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1
Berthelsen, Donna. "An ecology of centre-based child care." Thesis, Queensland University of Technology, 1997. https://eprints.qut.edu.au/36555/6/36555_Digitised%20Thesis.pdf.
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The studies in the thesis were derived from a program of research focused on centre-based child care in Australia. The studies constituted an ecological analysis as they examined proximal and distal factors which have the potential to affect children's developmental opportunities (Bronfenbrenner, 1979). The project was conducted in thirty-two child care centres located in south-east Queensland. Participants in the research included staff members at the centres, families using the centres and their children. The first study described the personal and professional characteristics of one hundred and forty-four child care workers, as well as their job satisfaction and job
commitment. Factors impinging on the stability of care afforded to children were examined, specifically child care workers' intentions to leave their current position and actual staff turnover at a twelve month follow-up. This is an ecosystem analysis (Bronfenbrenner & Crouter, 1983), as it examined the world of work for carers; a setting not directly involving the developing child, but which has
implications for children's experiences. Staff job satisfaction was focused on working with children and other adults, including parents and colleagues. Involvement with children was reported as being the most rewarding aspect of the work. This intrinsic satisfaction was enough to sustain caregivers' efforts to maintain their employment in child care programs. It was found that, while improving working conditions may help to reduce turnover, it is likely that
moderate turnover rates will remain as child care staff work in relatively small centres and they leave in order to improve career prospects. Departure from a child care job appeared to be as much about improving career opportunities or changing personal circumstances, as it was about poor wages and working conditions. In the second study, factors that influence maternal satisfaction with child care
arrangements were examined. The focus included examination of the nature and qualities of parental interaction with staff. This was a mesosystem analysis
(Bronfenbrenner & Crouter, 1983), as it considered the links between family and child care settings. Two hundred and twenty-two questionnaires were returned from mothers whose children were enrolled in the participating centres. It was found that maternal satisfaction with child care encompassed the domains of child-centred and parent-centred satisfaction. The nature and range of responses in the quantitative and qualitative data indicated that these parents were genuinely satisfied with their children's care. In the prediction of maternal satisfaction with
child care, single parents, mothers with high role satisfaction, and mothers who were satisfied with the frequency of staff contact and degree of supportive
communication had higher levels of satisfaction with their child care arrangements. The third study described the structural and process variations within child care programs and examined program differences for compliance with regulations and differences by profit status of the centre, as a microsystem analysis (Bronfenbrenner, 1979). Observations were made in eighty-three programs which
served children from two to five years. The results of the study affirmed beliefs that nonprofit centres are superior in the quality of care provided, although this was not to a level which meant that the care in for-profit centres was inadequate. Regulation of structural features of child care programs, per se, did not guarantee higher quality child care as measured by global or process indicators.
The final study represented an integration of a range of influences in child care and family settings which may impact on development. Features of child care programs which predict children's social and cognitive development, while taking into account child and family characteristics, were identified. Results were consistent with other research findings which show that child and family
characteristics and child care quality predict children's development. Child care quality was more important to the prediction of social development, while family
factors appeared to be more predictive of cognitive/language development. An influential variable predictive of development was the period of time which the
child had been in the centre. This highlighted the importance of the stability of child care arrangements. Child care quality features which had most influence
were global ratings of the qualities of the program environment. However, results need to be interpreted cautiously as the explained variance in the predictive models developed was low. The results of these studies are discussed in terms of the implications for practice and future research. Considerations for an expanded view of ecological approaches to child care research are outlined. Issues discussed include the need to generate child care research which is relevant to social policy development, the
implications of market driven policies for child care services, professionalism and professionalisation of child care work, and the need to reconceptualise child care
research when the goal is to develop greater theoretical understanding about child care environments and developmental processes.
2
Witt, Kendra Elizabeth Marie. "Evaluation of a nutrition program targeting child care centers." To access this resource online via ProQuest Dissertations and Theses @ UTEP, 2008. http://0-proquest.umi.com.lib.utep.edu/login?COPT=REJTPTU0YmImSU5UPTAmVkVSPTI=&clientId=2515.
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Fraser, Alexander Watson. "The evaluation of Fraserburgh Children's Home with new child care policies : an illuminative evaluation." Thesis, University of Aberdeen, 1989. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU031317.
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This Thesis is divided into five parts. Part One introduces the terms by which Fraserburgh Children's Home (FCH) was evaluated, and also gives a definition of, and a description of the methods used to collect evidence in illuminative evaluation. The structure of the thesis is also introduced. In Chapter One, we introduce and define terms. These are, 'integrated' and 'unintegrated ethos', 'siltation' and 'erosion', 'anti-institutional bias', 'open imperatives' and 'closed imperatives'. It is then asserted that FCH failed to achieve some of its objectives because; FCH had an 'unintegrated ethos', it thus suffered from cumulative dysfunction, involving 'siltation' and 'erosion'. This process was initiated by the 'anti-institutional bias'. In Chapter Two, illuminative evaluation is outlined, and the structure of the thesis is presented, namely, that Part Two deals with 'the instructional system', that is, the historical and intellectual antecedents of FCH and its original aims and objectives. In Part Three the 'care milieu', between 1982 and 1984 is given. In Part Four, some measures of output are given. Part Two outlines the history of the 'anti-institutional bias', and through an examination of the immediate 'instructional system' at FCH, argues that FCH was significantly affected by this bias. The 'instructional system' of FCH created a theoretical and ideological vacuity which provided the basis for 'unintegrated ethos'. Part Three provides evidence relating to staff reaction to this theoretical and ideological vacuity and demonstrates the cumulative dysfunction arising from this; pointing out the processes of 'siltation' and 'erosion' which affected FCH during 1982-84, and leading to an 'unintegrated ethos'. Part Four attempts to measure the consequences of this situation by noting the movement away from original aims and objectives. Particular attention is paid to the nature of the admission procedure, durations of stay and community links, although other measures are included. Part Five summarises and concludes the thesis, and outlines the implications for innovation and adaptation in residential child care.
4
Davis, David C. (David Carlton). "Four Types of Day Care and their Effects on the Well-Being of Children." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc279199/.
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Data gathered from Tyler, Texas, the University of North Texas, and the National Survey of Families and Households (NSFH) were used to compare children from commercial, home, church, and university based day care with children not attending day care. The research group, comprised of children attending day care (N=142), were located using non-probability sampling; those not in day care (the control group) came from the NSFH (N=1775). Data from the research group were weighted to match the control group. The independent and control variables included the child's age, length of time in day care, intellectual functioning; the parent's marital status and social class; the day care's staff to child ratio and the staff's training. All data, except that pertaining to the facility itself, were gathered from the children's parents using a self-report questionnaire. The remaining data were gathered through personal interview by the researcher. The dependent variable was an index of emotional and behavioral problems reported for the child. Overall, children who attended day care had only slightly more problems reported than those who did had not attended day care. When each center was examined separately, the children in home centers had the greatest number of problems, followed by the commercial centers and university center, with children from the church centers scoring the lowest. In contrast to earlier research, intellectual functioning was not enhanced by the day care experience. While the staff's training had a statistically significant relationship to the children's well-being, no relationship was found for the staff to child ratio. Further research on the impact of other characteristics of each type of day care is recommended.
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Kelleher, Killarney, University of Western Sydney, and Faculty of Health. "Evaluation of the Cottage Community Care Pilot Project." THESIS_FH_XXX_Kelleher_K.xml, 1999. http://handle.uws.edu.au:8081/1959.7/743.
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The outcomes of a child protection/family support programme, the Cottage Community Care Pilot Project, were evaluated in this study. The evaluation employed a non-equivalent comparison group design of 'at risk' consenting first-time mothers in the perinatal period with babies up to 6 weeks of age. Ninety-three families were recruited and 58 of these were matched with a trained volunteer home visitor. Analysis of assessment items and questionnaires, reviews of hospital records and the Department of Community Services Child abuse and neglect notification register and focus groups with mothers and volunteers provided the information used in this study. The CCCP had an impact on particular aspects of family function, certain infant and maternal health indices and the families' use of community services, but its contribution to reducing the incidence of child abuse and neglect is less clear. Client and volunteer feedback indicated support for the programme. While home visitation by trained volunteers is not proposed as the total answer for effective child protection or family support, the findings of this evaluation suggest that there is a place for similar programmes.Master of Science (Hons)
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Benjamin, Sara Elizabeth Ward Dianne Stanton. "Promoting healthy weight in child care pilot testing, training methodology, and instrument evaluation /." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2006. http://dc.lib.unc.edu/u?/etd,690.
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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2006.Title from electronic title page (viewed Oct. 10, 2007). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Nutrition in the Schools of Public Health and Medicine." Discipline: Nutrition; Department/School: Public Health; Medicine.
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Li, Jun. "The use of child health computing systems in primary preventive care : an evaluation." Thesis, University College London (University of London), 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274686.
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Elliott, Roslyn, University of Western Sydney, of Arts Education and Social Sciences College, and School of Education and Early Childhood Studies. "The book is open but you can't turn the page: parents' perceptions of early childhood service quality." THESIS_CAESS_EEC_Elliot_R.xml, 2003. http://handle.uws.edu.au:8081/1959.7/800.
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This research examines parents’ perceptions of quality on early childhood services as they support families in the care and education of children. Data were collected from parents of under school-aged children using interviews, questionnaires and focus groups. Data analysis has enabled a determination of: the link between parents’ perceptions of quality and early childhood professionals’ views as expressed in the literature; parents’ satisfaction with services and the evaluation processes used by them; opportunities available to parents to engage with service staff to influence the quality of the services provided; and parents’ knowledge and use of the information services provided by the National Childcare Accreditation Council to assist them in their decision making regarding early childhood services. Results showed that communication between parents and staff is problematic. An accretion model of communication is developed to enhance the quality of early childhood services by promoting shared understanding and values between parents and staff, enabling parents to take part in decision making and minimising perceptions of threat to staff’s professional integrityUniversity of Western Sydney
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Glazer, Courtney Anne, and Adrianne Marie Vance. "Process evaluation of treatment with adolescents in residential treatment foster care." CSUSB ScholarWorks, 2006. https://scholarworks.lib.csusb.edu/etd-project/3067.
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As the number of children in foster care without a familial placement continues to grow, the child welfare system is turning towards a new placement approach called Residential Treatment Foster Care. This study performed a process evaluation of 30 Residential Treatment Foster Care facilities in Los Angeles County that explored the four characteristics of case plan design, team decision-making, therapeutic intervention, staff training, and overall treatment effectiveness with regards to the number of Absences Without Leave (AWOL) and completion of treatment plan.
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Menzies, Peter, and de Sande Adje van. ""A formative evaluation of the Customary Care Program: Native Child and Family Services of Toronto"." School of Native Human Services, 2003. http://142.51.24.159/dspace/handle/10219/432.
