RESUMEN
A retrospective study of the stool patterns of 68 infants was conducted. The sample included 34 infants who developed necrotizing enterocolitis (NEC) and 34 infants who did not. The objective was to compare the stool patterns of the two groups. Data regarding number and characteristics of stools; time, types, and methods of feeding; feeding additives; and demographic information were extracted from inpatient medical records. Length of time between the passage of the first stool and initiation of the first feeding in the two groups was compared using the Wilcoxin Rank Sum Test. Findings were statistically significant (p = .008). Numbers of stools were compared using the Fisher Exact Test. Findings were significantly greater for the NEC group. Infants in the NEC group had 26 percent more stools and more than twice as many seedy stools as infants in the non-NEC group.
Asunto(s)
Defecación/fisiología , Enterocolitis Seudomembranosa/fisiopatología , Heces/microbiología , Enterocolitis Seudomembranosa/diagnóstico , Enterocolitis Seudomembranosa/microbiología , Enterocolitis Seudomembranosa/enfermería , Femenino , Humanos , Recién Nacido , Masculino , Enfermería Neonatal , Evaluación en Enfermería/métodos , Valor Predictivo de las Pruebas , Estudios RetrospectivosRESUMEN
This pilot study used medical records to examine the health outcomes of children receiving care in Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program. Medical records from 76 children seen for EPSDT visits during a 6-month period were reviewed to assess whether health problems were identified and whether treatment, follow-up, or referral care was provided. Health problems were identified for 43% of the children; 22% received treatment, and 18% were referred for specialty care. Checkups uncovered fewer problems than would be expected in a poor, largely minority population. Almost one third of the children referred for specialty care apparently did not receive such care. The study verified the need for further research and provides direction for future study.
Asunto(s)
Servicios de Salud del Niño/organización & administración , Medicaid , Servicios Preventivos de Salud/organización & administración , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , North Carolina , Evaluación de Procesos y Resultados en Atención de Salud , Proyectos Piloto , Evaluación de Programas y Proyectos de Salud , Derivación y Consulta , Estados UnidosRESUMEN
OBJECTIVES: To determine whether parents of student athletes plan to use the preparticipation physical examination (PPE) as their student athlete's only annual health evaluation, to identify factors associated with this decision, and to assess their knowledge about the objectives of PPEs and more comprehensive examinations. DESIGN: Survey. SETTING: General community, school-sponsored PPEs. PARTICIPANTS: A convenience sample of parents or guardians of high school student athletes who obtained a school-sponsored, multiple-station format PPE were surveyed by using an anonymous paper-and-pencil questionnaire. Questionnaires were completed by the parents of 381 of 763 student athletes who obtained PPEs (participation rate, 49.9%). RESULTS: Thirty percent of the parents in this sample planned to use the PPE as their student athlete's only contact with a health care provider. Parents whose adolescent's health insurance provided for comprehensive health assessments were more likely than those without this benefit to plan a comprehensive care evaluation (75% vs 60%, respectively) (P = .01 by chi 2 analysis). In addition to addressing problems that might affect sports participation, parents thought that the PPE visit should evaluate medical problems that are unrelated to athletics (34%), perform health screening procedures (22%), assess social or behavioral issues (16%), and provide immunizations (7%). CONCLUSIONS: Many parents plan to use the PPE as their student athlete's only scheduled contact with a health care provider; this decision may be influenced by factors that are related to access to health care and misperceptions with regard to the mission of these specialized examinations. For these adolescents, important medical, social, and behavioral needs may not be met. Consideration should be given to including elements of the PPE in health assessments that are performed by individual clinicians or expanding the scope of large-group, multiple-station format PPEs.
Asunto(s)
Padres , Examen Físico , Deportes , Adolescente , Adulto , Actitud Frente a la Salud , Femenino , Humanos , Masculino , Persona de Mediana Edad , Instituciones Académicas , Estudiantes , Encuestas y CuestionariosRESUMEN
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) is a Medicaid program designed to provide comprehensive well child care for children from low-income families. Each EPSDT checkup should include a physical examination; medical history; assessment of development, nutrition, and immunizations; assessment of hearing, vision, and dental status; and anticipatory guidance. This pilot study of the medical records of 76 children receiving EPSDT checkups in six rural counties in North Carolina provided a preliminary assessment of whether EPSDT checkups included the required components. The study showed that health care providers frequently did not provide adequate documentation of the care provided at the checkup, and it raised questions as to whether children received the required components of the EPSDT checkup.
Asunto(s)
Servicios de Salud del Niño/normas , Tamizaje Masivo/normas , Medicaid , Calidad de la Atención de Salud , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Auditoría Médica , Proyectos Piloto , Estados UnidosRESUMEN
The concept 'failure to thrive' (FTT) has been in the pediatric and child development/child psychiatry literature for many years. Recently it has appeared in the medical literature in relation to malnutrition, weight loss and depression. This paper draws upon the wider concept as applied to infants and young children, as well as on relevant gerontological literature, to analyse FTT as it relates to elderly people. Attributes, antecedents and consequences are identified. Case studies that illustrate the attributes, some of the attributes, or none of the attributes are provided.
Asunto(s)
Anciano , Insuficiencia de Crecimiento , Adaptación Psicológica , Anciano/psicología , Anciano de 80 o más Años , Preescolar , Dependencia Psicológica , Insuficiencia de Crecimiento/enfermería , Insuficiencia de Crecimiento/psicología , Femenino , Humanos , Lactante , Masculino , Modelos Biológicos , Modelos Psicológicos , Apoyo SocialRESUMEN
This article reports the results of an investigation of nurses' stereotypes of child abusers. Ninety-four registered nurses completed a questionnaire that measured subjects' knowledge of child abuse; professional contact with perpetrators and victims of abuse; knowledge of the causes of child abuse; and child abuser stereotypes. Results reveal a consensus among the subjects as to the stereotypes associated with child abusers. This study supports the notion that nurses stereotype individuals on the basis of demographic characteristics. This study also raises questions regarding the bias that may result from the use of child abuser stereotypes. Clinical decision-making processes could become compromised if biased judgements are used in planning nursing care for clients diagnosed as child abusers.