BVC, samt om det fanns ett samband mellan antal kontakter och föräldrarnas bedömning av barnets situation efter avslutat kontakt. Metod Designen var en deskriptiv, komparativ studie där 67 av 102 (66 %) föräldrar besvarade frågor om förhållanden före och efter kontakt med Special-BVC. Resultat Inom flera områden minskade barnens sömn- eller matproblem efter kontakten med enheten. Emellertid bedömde föräldrar till barn med matproblem att dessa fortfarande var ett problem för barnet men inte för familjen medan barns problem gällande sömn minskat både för barnet och familjen. Diskussion Kvalitetssäkring av vårdverksamheters resultat är viktigt. Studien visade att Special-BVCs arbete ledde till en förbättrad situation för familjerna. Barnen hade haft sina problem länge, i genomsnitt tio månader. Många familjer borde kunna få hjälp på sin ordinarie BVC genom primärprevention eller genom tidiga sekundärpreventiva åtgärder. Special-BVCs arbetsmetodik borde därför spridas till den ordinarie BVC-verksamheten. / Background Sleeping and feeding problems are common in young children. The problem can be large and the parents need professional help. The Child Health Clinics aim to give help but hasn’t always enough resources. In Uppsala, a Specialist Child Health Team (Special-BVC) provides help to families with special needs. Aim was to study parents’ assessment of their child’s sleep or feeding problems before and after contact with "Special-BVC" and the relation between number of contacts and the child’s situation after the contact. Method The design was a descriptive, comparative study where 67 of 102 (66%) parents answered two questionnaires measuring the situation before and after contact with Special-BVC. Results In many areas the children's sleep or feeding problems decreased after the contact. Parents to children with food problems thought the child’s situation still was a problem for the child but not for the family, whereas parents to children with sleeping problems thought the problematic situation hade improved both for the child and the family. Discussion Quality assurance of care is important. The study showed the work done by Special-BVC improved the situation for the families. The children had had their problems a long time, an average of ten months. Many families should be help from their regular child health clinics through primary prevention or earlier secondary prevention. The working methods used at the Special-BVC should be disseminated to the regular child health clinics.

<p>More than 26,000 children under the age of 5 die every day on average, mostly in the developing world. Malnutrition accounts for up to half of those deaths, and diarrheal diseases account for another 17 per cent. The concentration of child malnutrition and diarrhea in developing countries should be of particular interest to sociologists because of the potential role of macro, structural and institutional forces in accounting for such cross-national disparities. This study focuses on country-level development, gender inequality, and democracy as three dimensions of structural violence that have important effects on child health in developing countries. In addition, the analysis also incorporates household and maternal characteristics that have already been shown to affect child health at the individual level. Using data from the Demographic and Health Surveys and several other archival sources, I conduct a multi-level analysis of young children nested in a sample of approximately 50 developing countries. Specifically, I estimate a series of hierarchical generalized linear logit models (HGLM) that predict the likelihood that a child is stunted, wasted, underweight, or has had a recent episode of diarrhea, based on a set of country- and individual-level explanatory variables. </p><p>The introduction in Chapter 1 describes the concept of "structural violence," the orienting theoretical framework for the dissertation. Chapter 2 combines several theoretical perspectives to examine the effects of household-level socioeconomic resources as well as country-level economic development, water, sanitation, health care, and education. Household wealth and maternal education are the most important predictors of child health at the individual level; whereas, GDP per capita, secondary school enrollment, and a "capability development" scale have the most robust effects at the country level. Chapter 3 focuses on women's decision-making and resource control by examining 5 aspects of gender inequality: education, employment, political participation, reproductive autonomy, and life expectancy. Taken together, the results demonstrate that child health is likely to be better in countries where women have more education, control over their reproduction, representation in national politics, as well as longer life expectancy. Finally, Chapter 4 explores the link between democracy and child health, paying particular attention to various ways of measuring democracy. Surprisingly, bivariate correlations between democracy and child health are weak, and multivariate models do not yield consistent or robust effects. Overall, this dissertation demonstrates how child health is embedded in social, political, and economic contexts of inequality larger than the individual that partially determine who faces increased health risk factors and who is protected from them.</p> / Dissertation

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 6 uppsatser.

Att adoptera och att bli adopterad kan vara en påfrestande livserfarenhet så stöd och hjälp frånbarnhälsovården, socialtjänsten, sjukvården och barnpsykiatrin kan bli nödvändig. Föreliggandestudie är en registerstudie och omfattar 50 221 barn, varav 440 adopterade, som är födda mellan1994-2007 och folkbokförda i Uppsala län. Syftet med studien är att undersöka om det finnsnågra skillnader i kontakten med BVC för adoptivbarn jämfört med biologiska barn vad gällerantal mottagningsbesök, antal hembesök, MPR vaccinationer, skickade remisser till barnläkare,psykolog, ortoptist, audiolog och logoped samt om barnen genomfört syn-, hörsel ochspråkscreening och utfallet på dessa screeningar. Logistiska- och linjära regressionsanlysergjordes och en del korrigerades för ålder. Adoptivbarnen fick både färre hembesök och färremottagningsbesök. Det var också lägre andel adoptivbarn som blev vaccinerade mot MPR. Vadgäller remisser skickades för adoptivbarnen högre andel remisser till BHV-psykolog, ortoptistoch till logoped. De biologiska barnen genomförde synscreening i högre grad. Adoptivbarnenfick i högre grad utfall på syn- och hörselscreening. Adoptivbarnen får i lägre utsträckning änbiologiska barn ta del av viktiga komponenter i svensk barnhälsovård vilket kan leda till sämrehälsa för gruppen på lång sikt. Vården behöver bli mer jämlik för adoptivbarnen och för attkomma till insikt om varför dessa skillnader finns behövs fler studier på området. / To adopt and to be adopted can be a distressing experience of life, and support from child healthcare, social services, health care and child psychiatry may be necessary. This study is aregister study and covers 50,221 children, of which 440 are adopted, born between 1994-2007 and registered in Uppsala län. The purpose of the study is to investigate if there areany differences in the contact with child health care for adopted children compared withbiological children as regards to the number of clinic visits, number of home visits, children whoare vaccinated with MMR, referrals to pediatricians, psychologists, orthoptist and speechtherapist and if the children perform the visual-, auditory-, and language screening and theoutcome of these screenings. Logistic- and linear regression analyzes were made and some werecorrected for age. The adoptees had both significantly fewer home visits and office visits than thebiological children. There were also a lower proportion of adopted children who were vaccinatedagainst MMR. The adopted children had significantly more referrals sent to the BHVpsychologist,the orthoptist and the speech therapist. Adopted children take a lesser part inimportant childcare components than biological children. This could lead to a worse health forthis group in the long term. The healthcare need to be more equal amongst children, and to getcloser to the cause of these differences more studies is needed.

No abstract available. / Thesis (M.Med.)-University of Natal, 1981.