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Across Canada, the percentage of First Nations children in care of child welfare authorities is estimated to be six times that of the general population (Royal Commission on Aboriginal Peoples, Volume 3: Gathering Strength, 1996). Research into the impact of removing children from their homes due to child welfare issues has contributed to our understanding of the significant negative consequences on both the child and family (Bowlby, 1982; Johnson, 1983; Olsen, 1982). Further studies into the impact of government policies on Native people have clearly demonstrated that Native children face additional trauma; not only is the child removed from their home, they are removed from their community and culture (Andres, 1981; Bagley, 1985; Hudson, 1981; Johnston, 1983; Richard, 1989).
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Kelleher, Larni. "Evaluation of the Cottage Community Care Pilot Project /." View thesis View thesis, 1999. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030519.145848/index.html.
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Thesis (M.Sc.) (Honours) -- University of Western Sydney, Macarthur, 1999.A thesis presented to the University of Western Sydney, Macarthur, in partial fulfillment of the requirements for the degree of Master of Science (Honours), March, 1999. Bibliography : leaves 117-125.
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Evans, Lauren B., and L. Lee Glenn. "Type II Error and Evaluation of Kangaroo Care in Tertiary Neonatal Units." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7461.
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Banks, Kristina L. "Process Evaluation of Group Well Child Visits for One-Month-Old Infants." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1460750207.
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Perazzo, Lauren. "Barriers to Medication Adherence Following Pediatric Renal Transplantation: The Utility of Independent and Interrelated Parent and Child Reports." Xavier University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1396372473.
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Agere, Leonard Munyaradzi. "An evaluation of the role of child and youth care centres in the implementation of South Africa’s children’s act." Thesis, University of Fort Hare, 2014. http://hdl.handle.net/10353/d1015406.
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The aim of this study was to evaluate the role played by CYCCs to provide support and protection to children who have been found to be in need of care, according to the criteria given in the Children’s Act No. 38/2005 as amended. The study made use of a qualitative approach and the research design was provided by the case study. Data was gathered by means of semi-structured interviews and focus group discussions. The most important findings to emerge from the study were that the factors which affect the operation of CYCCs are either institutional, or else challenges arising from issues pertaining to infrastructure and human resources. However, it was also acknowledged that, despite the challenges which affect their ability to provide their services to young people, the CYCCs had also made progressive steps to halt the suppression of the fundamental rights of children. It has been recommended that the government should apply comprehensive funding to the objectives of the Children’s Act, which would entail increasing the subsidies to CYCCs. It has also been recommended that the Policy on Financial Rewards should call for the same benefits and salary scales to apply for professional staff working in the government and to those working in the CYCCs. The repercussions from failing to adjust to these recommendations will inevitably lead to the employment of a remedial model of care.
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Egan, Diana Ray, and Meri Lynn Vandom. "Kin caregivers' perceptions of social worker and agency services and support." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2783.
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Investigates kin caregiver's perceptions about social workers and child welfare agencies they worked with in caring for court dependent relative children who are/were placed in their care. A stratified random sample from 150 interviews of kin caregivers with dependent relative children maintained by San Bernardino and Riverside County Child Protective Services allowed for qualitative analysis of interview responses that related kin caregiver's perceptions of social workers and social service agencies. Results indicate that some relative caregivers were satisfied with the support they received from social workers/agency staff, while others did not feel supported at all.
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Gurganus, Jill Renee. "An evaluation of educational literature distributed by the Child Health Investment Partnership." Thesis, Virginia Tech, 1993. http://hdl.handle.net/10919/46306.
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Educational literature distributed by the Child Health Investment Partnership (CHIP) staff to CHIP parents was identified and evaluated in terms of readability level and availability of information to assist with meeting the identified needs of CHIP parents. One-hundred percent (n=137) of the educational material available to CHIP staff through their library was analyzed. Readability levels were calculated by using the SMOG Readability Formula and the FRY Graph Reading Level Index.
A previous study (Brindle, 1992) was used to determine whether CHIP had adequate material to meet the educational needs of CHIP families. Forty-eight percent of CHIP parents cited health as their primary concern. Almost one-half of an educational literature stocked in CHIP's library relates to health. Thus, results indicate that CHIP has a more than adequate amount of educational literature relating to topics CHIP parents believed they needed assistance with the most. It was found, however, that other areas such as financial and job assistance were underrepresented in CHIP's library. While 36 percent and 35 percent of CHIP parents believed they needed assistance with finances and jobs, respectively, only 6 percent of CHIP's library was devoted to financial assistance and two percent was devoted to job assistance. The apparent need for assistance in these areas greatly outweighs CHIP's educational resources. Results also indicate that the average CHIP parents (one who has completed high school) has the education equivalent to or more than was required for reading the majority of CHIP's educational literature. While the mean Reading Level of educational materials was at the tenth grade level sixty percent of CHIP families surveyed had completed high school. Results and conclusions are discussed in detail.Master of Science
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Aluha, Roselidah Anyango. "Evaluation of the food service for adolescent boys in Mogale Child and Youth Care Centre in Gauteng, South Africa, 2012." Diss., University of Pretoria, 2013. http://hdl.handle.net/2263/43670.
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The study was carried out at the Mogale Child and Youth Care Centre (MCYCC) a privately run institution by Bosasa Operations in partnership with the Gauteng Provincial Departments of Social Development and Health and Social Welfare Department. The facility caters for boys in conflict with law aged 14–18 years, who have been legally placed in the facility as a place of safety by court order. It is expected that the findings and recommendations from this study will be useful in improving the food service standards for such institutions. At the time of this study there were 200 adolescents, 137 were awaiting trial, 55 on the diversion programmes and 8 were serving court sentence at the centre.
The cross sectional study evaluated the food service offered at the MCYCC to establish the nutritional adequacy of the food served. Both qualitative and quantitative research methods were used to collect and analyse data. Out of the 200, 144 answered the customer satisfaction questionnaire and 167 took the BMI test. Observations were done in the kitchen to determine the compliance level to the food and safety regulations.
The analytical results of the responses from the self-administered questionnaire on the customer service satisfaction generated by the SAS software revealed reliable results. The probability, (p-value) from the Chi-square (χ2) test showed that there was a significant difference in response the parameters tested including the overall satisfaction. Body Mass Index (BMI) calculations established different anthropometric patterns of which 1.3% adolescents were found to be obese, 28.2% were overweight, 57% had normal weight while 13.5% were found to be underweight. The Foodfinder 3 software used to evaluate the nutrient composition in a 2-week cycle menu revealed that in most cases both the macronutrients and micronutrients in the menus exceeded the recommended daily allowance (RDA) for the adolescent boys. Food safety and hygiene standards results showed that the unit is compliant with the required standards as it scored 86%; it was colour coded Silver and rated as very good.
All the parameters evaluated scored above average percentage rating the customer satisfaction level for the services offered at the MCYCC are as good. Both underweight and overweight adolescents exist among the adolescents at the centre. The weights from the sample food plates exceeded the RDA of the adolescent boys. The centre’s compliance to health and safety regulations was rated as very good. The authorities in the Gauteng Provincial Departments of Social Development and Health and Social Welfare and Bosasa operation management should make use of this evident information to further improve the food service standards for other such institutions.Dissertation (MSc)--University of Pretoria, 2014.
gm2015
School of Health Systems and Public Health (SHSPH)
MSc
Unrestricted
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McLean, Cathy. "Evaluation of an emotional awareness programme for children in middle childhood in a child and youth care centre in Pretoria." Diss., University of Pretoria, 2015. http://hdl.handle.net/2263/53437.
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Emotional awareness, a pre-requisite for emotional intelligence, encompasses being in contact with, as well as effectively expressing and owning one s emotions, and is critical to the holistic functioning of children. Children in the middle childhood years are primed for learning as they have entered their formal schooling years, thereby not only needing to learn to read and write but to interact with peers and adults in a socially acceptable manner.
Children in child and youth care centres have unique challenges in coping with and overcoming the emotions caused by the circumstances that have brought them into care. Emotional awareness, and the potential benefits for children s socio-emotional skills, can be to the advantage of these children.
It is believed that emotional awareness can be taught through specific interventions, such as programmes aimed at enhancing children s skills in identifying, understanding and effectively expressing their emotions. The goal of this study was to evaluate such a programme, referred to in this study as an Emotional Awareness Programme for children in middle childhood, to be implemented within the context of a child and youth care centre. The Emotional Awareness Programme was implemented over two months at a child and youth care centre in Pretoria.
The study followed a quantitative research approach, with a quasi-experimental comparison group pre-test post-test research design. Data was collected by means of a standardised measuring instrument, the Levels of Emotional Awareness Scale for Children (LEAS-C).
The findings of the study suggested that the exposure of participants of middle childhood age in a child and youth care centre to the Emotional Awareness Programme had a limited effect on their emotional awareness. However, this effect could not be exclusively ascribed to the programme. As the context of the child and youth care centre and the traumatic experiences of children in alternative care could have an effect on the implementation of the Emotional Awareness Programme as well as on the measurement of emotional awareness, and as such, further research on the topic of this study is recommended. It is recommended that the study be replicated in other child and youth care centres.Mini Dissertation (MSW)--University of Pretoria, 2015.
Social Work and Criminology
MSW
Unrestricted
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Prill, Hollie Rae. "The quality of the family day care setting and its effects on children's social and cognitive play behaviors." CSUSB ScholarWorks, 1998. https://scholarworks.lib.csusb.edu/etd-project/1670.
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au, Glenn Cupit@unisa edu, and Christopher Glenn Cupit. "Spiritual development and the public educative care of children: a critical evaluation of biblical and dynamic systems perspectives." Murdoch University, 2002. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20051129.114720.
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A useful model of spiritual development in the public educative care of children must: specify the meaning and nature of spirituality; clarify its relationship to an underlying ontology; identify in what sense spirituality is developmental; be consistent with a justifiable paradigm of human development; explain the role and status of such spiritual development with a secular system of educative care; and specify practical implications flowing from these matters.
Using narrative criticism within an evangelical framework, the biblical descriptions of spirituality and childhood were critically examined as a basis for such a model. Biblical spirituality was developmental and was identified with encounters, usually naturally mediated, between human spirits and God's Spirit, and spirits which alienate from God's Spirit. All children, without qualification of belief, community, rite or age, were identified as spirits who share a special relationship with God's Spirit both ontologically and experientially. Biblical childhood was not defined chronologically but functionally by inability to take responsibility for one's own spiritual life because of openness to God's and other spirits.
Principles of 'magician systems' in Dynamic Systems Theory parallel phenomena of human development and those commonly designated as spiritual. Consequently, a dynamic model of spiritual development is proposed which is consonant with biblical teaching and grounded in an established scientific paradigm. This indicates that spirituality is an inescapable aspect of any educative care setting or system and need not be introduced as though children lack it. Spiritually salient aspects of educative care will lead children to spiritual encounters which are derivative of a positive life affirming principle or fundamentally destructive and alienating. These aspects encompass the spiritual ontology of the setting, the children, the personnel, the physical environment, the nature and quality of relationships, the curriculum, religious activities, the nurture provided, and the wider context, all of which are of spiritual moment.
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Diggs, Jessica Carmelita. "The imact of Medicaid expansion initiatives and county characteristics on the health and healthcare access of Ohio's children." Connect to text online, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=case1144677107.
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Thesis (Ph. D.)--Case Western Reserve University, 2006.[School of Medicine] Department of Epidemiology and Biostatistics. Includes bibliographical references. Available online via OhioLINK's ETD Center.
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De, Waal Alet. "Evaluation of an emotional awareness programme for children in middle childhood in a child and youth care centre in the North-West Province." Diss., University of Pretoria, 2015. http://hdl.handle.net/2263/53400.
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The focus of this study was to evaluate an emotional awareness programme for children in middle childhood in a school setting developed by Dr JS Knoetze. This research measured the effectiveness of the emotional awareness programme (EA Programme) in a different context, a child and youth care centre. The goal of the EA Programme is to cultivate children?s emotional awareness. The Gestalt theoretical approach rendered itself pragmatic to this study as various key concepts of this theory was integrated into the academic underpinnings.
Emotional awareness benefits children in the sense that they are more equipped to handle stressful events. Children with emotional awareness demonstrate introspective skills and have a better understanding of emotions in their social contexts. They are better able to apply functional emotional regulation strategies which in turn nurture personal goal attainment and positive relationships with others.
The advances in terms or their cognitive skills of children in middle childhood allow a better understanding of emotions and create an ideal platform for socio-emotional learning. Children in this phase of development have mastered the skills of reading, writing and reasoning, which are necessary to understand and participate in the EA Programme.
Emotional awareness is specifically important for children who reside in a child and youth care centre. These children were exposed to some degree of trauma and experience the placement in alternative care in itself as disruptive. The literature describes the challenges children in a child and youth care centre face, which supports the assumption that interventions are needed to assist these children to develop effective emotional regulation strategies. The EA Programme is regarded as such an intervention. This investigation was executed from a quantitative research approach as the relationship between two variables was measured. The data was collected by using a standardised measuring instrument, the Levels of Emotional Awareness Scale for Children (LEAS-C). The researched is catagorised as applied research as it focused an issue in practice, namely emotional awareness of children in alternative care.
The quasi-experimental design that was followed was the comparison group pre-test, post-test design. This entailed that both groups completed the pre-test after which the experimental group was exposed to the EA Programme, then both groups completed the post-test. The availability sampling method was applied to select the respondents who were children in middle childhood residing in a child and youth care centre in the North-West Province.
The LEAS-C is a standardised questionnaire that was developed by Dr. Jane Bajgar and Dr. Richard Lane (2003). The questionnaire is suitable to be completed by children as the questions are formulated in understandable language.
The main conclusions drawn from this study are:
? Emotional awareness forms a central building block of the development of emotional intelligence, emotional competence and emotional regulation. Emotional awareness is regarded as a cognitive ability that can be learnt in order to develop other emotional abilities.
? Children placed in a child and youth care centre are specifically at risk to develop impaired emotional functioning as a result of trauma, maltreatment and the care-giving environment. Their disorganised emotional experiences translate into complex behavioural issues. Children placed in a child and youth care centre could specifically benefit from a programme, such as the EA Programme, that focus on nurturing skills that enhance emotional awareness.
? The research findings suggest that the EA Programme increased the experimental group?s ability to be in contact with own emotions, their emotional vocabulary and emotional expression skills as well as their levels of emotional awareness. The EA Programme can be delivered as an effective intervention within the context of a child and youth care centre.
? The findings and conclusions derived from this study made a meaningful contribution to the field of social work as it focused on evaluating an intervention. This research specifically contributed to social work service delivery to looked after children in institutional settings.Mini Dissertation (MSW)--University of Pretoria, 2015.
Social Work and Criminology
MSW
Unrestricted
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Hassanali, Khadija. "The United States Foster Care System: An Analysis of Racial Inequality and Privatization Efforts." Scholarship @ Claremont, 2017. http://scholarship.claremont.edu/cmc_theses/1688.
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This paper investigates two aspects of the United States Foster Care System: racial inequality and privatization. Investigating the racial disproportionality of foster care children reveals that racial inequalities result from disproportionate rates of child maltreatment among minority children. The extended lengths of stay of minority children and difficulties in placing minority children in adoptive homes reveal that racial biases can impact the system, and overcoming these biases requires reforming child welfare either through developing orphanages, altering pay structures, racial matching, or privatization. Privatization, however, does not always result in improved quality and reduced costs. This paper analyzes the state-wide privatization initiative of Kansas and prison privatization movement to draw recommendations about the efficacy of future privatization efforts in the child welfare space.
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Gumpo, Hlalani. "A theory-driven evaluation of an early childhood school readiness programme in an under-served area in the Western Cape Province." Doctoral thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/27858.
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Early childhood development, care and education interventions coordinate resources and services that are aimed at stimulating growth for young children. Resource constraints in low and middle-income countries contribute towards a lag in childhood development initiatives compared to high-income countries. This thesis focused on the context of South Africa where the government has a long-term objective of ensuring that all children have access to quality services. However, the attainment of this goal is currently not a financially viable option, and many community-based organisations resort to alternative provisions of early childhood interventions to ensure that poor children are served. This thesis investigated implementation and associated outcomes for the Family in Focus (FiF) programme. This home-based early education programme that is targeted at young children between the ages of 0-6 years, who live in poor and marginalised communities where access and resources for care and stimulation are limited, was the programme of interest. A small sample theory-driven evaluation approach was applied to this programme to assess its viability to alleviate service access issues and produce meaningful outcomes for marginalised children. Evaluation questions were posed and a descriptive research design and a pre-post non-equivalent group quasi-experimental design that compared the results of the FiF programme to a traditional pre-school were utilised. Qualitative descriptions, descriptive statistics (mean and standard deviation) and inferential statistics (t-tests) were used to analyse the results. The FiF programme theory, although not initially clearly defined, was found to be plausible with moderate change expected for the beneficiaries of the programme. The programme, however, had a very low implementation fidelity level of 37.5%, meaning that the programme was not being implemented according to design. This was further associated with poor outcomes for the small sample of children in the FiF programme group utilised. Across the five developmental outcomes of cognitive, language, motor, social and emotional development, outcomes were particularly poor for the first three development domains against South African norms and the comparison group used in the evaluation. Early childhood education home-visiting programmes have the ultimate goal of improving child development outcomes. However, evidence shows that these programmes seem to be more successful in improving parenting skills and caregiver coping, without reaching the former ultimate goal. The comprehensive approach to assessing child development in underserved areas in this evaluation provided a novel overview of the interaction of multiple factors in school readiness in impoverished communities. There is still a lingering question as to the benefits of home visiting programmes that are increasingly being implemented across the country as an alternative provision of early childhood care and education services.
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Braz, Janaina Carvalho. "Avaliação da atenção às crianças menores de um ano na Estratégia Saúde da Família em um município da Bahia, sob a ótica dos cuidadores." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-15012013-113853/.
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As políticas públicas de atenção à criança no Brasil têm se aprimorado com vistas à qualidade do cuidado integral. Este estudo objetivou avaliar a presença e extensão dos atributos da Atenção Primária à Saúde (APS) e o grau de afiliação do usuário na Estratégia Saúde da Família (ESF), a partir da ótica dos cuidadores com a assistência prestada a crianças menores de um ano de idade. Trata-se de uma pesquisa quantitativa, transversal com dados coletados mediante uso do Instrumento de Avaliação da Atenção Primária (PCATool - infantil). Foram entrevistados 271 cuidadores cujas crianças pertenciam às áreas de abrangência das 13 equipes de saúde da família da zona urbana de Vitória da Conquista - BA. Os escores foram atribuídos para 10 dimensões da APS. Os resultados revelaram escores elevados para apenas quatro dimensões: grau de afiliação, acesso de primeiro contato (utilização), longitudinalidade e coordenação (sistema de informação). As outras dimensões apresentaram baixos valores de escore, tais como: o acesso de primeiro contato (acessibilidade), a coordenação (integração de cuidados), a integralidade (serviços disponíveis e prestados), a orientação familiar e a orientação comunitária. Ao avaliar as dimensões em conjunto encontramos os escores essencial e geral com baixos valores. Concluímos que a ESF, apesar de ser um cenário preferencial para as ações de promoção e prevenção à saúde e se constituir como porta de entrada para os serviços, não tem alcançado uma assistência à criança com ênfase no cuidado integral.Public policies on childcare in Brazil have been enhanced to promote quality on comprehensive care. This study aimed to evaluate the presence and extent of the attributes of the Primary Health Care (PHC) and the degree of user affiliation in Family Health Strategy (FHS) from the perspective of caregivers with the care provided to children under one year of age. This is a quantitative, cross-sectional study which data were collected using Primary Care Assessment Tool (PCATool). We interviewed 271 caregivers whose children belong to the areas of 13 family health teams in the urban area of Vitoria da Conquista - BA. The scores were assigned to 10 dimensions of APS. The results revealed high scores for only four dimensions: degree of affiliation, first contact access (use of service), longitudinality and coordination (information system). Other dimensions had low score values such as: first contact access (accessibility), coordination (integrated care), comprehensiveness (services available and services provided), and family and community orientation. By assessing the dimensions together we found low values for the essential and general scores. We conclude that despite FHS has being a preferred scenario for the actions of health promotion and disease prevention and gateway to health services FHS has not been attained the child care with emphasis on comprehensive care
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Ezechukwu, Rebecca Nneoma. "Negotiating (Un)Heard Voices: Exploring A Fourth Generation Evaluation Approach to Examining the Wraparound Process." Oxford, Ohio : Miami University, 2009. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1260316500.
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Schaefer, Jay M. "Is "good" good enough? a small area variation analysis of disparity in expressed rates of access to and satisfaction with child and adolescent healthcare services in east Central Florida." Doctoral diss., University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/4603.
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Further research specific to these phenomenon encompassing a clearer understanding of the type of care received and the individual's specific experiences with their healthcare providers was recommended, with ensuing research to better identify commonalities of interactions with specific area providers, local restrictions imposed by area insurance carriers, influences caused by language and/or cultural barriers, and the like as drivers in understanding the individual dynamics of satisfaction.; The purpose of this dissertation research was to explore indications of disparities within the east Central Florida child and adolescent healthcare services market. Structured as a follow-up study to work completed in 2005 under the direction of the Health Council of East Central Florida assessing parental perceptions of community child and adolescent healthcare services, this research extended that evaluation by aggregating participant responses at the county and small area zip code group levels, contextually testing the uniformity of responses in understanding parent perceptions of access to, and satisfaction with, community healthcare service offerings available for children and adolescents. Under a variety of methodologies significance in the responses concerning access to healthcare services were demonstrated between the counties studied. Statistical modeling, however, could not demonstrate the core demographic differences among these data. Data representing perceptions of satisfaction with the services received by children and adolescents were demonstrated at the small area zip code group level within Orange county. Primary effect assessment of the demographic variables representing these respondents yielded findings generally consistent with theoretical expectations of disparity but, notably, the correlation effects between a number of key independent variables demonstrated a mediation of the primary effects on overall perception of satisfaction. Specifically, it was demonstrated that the interaction of white race with possession of private healthcare insurance, and the interaction of greater levels of educational attainment with black race, caused a proportional reduction in the predicted satisfaction score of these survey respondent cohorts.ID: 029050697; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (Ph.D.)--University of Central Florida, 2010.; Includes bibliographical references (p. 117-123).
Ph.D.
Doctorate
Health and Public Affairs
Public Affairs
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Lau, Wai-ha Abby, and 劉慧霞. "Structural equation modeling of the child perceptions questionnaire measuring oral health-related quality of life of children in HongKong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40988089.
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Brind'Amour, Katherine. "Maternal and Child Health Home Visiting Evaluations Using Large, Pre-Existing Data Sets." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1468965739.
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Chong, Kelly. "Psychometric analysis and evaluation of Iowa medicaid adult and child enrollees' experiences with health care using the beta version of the CAHPS® 4.0 health plan survey." Diss., Restricted to subscribing institutions, 2008. http://proquest.umi.com/pqdweb?did=1666128111&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Habulembe, Raider. "Evaluation of the effect of poor water, sanitation and hygiene practices on growth and the incidence of infectious diseases in infants and young children aged 6-23 months in a selected rural district, Zambia." University of the Western Cape, 2018. http://hdl.handle.net/11394/6430.
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Philosophiae Doctor - PhD (School of Public Health)Poor water, sanitation and hygiene (WASH) services and practices in communities are known to be responsible for most of the infections occurring among infants and young children in developing countries. A combined effect of disease, poor diet, care practices and other factors among infants/children are known to lead to undernutrition reported in most developing countries. Apart from the reduced growth and productivity potential that malnutrition exhibits on the affected population, it is also an underlying cause to 50% of child mortality in poor communities. In light of this, the primary objective of the study was to evaluate the effect of poor WASH practices on growth and infectious disease incidence in infants and young children aged 6-23 months in the rural district of Monze in Zambia.
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Sanine, Patricia Rodrigues. "Dos diferentes significados sociais do “ser criança” aos contextos gerenciais na organização da atenção à saúde da criança em serviços de atenção primária." Botucatu, 2018. http://hdl.handle.net/11449/153224.
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Orientador: Elen Rose Lodeiro CastanheiraResumo: A atenção à saúde da criança está entre as ações mais tradicionais e bem estruturadas na Atenção Primária à Saúde (APS) no Brasil, entretanto deve-se reconhecer que as relações entre as necessidades sociais de saúde desse grupo e as práticas a ele dirigidas foram construídas de diferentes maneiras ao longo da história. O reconhecimento desse processo mostra-se importante para identificar quais necessidades sociais de saúde estão sendo respondidas pelas práticas atuais. Apesar dos grandes avanços alcançados, como a redução das taxas de mortalidade infantil, indicadores de atenção à saúde da criança apontam a necessidade de melhorias, como nas taxas de internações por causas evitáveis pela APS, no crescente número de afecções originadas no período perinatal e na atenção ao parto. Avaliar a qualidade da organização da atenção, a partir do projeto contemporâneo para a saúde desse segmento, permite julgar a base material do projeto social em execução pelas práticas. O presente trabalho tem por objetivos: reconhecer a construção histórica do significado social de “ser criança” no Brasil e avaliar a capacidade de resposta dos serviços de APS às necessidades sociais de saúde das crianças. Os estudos foram apresentados na forma de 3 artigos. Parte de um ensaio alicerçado em revisão bibliográfica e na análise de sua correlação com as práticas de saúde pública voltadas à criança, privilegiando-se as ações desenvolvidas na APS (Artigo 1). A avaliação da organização das ações de atenção à... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The child health care in Brazil is among the most traditional and well-structured actions in Primary Health Care (PHC). However, it must be acknowledged that the child's health needs and practices directed at children have been constructed differently. Recognition of this construction process is important in identifying what needs are being replicated by current practices. Indicators of child care show poor performance, as in the rates of hospitalizations for sensitive conditions by PHC and the increasing number of conditions originating in the perinatal period. Evaluating the quality of the organization of child health care today allows us to judge the material basis of the social project being implemented by the practices. The objective of the study is: to recognize the historical construction of the social meaning of being a child in Brazil; and to assess the responsiveness of PHC services to the health needs of children. Three articles were presented. The first is an essay based on a bibliographical review and the analysis of its correlation with the health practices/public of the child, with a focus on PHC actions (Article 1). Then, an evaluation of the organization of actions of children's health care in PHC services in the interior of the State of São Paulo/Brazil was carried out, using two cross-sectional evaluative surveys. The first one sought to identify changes in child health care in the years 2007/2010/2014. It evaluated 86 services from 32 municipalities that r... (Complete abstract click electronic access below)
Doutor
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Bronsard, Guillaume. "Evaluation en santé mentale chez les adolescents placés : L’épidémiologie à la relance de la pédopsychiatrie dans le champ de l’enfance en danger." Thesis, Aix-Marseille, 2012. http://www.theses.fr/2012AIXM5028/document.
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250 000 enfants sont impliqués dans les dispositifs de l'Aide Sociale à l'Enfance ; 135 000 sont placés. Ils devraient présenter des taux élevés de troubles mentaux car la raison principale qui conduit au placement, le dysfonctionnement familial sévère et durable, est aussi un facteur de risque largement reconnu au développement de la plupart des troubles mentaux survenant dans l'enfance. Les rares études d'épidémiologie pédopsychiatrique réalisées auprès de cette population spécifique et repérable dans quelques pays anglo-saxons et germaniques, affirment effectivement des taux dépassant volontiers les 50%. Ces enfants sont paradoxalement peu pris en charge par les dispositifs de pédopsychiatrie, car la place des parents, ici défaillants, y est en général essentielle et l'articulation entre les professionnels des champs socio-éducatif et médico-psychologique est médiocre. Le contact avec les services de pédopsychiatrie se fait volontiers par les urgences en situation de crise comportementale. Après avoir décrit l'histoire de la « protection de l'enfance » et de la pédopsychiatrie, notamment leur construction concomitante et entremêlée à partir du 19ème siècle, nous analysons les points favorisant et défavorisant leur rencontre. Nous envisageons aussi les possibilités et les freins à la recherche scientifique en milieu socio-éducatif. Nous présentons ensuite les résultats de deux études menées auprès d'adolescents placés en foyers du département des Bouches-du-Rhône : une étude de prévalence des troubles mentaux et une étude de leur Qualité de la Vie et des liens de ces valeurs avec les troubles mentaux250 000 children and adolescents are involved in the child welfare system in France. 135 000 are living in « out-of-home care ». These children should have high rates of mental disorders because the severe familial dysfonction which drive them in these social institutions is a wellknown risk factor for the main mental disorders too. Prevalence studies of mental disorders among this very specific population are rares and have been held in anglo-saxon or germanics countries. They show mental disorders rates above 50%. However, their access to regular mental services is weak, because of failing parents and the poverty of the partnerships between social workers and child mental health professionals. These adolescents often meet child psychiatry through emergency during a behavioral crisis. We describe, in a first part, the history of child welfare system and of the child psychiatry, in particular through their co-construction since the 19th century. We analyze the elements influencing their partnerships. We examine too the difficulties to organize scientific research in the field of the child welfare. We presents, then, the results of two studies among adolescents living in residential group homes in the county of Bouches-du-Rhône (France) : a prevalence of mental disorders study and a Quality of Life study including the links between these values and the mental disorders. Results show mental disorders rates five times more frequents than in general population, and much more among girls, with specific psychopathologic profiles and an irregular expression of mental health needs degrading the screening. These data are the first in France
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Bjerkeli, Grøvda Lillian. "Evaluering av bruken av egenjournal i helsestasjon : et empowermentprosjekt." Thesis, Nordic School of Public Health NHV, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3272.
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Forskning har vist at dårlig kommunikasjon og mangelfull kontinuitet kan føre til dårlig kvalitet på tjenestene til barn. I noen tilfeller har dette ført til uriktige diagnoser og behandling, samt til mangelfull informasjon til foreldrene. Statens Helsetilsyn opprettet en arbeidsgruppe som utformet et forslag til egen journal til bruk for barn og foreldre. Gruppen foreslo å prøve ut egenjournalen til enutvalgt populasjon, og evaluere denne før den ble tatt i bruk i resten av landet. Mål/ hensikt: Endepunktsmål var foreldrenes opplevde kvalitet på kommunikasjon med helsepersonell, informasjonens relevans, følelse av likeverd og invitasjon til egen delaktighet. En ønsket å finne ut ihvilken grad foreldrene ville bruke egenjournalen i møte med helsetjenesten, om foreldrene opplevde at bruk av egenjournal ville føre til en bedre og mer delaktig kommunikasjon, om egenjournalen ville påvirke bruken av helsetjenester, og om foreldrene fikk tilført mer kunnskap om barns helse gjennom egenjournalen. Setting: Helsestasjoner i ti kommuner på nordvestlandet i Norge Metode: Et utvalgpå 309 barn født mellom 1. august 2000 og1. oktober 2001, ble rekruttert gjennom helsestasjonsbesøk og randomisert i en intervensjonsgruppe eller en kontrollgruppe. Førstefødte ble ekskludert. Vi brukte selvutfyllende spørreskjema, som var standardiserte og lukkede. Begge gruppene besvarte del 1 både før og etter intervensjonen. Intervensjonsgruppen besvarte i tillegg del 2 etter intervensjonen. Det var 289 (94%) foreldre som besvarte spørreskjemaet før intervensjonenog 260 (84%) etter. Helsesøstrene introduserte både egenjournalen ogspørreskjemaene. Helsepersonell ble også intervjuet for å validere resultatene. Resultat: Ca ¾ av foreldrene benyttetegenjournalen ved besøk på helsestasjonen, og en tilsvarende andel mente den var nyttig og haddeselv skrevet i den. Halvparten av foreldre oppgav at egenjournal førte til bedre oversikt over barnets helse og utvikling og at de ble mer involvert i bestemmelser. Den ble mindre brukt ved andre typerkontakter med helsetjenesten. Brukav egenjournalen påvirket ikke bruken av helsetjenester, kunnskaper om barns helse eller tilfredshet med informasjon og kommunikasjon med helsepersonell. Konklusjoner: Egenjournalen ble godtmottatt og hyppig benyttet i denne randomiserte og kontrollerte undersøkelsen, men undersøkelsen støttet imidlertid ikke de positive resultatene egenjournalen hadde på kommunikasjon og informasjon, som er blitt vist i tidligere deskriptive oppfølgingsstudier. Foreldre og helsesøstre som deltok i studien, trodde imidlertid at resultatene ville blitt bedre dersom egenjournalen ble introdusert ved første hjemmebesøk etter fødsel, og dersom det ble gitt mer opplæring i bruken av egenjournalen. Det vil være behov for videre forskning for åkunne bestemme hva som videre skal skje med egenjournalen i det helsefremmende arbeidetBackground:Research has shown that insufficient communication skills and lacking continuity has led to poor quality of the children's health services. In some cases this has caused incorrect diagnosis and treatment and insufficient information to the parents. The Norwegian Board of Health appointed a working group that created a parent-held child health record. The group proposed the record to betried out in a selected population and evaluated before introducing it for the whole country. Aim: Tostudy parents use of the PHCHR, and to evaluate participation in decisionmaking and communication with the professionals. We also wanted to determine the PHCHR’s influence on health care utilisation, knowledge about child health and self-care. Setting: Maternal child health centres in ten municipalities in the North-west of Norway between October 2001 and January2003. Method: A sample of 309 children born between Jan 8. 2000 (00.08.01) and Oct 1. 2001 (01.10.01) was recruited successively at routine health surveillance visits and randomised into an intervention ora control group. First-born children were excluded. We used self-completed questionnaires, which had standardised, specific and closed questions. Both groups answered part one before and after the intervention, and the intervention group also answered part two after the intervention. It was 289(94%) parents who answered the questionnaires before the intervention, and 260 (84%) after. Public health nurses introduced both the PHCHR and the questionnaires. The nurses were interviewed to validate the interpretation of the results. Results: 3/4 of the parents used the PHCHR when visiting the maternal child health centres, 3/4 reported that the record had been helpful to them and 3/4 had entered information in the PHCHR themselves. Half of the parents claimed that the PHCHR led to better view of the child's health and development, and that they got more involved in decisions. The PHCHR was less used visiting other health professionals. The use of PHCHR did not influence the utilisation of health care services, parents’ knowledge of child's health, or the parents' satisfaction of information and communication with professionals. Conclusions: The PHCHR was well acceptedand frequentlyused in this randomised controlled trial, but the survey does not support the positive results using PHCHR shown in earlier descriptive follow up studies. Still, the public health nurses taking part in the study believe that an earlier introduction of the parent-held child record – at the first home visit, and more training would alter the results. Further studies are needed before one is to decide what to do about PHCHR in health promotion in children
ISBN 91-7997-092-3
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Ravanini, Solange Gagheggi 1956. "Triagem do comportamento visual de lactentes nos três primeiros mese de vida = medida de promoção à saúde ocular." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/310944.
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Orientadores: Maria Francisca Colella dos Santos, Maria de Lurdes ZanolliTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-19T19:15:34Z (GMT). No. of bitstreams: 1 Ravanini_SolangeGagheggi_D.pdf: 4014610 bytes, checksum: 77c3a41ed1d7c30c350441a7c524a29b (MD5) Previous issue date: 2012
Resumo: Objetivos: Analisar o desenvolvimento visual de lactentes, por meio da identificação dos comportamentos visuais mais freqüentes nos três primeiros meses de vida e identificar qual o mês mais favorável para realização da triagem visual. Método: Estudo analítico, seccional, realizado no CEPRE/FCM/UNICAMP, com lactentes saudáveis, nos três primeiros meses de vida. O instrumento utilizado foi o Método de Avaliação da Conduta Visual de Lactentes. A análise estatística foi realizada pelo modelo loglinear para associações entre o sexo, faixa etária e as respostas dos lactentes em cada prova. Resultados: A amostra do estudo foi de 1073 lactentes (50,1% meninos e 49,9% meninas), sendo no primeiro mês 688 lactentes, no segundo mês 229 e no terceiro mês 156. Verificou-se diferença significante entre a freqüência das respostas dos lactentes e a faixa etária nas provas P3 (sorriso social), P5 (seguimento visual vertical), P7 (exploração visual da mão), P8 (movimentos dos membros ao visualizar objeto) e P9 (estender o braço na direção do objeto visualizado). Na P5 verificou-se freqüência de respostas positivas acima de 95% a partir do segundo mês. Não houve diferença significante nas provas P1-contato de olho, P2- fixação visual, P4- seguimento visual horizontal e P6- observação visual do ambiente. Estas provas apresentaram freqüência superior a 99% já no primeiro mês. A P9 foi significante quando comparada ao sexo. A comparação do sucesso das respostas dos lactentes na aplicação do instrumento de triagem com os meses foi significante entre o primeiro e segundo e entre primeiro e terceiro meses. Conclusão: A triagem do comportamento visual de lactentes deve ser realizada entre o segundo e terceiro meses de vida, pelas provas: P1, P2, P4, P5 e P6, como ação de promoção da saúde ocular e detecção precoce de alterações visuais
Abstract: Objectives: To analyze the visual development of infants, by identifying the most frequent visual behaviors in the first three months and to identify the most favorable month for carrying out visual screening. Method: Sectional analytic study, carried out at CEPRE/FCM/UNICAMP, with healthy infants, during their first trimester. The instrument used was the Assessment Method of Infant Visual Behavior. Statistical analysis was carried out using the log-linear model of association between sex, age and infant responses to each test. Results: The study sample was made up of 1073 infants(of which 50,1% were boys and 49,9% girls), with 688 first month infants, 229 second month infants and 156 third month infants. The results showed a significant difference among frequency of infant responses and age for the following tests: T3 (social smile), T5 (vertical visual tracking), T7 (visual exploration of hands), T8 (arm and leg movements when looking at object) and T9 (arm extension towards the object being visualized). For T5, the frequency of positive answers was more than 95% after the second month. There was no significant difference for tests T1 - eye contact, T2 - visual fixation, T4 - horizontal visual tracking and T6 - visual observation of environment. These tests presented frequency higher than 99% already at the first month. T9 was significant when compared to sex. Comparison of the success of newborn infants for the application of the screening instrument monthly was significant between the first and second months and between the first and third months. Conclusion: Screening of visual behavior of infants should be carried out between the second and third months of life using the tests: T1, T2, T4, T5 and T6, as an action for ocular health promotion and early detection of visual alterations
Doutorado
Saude da Criança e do Adolescente
Doutor em Saude da Criança e do Adolescente
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Žiaunienė, Elika. "Tėvų, auginančių vaikus su negalia, sveikatos priežiūros įstaigų teikiamų paslaugų vertinimas." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140618_142836-85213.
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Magistro darbe pristatomo tyrimo tikslas yra atskleisti, kaip tėvai, auginantys vaikus su negalia, konstruoja sveikatos priežiūros įstaigų teikiamų paslaugų vertinimą. Keliamas mokslinis klausimas: Kaip tėvai, auginantys vaikus su negalia, konstruoja sveikatos priežiūros įstaigų teikiamų paslaugų vertinimą? Tokiam tikslui pasiekti buvo pasirinktas kokybinis tyrimas. Tyrimui duomenys buvo surinkti 2014 metų vasario – kovo mėnesiais vienoje vaikų sveikatos priežiūros įstaigoje giluminio nestruktūruoto interviu metodu. Interviu dalyvavo 8 tyrimo dalyviai, kurie tyrimui buvo pasirinkti pagal kriterinę atranką. Duomenys buvo analizuojami pasitelkiant grindžiamąją teoriją. Teorinė koncepcija - socialinio konstruktyvizmo teorija.
Ašinio kodavimo metu sujungiant atviro kodavimo metu išskirtas kategorijas suformuotos dvi didžiosios tyrimo kategorijos – fenomenai: Negalios pasitvirtinimas “Iš pradžių net nepatikėjome“ ir Vaiko su negalia sveikatinimas „Laviruoti tuose (sveikatos paslaugų) labirintuose“. Atrankiniame kodavime buvo pasirinkta ir aprašoma „šerdinė“ kategorija „Mus prisimena ir supranta“. Visos kategorijos vadovaujasi Strauss ir Corbin (1990) paradigminio modelio logika, kuriame išskiriamos fenomeno priežastys, kontekstas, įsiterpiančios sąlygos, veiksmų strategijos bei to pasekmės.
Tyrimo rezultatai atskleidė, kad pagrindinės priežastys, kurios konstruoja tėvų, auginančių vaikus su negalia, sveikatos priežiūros įstaigų teikiamų paslaugų vertinimą yra aktualios... [toliau žr. visą tekstą]The objective of research of the master thesis is to reveal how parents, raising children with disabilities, construct evaluation of services of health care institutions. Raised scientific question: How parents, raising children with disabilities, construct evaluation of services provided by health care institutions? Qualitative research was selected for implementation of the objective. Data for the research was collected in February – March 2014 in selected children’s health care institution by the method of in-depthunstructured interviews. Eight research subjects participated in the interviews. They were selected for the interview according to targeted selection. The data was analyzed using grounded theory and based on theoretic concept of social constructivism theory. During axial coding, while connecting categories distinguished during open coding, two main research categories – phenomenon – were identified: Approval of disability “We didn’t even believe in the beginning” and Health rehabilitation of the child with disability “Trimming in these (health care services’) labyrinths”. “Core” category “We are remembered and understood” was selected and described in selective coding. All categories are based on logic of Strauss and Corbin (1990) paradigm model where reasons of the phenomenon, context, interfering conditions, strategies of actions and their consequences are defined. Results of the research reveal that the main reasons that construct evaluation of services... [to full text]
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Aguilar, Myriam Renee, and Amanda Nicole Robles. "Cultural competence needs of non-Latino foster parents: A study of transcultural foster care with Latino children." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2728.
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Araujo, Juliane Pagliari. "Atributos da Atenção Primária à Saúde da Criança: avaliação sob a ótica dos cuidadores." Universidade Estadual do Oeste do Parana, 2014. http://tede.unioeste.br:8080/tede/handle/tede/646.
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Previous issue date: 2014-02-17Introduction: The Primary Health Care (PHC) is a strategy of organization and reorganization of the health system as well as the change in clinical care practice, constituting the first level of care. According to the theory postulated by Starfield, PHC is characterized by essential attributes: first contact access, longitudinality, comprehensiveness, and coordination of care, and derived attributes: family counseling, community orientation and cultural competence, which must be present in the service health so that this is really oriented PHC. From the evaluation of the presence and extent of the essential attributes and derived the PHC, have become consistent elements to identify the weaknesses of the system and guide the organization of health care services in production, specifically in this study, the population group zero to 12 years old. Objective: To evaluate the degree of orientation of the primary health care of the child in relation to the extension of the attributes of PHC. Methodology: This is a quantitative study, the evaluative. 548 interviews with caregivers of children younger than 12 years who were treated in 24 health units in the urban area of the city of Cascavel - PR were performed. The interviews were conducted by special act called Assessment Tool Primary - PCATool - Brazil child version , as well as by an instrument made by the research group, in relation to socioeconomic families. Data collection occurred from October 2012 and February 2013. Data were entered into a database created in Excel 2010 program, with double entry and checking of data for greater reliability, then sent to the software SPSS 17.0, the mean, standard error, minimum and maximum being calculated. Descriptive samples were presented as absolute and relative frequencies. For the bulk of the PHC score, the overall average of the attributes was calculated and divided by the number of attributes. For comparison of the presence and extent of attributes was used as cutoff values ≥ 6.6 scores, defined as high and values < 6.6 were considered low/unsatisfactory. Results: The data showed that the basic public health services of the city of Cascavel - PR, does not have guidance for PHC because the essential attributes and derivatives were not recognized in their full extent and caregivers of children using these services. The overall score of APS was 6,3, demonstrating the lack of guidance PHC for primary care to the child, not contributing to solving the healthcare provided. The access attribute of first contact had satisfactory mean score in the care process - using (8,6), however, on the structure of care - accessibility - score 5.5 points fragility in this attribute. The low score of the structure implies difficulties in children access to services, as well as deficiency of organizational structure and human resources for comprehensive care and quality focused on child health. The longitudinality also showed low score (6,1), indicating the difficulty of interaction between services and families of children over time, which implies a fragmented and poorly resolutive care. In the evaluation of integrated care services available and services produced unsatisfactory average scores (6,0 and 6,1 respectively). In this sense, there is a need to expand the services offered by the primary care for the child care may be resolving this point of attention. Essential attributes, the one to submit satisfactory scores on the structure (7,4) and the process (6,9) care referred to the coordination of care. Derived attributes - family orientation (4,4) and community orientation (5,1) had scores below the satisfactory, non integrating family and community in child care. Considerations: We can see the difficulty of guidance for PHC in health services measured by the lack of full extension of the APS attributes of care, strengthening the culture of curative care and focused on the individual. We emphasize the need for expansion of the Family Health Strategy services in the city, changing the process of care and assistance model, as well as the adoption of an integrated system of health services. Strengthening of PHC can result in better health of the child population, tending to reduce morbidity and mortality from preventable causes
Introdução: A Atenção Primária à Saúde (APS) é uma estratégia de organização e reorganização do sistema de saúde, bem como da mudança na prática clínico-assistencial, constituindo-se no primeiro nível de atenção. Segundo o referencial teórico postulado por Starfield, a APS é caracterizada por atributos essenciais: acesso de primeiro contato, longitudinalidade, integralidade e coordenação da atenção; e atributos derivados: orientação familiar, orientação comunitária e competência cultural, os quais devem estar presentes nos serviços de saúde para que realmente este esteja orientado para a APS. A partir da avaliação da presença e extensão dos atributos essenciais e derivados à APS, têmse elementos consistentes para identificar as fragilidades do sistema e orientar a organização dos serviços de saúde na produção do cuidado, em específico neste estudo, ao grupo populacional de zero a 12 anos incompletos. Objetivo: Avaliar o grau de orientação da atenção primária à saúde da criança em relação à extensão dos atributos da APS. Metodologia: Trata-se de um estudo quantitativo, do tipo avaliativo. Foram realizadas 548 entrevistas com cuidadores de crianças menores de 12 anos atendidas nas 24 unidades de saúde da área urbana do município de Cascavel- PR. As entrevistas foram conduzidas por instrumento próprio denominado Instrumento de Avaliação da Atenção Primária - PCATool - Brasil versão criança, bem como, por um instrumento formulado pelo grupo de pesquisa, com relação aos aspectos socioeconômicos das famílias. A coleta de dados ocorreu nos meses de outubro de 2012 e fevereiro de 2013. Os dados foram digitados em um banco de dados criado no programa Excel 2010, com dupla entrada e conferência dos dados para maior confiabilidade, posteriormente enviados para o software SPSS 17.0, sendo calculado a média, erro padrão, mínima e máxima. As amostras descritivas foram apresentadas por frequências absolutas e relativas. Para obter o escore essencial da APS, foi calculada a média geral dos atributos e dividido pelo número de atributos. Para comparação da presença e extensão dos atributos utilizou-se como ponto de corte os valores de escores ≥6,6, definidos como elevados e valores <6,6 considerados baixos/insatisfatórios. Resultados: Os dados analisados demonstraram que os serviços básicos de saúde pública do município de Cascavel-PR, não apresentam orientação para a APS, pois os atributos essenciais e derivados não foram reconhecidos em sua extensão e totalidade pelos cuidadores das crianças que utilizam esses serviços. O escore geral da APS foi 6,3, demonstrando a não orientação da APS para a atenção primária à criança, contribuindo para a não resolutividade da assistência prestada. O atributo acesso de primeiro contato obteve escore médio satisfatório no processo do cuidado utilização (8,6), porém, relativo à estrutura do cuidado acessibilidade- o escore 5,5 aponta fragilidade nesse atributo. O baixo escore da estrutura implica em dificuldades de acesso das crianças aos serviços, bem como, deficiência de estrutura organizacional e recursos humanos para uma assistência integral e de qualidade voltada à saúde infantil. A longitudinalidade também apresentou baixo escore (6,1), apontando dificuldade de interação entre os serviços e as famílias das crianças ao longo do tempo, o qual implica em um cuidado fragmentado e pouco resolutivo. Na avaliação da integralidade da atenção, os serviços disponíveis e os serviços prestados apresentaram escores médios insatisfatórios (6,0 e 6,1 respectivamente). Nesse sentido, tem-se a necessidade de ampliação dos serviços ofertados pela atenção primária para que o cuidado à criança possa ser resolutivo nesse ponto da atenção. Dos atributos essenciais, o único a apresentar escores satisfatórios na estrutura (7,4) e no processo (6,9) do cuidado referiu-se à coordenação da atenção. Os atributos derivados orientação familiar (4,4) e orientação comunitária (5,1) apresentaram escores aquém do considerado satisfatório, não integrando a família e a comunidade no cuidado à criança. Considerações: Percebe-se a dificuldade de orientação para a APS nos serviços de saúde avaliados pela falta de total extensão dos atributos da APS no cuidado, fortalecendo a cultura de assistência curativa e centrada no indivíduo. Salienta-se a necessidade de ampliação da rede de Estratégia Saúde da Família no município, alterando o processo de cuidado e o modelo assistencial, assim como a adoção de um sistema integrado de serviços de saúde. O fortalecimento da APS pode resultar em melhores condições de saúde da população infantil, tendendo à redução da morbimortalidade por causas evitáveis
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Blankenberg, Cheryl Marion. "Evaluating the special sexual offences courts in Cape Town and Wynberg through professional perspectives." University of Western Cape, 2020. http://hdl.handle.net/11394/7352.
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Magister Artium (Social Work) - MA(SW)This is an evaluative research study which was undertaken to establish whether the legal reforms, through the establishment of the Special Sexual Offences Courts, have been effective in reducing secondary traumatisation. In attempting to examine this crucial area, I focused specifically on the perceptions of professionals who are involved in child sexual abuse matters in the Special Sexual Offences Courts at Wynberg (Court G) and Cape Town (Court 32). The study employed qualitative research methodology, in the form of individual and group interviews, structured questionnaires and participant observation, to collect data. The respondents included magistrates, prosecutors, both victims support services coordinators within the court system, social workers who work with child abuse matters, Child Protection Unit investigating officers who investigate matters of this nature and attorneys who have defended offenders of child sexual abuse. The results indicate a marked disparity in physical appearance, location and an overall sense of child-friendliness between the two Special Sexual Offences Courts; a need for joint training of inter-disciplinary professionals, and a need for a more effective multidisciplinary team approach to the problem of child sexual abuse. The findings also indicate a need for regular contact between the professionals involved at the two Special Courts to ensure uniformity in terms of service provision, and a need for the restructuring of the job description of the co-ordinator. The findings reported and discussed, suggest that the legal reforms promulgated are but one aspect to the entire area of child protection. The overall success of these legal reforms depends upon the involvement, commitment and development of a common philosophy in child protection by, the medical, social, legal and police service systems. It is hoped that this report will act as a catalyst to urgently address the shortcomings which have been identified by the respondents, and that the recommendations reported will contribute to measures which will result in the development and implementation of effective child protective policies and practices.
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Damasceno, Simone Soares. "Avaliação da orientação à atenção Primária à Saúde da Criança." Universidade Federal da Paraíba, 2014. http://tede.biblioteca.ufpb.br:8080/handle/tede/5146.
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Previous issue date: 2014-02-28Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
The presence of attributes of the Primary Health Care qualifies the services of basic attention ensuring a higher effectiveness of the developed actions. The general objective was to evaluate the guidance degree related to the child´s Primary Health Care in the Family Health Strategy and the specific ones were to identify the presence and scope of Primary Care attributes concerning the child´s health; to verify the association between the user´s characteristics and the quality of child´s health care in the Family Health Strategy; and to analyze the effectiveness of the child´s health care by means of the association among the Primary Care attributes. It is an evaluative and cross-sectional study of quantitative approach. A total of 344 children´s family members in Family Health Units took part in the research. Data collection occurred from October 2012 to January 2013 by using the Primary Care Evaluation Tool, child´s version, and a tool structured for collecting the families´ socio-demographic data. Data were analyzed in the light of descriptive statistics, distribution of absolute/relative frequencies, calculation of average and construction of scores for the measured attributes, following the guidance contained in the tool´s manual issued by the Health Ministry. In order to analyze the association among the variables, univariate statistical tests and the adaptation of a logistic regression model were used. The study followed the guidelines of the Resolution number 466/12 of the National Council of Health, and obtained favorable opinion of the Research Ethics Committee number 044/2012 and CAAE number 01295412.2.1001.0107. High scores for the access attribute were verified in their procedural component, use and longitudinality which highlight that the service is reference for infantile care and it has been used as regular source of care. Longitudinality is favored by the existence of a suitable information system, procedural component of the coordination. Nevertheless, it was observed commitment of the structural dimension of access accessibility, of the integrality attribute in both evaluated dimensions available and offered services, which consequently resulted in the low family and community guidance. From the user´s characteristics associated to the satisfactory evaluation of the service, the affiliation degree was highlighted which was presented as possibility for a better evaluation of the Family Health Strategy. Probably, the bond is the factor related to the satisfactory evaluation once it provides favorable conditions for the offer of measured attributes. This result emphasizes the importance of the bond for the quality of primary care services in the child´s health. It can be concluded that the Family Health Strategy still is not directed to the child´s Primary Health Care in the investigated context, but it focuses on attaining satisfactory levels for the evaluated attributes, highlighting the need for improving aspects of the service process and structure, especially related to the access accessibility and integrality attributes, in addition to the attributes derived from family and community guidance with the purpose of qualifying the developed actions.
A presença dos atributos da Atenção Primária à Saúde qualificam os serviços de atenção básica garantindo maior efetividade das ações desenvolvidas. O objetivo geral foi avaliar o grau de orientação à Atenção Primária à Saúde da criança na Estratégia Saúde da Família e os específicos identificar a presença e a extensão dos atributos da Atenção Primária relacionados à saúde da criança; verificar a associação entre características do usuário e a qualidade da atenção em saúde da criança na Estratégia Saúde da Família; e analisar a efetividade do cuidado à saúde da criança por meio da associação entre os atributos da Atenção Primária. Estudo avaliativo, transversal de abordagem quantitativa. Participaram 344 familiares de crianças em Unidades de Saúde da Família. A coleta de dados ocorreu no período de outubro de 2012 a janeiro de 2013 utilizando-se o Instrumento de Avaliação da Atenção Primária versão criança e um instrumento estruturado para coleta dos dados sociodemográficos das famílias. Os dados foram analisados a luz da estatística descritiva, distribuição de frequências absolutas/relativas, cálculo de médias e construção dos escores para os atributos mensurados, seguindo as orientações contidas no manual do instrumento divulgado pelo Ministério da Saúde. No intuito de analisar a associação entre variáveis foram empregados testes estatísticos univariados e adaptação de um modelo de regressão logística. O estudo seguiu as orientações da Resolução nº 466/12 do Conselho Nacional de Saúde, obteve parecer favorável do Comitê de ética em Pesquisa nº 044/2012 e CAAE nº 01295412.2.1001.0107. Verificou-se escores elevados para os atributos acesso em seu componente processual, utilização e longitudinalidade, os quais evidenciam que o serviço é referência para o atendimento infantil e vem sendo utilizado como fonte regular de atenção. A longitudinalidade é favorecida pela existência de um sistema de informação adequado, componente estrutural da coordenação. No entanto, observou-se comprometimento da dimensão estrutural do acesso-acessibilidade, do atributo integralidade em ambas as dimensões avaliadas - serviços disponíveis e serviços prestados, consequentemente resultaram a baixa orientação familiar e comunitária. Das características do usuário associadas à avaliação satisfatória do serviço sobressaiu-se o grau de afiliação, o qual se apresentou como possibilidade para uma melhor avaliação da Estratégia Saúde da Família. Registra-se que, provavelmente o vínculo é o fator relacionado à avaliação satisfatória, pois fornece condições favoráveis à oferta dos atributos mensurados. Esse resultado reforça a importância do vínculo para qualidade dos serviços de atenção primária na saúde da criança. Conclui-se que a Estratégia Saúde da Família ainda não está orientada à Atenção Primária à Saúde da criança no contexto investigado, mas caminha na direção de alcançar patamares satisfatórios para os atributos avaliados, destacando-se a necessidade de melhorar aspectos de estrutura e processo do serviço, especialmente relacionados aos atributos acesso-acessibilidade e integralidade, além dos atributos derivados orientação familiar e comunitária, no sentido de qualificar as ações desenvolvidas.
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Oliveira, Vanessa Bertoglio Comassetto Antunes de. "Avaliação da atenção primária à saúde da criança no município de Colombo - Paraná." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/7/7141/tde-22022013-125217/.
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O presente estudo enquadra-se no campo cuidados em saúde e sua temática refere-se à avaliação do serviço de saúde da criança na rede básica do município de Colombo Paraná. Constitui-se seu objeto o desempenho das Unidades Básicas de Saúde (UBS) e das Unidades de Estratégia Saúde da Família (USF) do município. Os objetivos foram: avaliar a presença e a extensão dos atributos essenciais e derivados relativos à Atenção Primária à Saúde (APS) no cuidado prestado na atenção primária às crianças, sob a ótica das suas famílias, e comparar o desempenho das UBS e USF quanto a esses atributos. Os sujeitos da pesquisa foram responsáveis por crianças de 17 a 22 meses cadastradas e assíduas às atividades das unidades de saúde do município, numa amostra aleatória total de 482 pessoas, sendo 247 das Unidades Básicas e 235 das Unidades de ESF. A coleta de dados foi feita em domicílio e o instrumento utilizado foi o Primary Care Assessment Tool (PCATool) versão criança, já validado em 2008 e utilizado como referência pelo Ministério da Saúde do Brasil. As entrevistas aconteceram entre junho e julho de 2012. As análises, com auxílio do software Statistica 10.1, incluíram o teste t de student para comparação de variáveis quantitativas e o teste qui-quadrado para variáveis qualitativas; para verificação da consistência interna dos itens do instrumento foi obtido o Alfa de Crombach para cada um dos atributos e para o instrumento total. Um estudo piloto foi realizado para garantir a eficácia do instrumento e da entrevista. O estudo seguiu a Resolução 196/96 do Conselho Nacional de Ética em Pesquisa. A pesquisa revelou que as Unidades de ESF obtiveram escores superiores ao mínimo exigido em Afiliação, Coordenação, Integralidade, Orientação Familiar e Acessibilidade, metade dos 10 atributos estudados, indicando que os responsáveis das crianças atendidas nessas unidades referem ter mais frequentemente acesso à utilização dos serviços de saúde, utilizam com mais frequência a unidade de saúde como porta de entrada para o sistema de saúde, estabelecem com maior constância um atendimento integrado entre os serviços e referem reconhecer a valorização dos profissionais quanto ao vínculo com a família. No que tange às UBS, todos os escores ficaram abaixo do ideal para a APS, apontando que essas unidades apresentam maior dificuldade em vincular seus usuários e reconhecê-los como parte de uma comunidade. Observou-se que os trabalhos de avaliação desempenham um papel fundamental no aprimoramento dos eixos de intervenção com o propósito de aderir ao foco do Ministério da Saúde em transformar os serviços de saúde em Atenção Primária. No município em questão, concluiu-se que as unidades de ESF estão mais próximas das diretrizes da APS do que as UBS, entretanto há a necessidade de rever as ações vinculadas à assistência à criança a fim de alcançar consonância com os atributos da APS em ambas as unidades.This study is placed in the health caring field and its thematic refers to the evaluation of childs health care in the city of Colombo Paraná. Its object of study is the performance of Basic Health Units (UBS) and the Strategy Units of Family Health (USF). The study aims: to evaluate both the presence and extention of the essential attributes and derivates relative to the APS regarding the care given at the primary care of the children at their family perspective, and to compare the UBS and USF attributes performance. This research subjects were responsible for 17-22 month-old children, registered and assiduous to the city health units activities, in a random sample of 482 people: 247 from the Basic Units and 235 from the ESF units. Data was collected at their houses and the Primary Care Assessment Tool (PCATool), childrens version, was used. PCATool was validated in 2008 and used by the Brazilian Health Ministry as reference. Interviews were held between June and July 2012. The samples, using the software Statistica 10.1, included the t student test to compare the quantitative variants and the qui-square test, for qualitative variants; Crombachs Alfa was obtained in order to verify the intern consistency of instrument items for each one of the attributes and total instrument. A pilot study has been performed as to guarantee both the instrument and interview efficacy. This study followed Resolution 196-96 from Research Ethics National Council. The research revealed that the ESF units obtained scores higher than the minimum required in Affiliation, Coordination, Integrality, Familiar Orientation and Accessibility, half the studied attributes, indicating that the ones responsible for the children who attend those units refer to having more frequent access to health services, use more often the health unit as an entrance door to the health system, establish more constantly an integrated service and recognize the professional valorization regarding the bond with the family. Regarding the UBS, all the scores were below ideal for the APS, indicating that those units seem to struggle to bond with its users and recognizing them as part of a community. It has been observed that assessment works play a fundamental role in perfecting the intervention axis aiming at joining the Health Ministry focus, which is to transform health services into Primary Care. In that city it has been concluded that the ESF units are closer to APS directress than UBS, however it is necessary to revise the child assistance related actions in order to reach consonance with the APS attributes at both units.
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Lebihan, Laëtitia. "Trois essais économétriques sur le développement et le bien-être des enfants canadiens." Thesis, La Réunion, 2014. http://www.theses.fr/2014LARE0010/document.
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Cette thèse propose trois essais économétriques ayant trait au capital humain et au bien-être de l'enfant. Chacun des essais présente une méthodologie distincte afin de répondre à l'objectif concerné. Dans le premier chapitre, nous évaluons les effets à long terme d'une politique de services de garde universels au Canada sur le bien-être de l'enfant (santé, comportement, développement moteur et social). Nous montrons que la réforme a un effet négatif sur le bien-être des enfants d'âge préscolaire, mais ces effets tendent à disparaître lorsque l'enfant devient plus âgé. Nous trouvons que cette tendance persiste même dix ans après la mise en place de la réforme. Le second chapitre s'intéresse à l'effet de l'intensité des services de garde sur le développement cognitif des enfants d'âge préscolaire. Nous utilisons la méthode d'appariement à traitements multiples pour répondre à cet objectif. Nous montrons que les effets des services de garde sont grandement hétérogènes. Leurs effets varient selon le statut socioéconomique des familles, la scolarité ou non de l'enfant, le niveau d'intensité des services de garde ainsi que le mode de garde utilisé. Le troisième chapitre porte sur la modélisation des trajectoires des performances mathématiques des enfants canadiens de 7 à 15 ans ainsi que sur l'identification des facteurs de risque durant la petite enfance susceptibles d'influencer l'appartenance à ces trajectoires. La méthode utilisée est celle du Group-Based Trajectory Modeling de Nagin (2005)This thesis contains three econometric essays on child human capital and well-being. Each essay has a distinct methodology to meet the purpose. In the first chapter, we evaluate the long-term effects of a reform of universal child care in Canada on children's health, motor and social development, and behaviour. We show that the policy had negative effects on preschool children's well-being, but these effects tend to disappear as the child gets older. We find that this pattern persist even ten years after the implementation of the reform. The second chapter focuses on the effect of the intensity of child care on preschool children's cognitive development using propensity score matching with multivalued treatments. We show that the effects of child care are significantly heterogeneous and vary by family socioeconomic status, schooling or not of the child, the intensity of child care and the type of child care arrangement. The third chapter models mathematics trajectories of Canadian children aged 7 to 15 years and identifies risk factors during early childhood on the membership of these trajectories using Group-Based Trajectory Modeling (Nagin, 2005)
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Meira, Denise Sayuri Maruo. "Analise das praticas de humanização do SUS = acompanhamento multidisciplinar em ambulatorio de follow up de bebes de risco - CRDI Fenix." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311692.
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Orientador: Regina Yu Shon ChunDissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Introdução: O predomínio do componente neonatal sobre o pós-natal na mortalidade infantil, nas décadas de 1980 e 90 no Brasil, trouxe em evidência a elevada proporção de óbitos evitáveis e a importância da qualidade assistencial mãe-bebê. A especialização, o desenvolvimento de tecnologias, a valorização e capacitação de recursos humanos além do estabelecimento de políticas públicas de saúde voltadas à Atenção Materno-Infantil contribuíram para maior sobrevida de bebês com graves intercorrências perinatais. Tais fatos contribuíram para a criação de Ambulatórios de Follow Up, proporcionado por programas longitudinais como o Centro de Referência em Desenvolvimento Infantil Fênix - CRDI (Campinas, SP, Brasil). O serviço segue as diretrizes da Política Nacional de Humanização, buscando superar a fragmentação da rede e do processo de trabalho e recebeu reconhecimento do Ministério da Saúde em 2006, tendo sido inserido no Banco de Projetos do Humanizasus. O Programa Nacional Avaliação de Serviços de Saúde alerta sobre a importância de mecanismos de avaliação e de controle da qualidade assistencial bem como da opinião daqueles aos quais os serviços se destinam. Assim, este estudo volta-se à avaliação desse Programa por meio da análise de indicadores de avaliação do serviço e da perspectiva do cuidador. Objetivo: Avaliar a assistência do CRDI-FÊNIX por meio de (i) indicadores de oferta (capacidade de oferta do serviço), da demanda de encaminhamento e de chegada, de cobertura (proporção da população-alvo atingida pelo programa/intervenção), e de utilização (proporção de uso do serviço da população alvo) e (ii) entrada, acompanhamento multidisciplinar, qualidade e resolutividade da assistência e vínculo entre usuário/cuidador/equipe na opinião do cuidador. Sujeitos e métodos: Trata-se de pesquisa retrospectiva aprovada pelo Comitê de Ética e Pesquisa. Foi feito levantamento dos sujeitos que receberam alta de junho de 2005 a julho de 2006 para constituição do corpus e caracterização do perfil da população atendida. Resultados: Os prontuários caracterizaram os bebês quanto a: local de moradia, tempo médio de seguimento e profissionais envolvidos na assistência. A adesão foi de 53% dos sujeitos e demanda de encaminhamento da maternidade de referência de 28,77%. A demanda de chegada ao serviço foi de 83,22% e a capacidade de oferta estimada em 140 bebês/ano. Verifica-se que do total de nascimentos, 10,74% dos bebês foram encaminhados para cuidados intensivos e intermediários, sendo que 6,09% pertenciam ao Sistema Único de Saúde. Desses, chegaram ao serviço 1,60% por apresentarem risco para alteração no desenvolvimento neuropsicomotor. A utilização integral do serviço foi de 52,78% e a parcial, 47,22%. Os cuidadores indicam satisfação quanto a qualidade, resolutividade da assistência e a importância do acompanhamento multidisciplinar. Conclusão: Os achados mostram a eficácia dos indicadores estudados e reiteram a importância da escuta e do acolhimento ao usuário em uma perspectiva humanizada e integral, mostrando-se como ferramentas fundamentais para conhecimento e avaliação do serviço. A responsabilização dos diferentes sujeitos implicados no processo dessa rede de cuidados contribui para desburocratização da assistência e para maior autonomia dos atores envolvidos, exercendo-se a humanização, como proposta pelas políticas vigentes
Abstract: Introduction: The prevalence of the neonatal component over the post-neonatal in infant mortality, in the decades of 1980 and 1990 in Brazil, showed the high proportion of avoidable deaths and the importance of the care quality mother-baby. The specialization, the development of technologies, the valuing and capacity of human resources in addition to the establishment of public health policies aiming the Mother-Child attention, contributed for a highest survival of babies with severe perinatal interferences. These facts contributed to the creation of High-risk Infant Follow-up Program , provided by longitudinal programs such as the Fenix Reference Center in Children Development - CRDI (Campinas, SP, Brazil). The service follows the guidelines from the National Policy of Humanization, aiming to overcome the system and work process fragmentation and was recognized by the Ministry of Health in 2006, being inserted in Humanizasus projects database. The National Program of Health Services Assessment warns about the importance of assessment tools and of assistential quality control such as the opinion of those at whom the service is aimed. Therefore, this study aims to evaluate this program through the analysis of the service assessment indicators and the caregiver perspective. Objective: To evaluate the assistance of CRDI-FENIX through (i) provision indicators (capacity of service provision), incoming and referral demand, coverage (proportion of target population that is assisted by the program/intervention) and use (proportion of the service use by target population) and (ii) incoming, multidisciplinary assistance, quality assistence, solving assistance and attachment between the user/caregiver/staff according to the caregiver opinion. Subjects and methods: This is a retrospective research approved by Research Ethics Committee. A survey was done on subjects that received medical discharge during the period of June 2005 to July 2006, composing the corpus and the population characterization. For the analysis of the target population that was assisted by the program, it were used data from July 2007 to June 2008, since the reference maternity did not have the data from 2005 and 2006. Results: The subject records categorized the babies according to: the place of their residences, average period of assistance, and professional involved in assistance. The adherence was of 53% and referral demand from the reference maternity was 28.77%. The incoming demand to the service was 83.22% and the offer capacity estimated of 140 babies per year. The results showed that from the total of the new bourns, 10,74% need intensive care, from that 6,09% are dependent from the Brazilian Unified Health System (SUS) and 1.6% arrived at the service. The integral use of the service was 52.78% and parcial 47.22%. The caregivers showed satisfaction regarding the quality and solving of the assistance, and the importance of the multidisciplinary assistance. Conclusion: The findings revealed the efficiency of the indicators studied and reiterate the importance of the user's listening and embracement according to a humanized and integral perspective, considered as important tools to know and evaluate the service. The responsibility of the different subjects involved in the process of this care network contributes for the disbureaucracy of the assistance and for a greater independence of the people involved, considering the humanization as a proposal from the current politics
Mestrado
Saude, Interdisciplinaridade e Reabilitação
Mestre em Saúde, Interdisciplinaridade e Reabilitação
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Tolliver, Matthew, Jodi Polaha, Stacey L. William, and Christina R. Studts. "Evaluating the Prevalence of Child Psychosocial Concerns in Rural Primary Care." Digital Commons @ East Tennessee State University, 2021. https://doi.org/10.1037/rmh0000130.
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Child psychosocial concerns in rural areas are assumed to be greater than national averages due to mental health provider shortages, however, there is minimal empirical support for this claim. The present study aimed to replicate findings showing a higher prevalence of child psychosocial concerns in rural areas. In addition, this study evaluated six distinct definitions of “rural” to determine whether the operational definition of rurality was associated with prevalence of psychosocial concerns. Caregivers presenting with their child at 8 pediatric primary care sites (N = 2,672) completed a demographic questionnaire and the Pediatric Symptom Checklist (PSC). Logistic regression models tested associations between operational definitions of rurality and prevalence of clinically significant child psychosocial concerns. Multiple logistic regression models were used to test additional independent effects of maternal education level while controlling for child age. The effects of rurality on prevalence of clinically significant psychosocial concerns were inconsistent across the 6 measures of rurality; when significant, however, effects were small and in the opposite direction than hypothesized. These findings highlight discrepancies in results based on disparate operational definitions and measures of rurality. When rurality was associated with child psychosocial concerns, children in more highly populated areas reported more psychosocial concerns than children in smaller rural areas.
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Freitas, Marsilene Gomes. "Avalia??o da qualidade da aten??o prim?ria ? sa?de da crian?a no Rio Grande do Norte: vis?o das usu?rias." Universidade Federal do Rio Grande do Norte, 2013. http://repositorio.ufrn.br:8080/jspui/handle/123456789/17859.
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Previous issue date: 2013-12-19Universidade Federal do Rio Grande do Norte
The study aims to evaluate the quality of the work processes of the teams from the Family Health Strategy regarding the comprehensive health care for children, in the view of users in the state of Rio Grande do Norte. This is a cross-sectional observational evaluative research with quantitative approach. The primary data are part of the External Review from the Program of Improving Access and Quality of Primary Care (PMAQ) in 2012. 190 women were interviewed. The inclusion criteria was the presence in the clinic at the time of the survey, have attended the service in the last 12 months and be a mother or companion of a child up to two years old. A research protocol was developed in the dimensions of Growth and Development, Breastfeeding and nutrition, and health problems and its variables. The results revealed that mothers / companions who responded to the questionnaire 71% were aged between 18 and 35 years, 92.1% were literate, 96.3% had a monthly income and 62.6% received financial assistance from the government. As for the children, 39.4% were aged between 13 to 24 months. In promotion and prevention actions for children, 64.2% had consultation up to the 7th day of life, 91.1% underwent the screening test, 95.3% had a health handbook, 98.9% had a vaccine, 17.9% breastfed or breastfeed from 6 to 24 months. As for link and continuity of care, 86.8% of the children were accompanied by the same professional staff and 59.5% left with next consultation scheduled. In acute situations 42.4% of the children went to the health unit and 64% of these were attended. It is concluded that the actions involving prevention and health promotion of children in RN, are evaluated positively by the service users and meet the requirements of MS, as well as link and continuity of care. The weakness in access and reception of users is evident, indicating the need to adapt the service to the demand of health and planning actions to welcome all who seeks basic health unit-UBS
O estudo tem por objetivo avaliar a qualidade dos processos de trabalho das equipes da Estrat?gia de Sa?de da Fam?lia referentes ? aten??o integral ? sa?de da crian?a na vis?o dos usu?rios no Estado do Rio Grande do Norte. Trata-se de uma pesquisa avaliativa observacional transversal com abordagem quantitativa.Os dados prim?rios fazem parte da Avalia??o Externa do Programa de Melhoria do Acesso e da Qualidade da Aten??o B?sica (PMAQ) em 2012. Foram entrevistadas 190 mulheres usu?rias. O crit?rio de inclus?o foi a presen?a na unidade de sa?de no momento da pesquisa , ter frequentado o servi?o nos ?ltimos 12 meses e ser m?e ou acompanhantes de crian?a at? dois anos de vida. Elaborou-se um protocolo de pesquisa com as dimens?es de Crescimento e Desenvolvimento , Amamenta??o e alimenta??o, e Problemas de sa?de e suas respectivas vari?veis. Como resultados observou-se que das m?es/acompanhantes que responderam ao question?rio 71% tinham idade entre 18 e 35 anos, 92,1% eram alfabetizadas, 96,3% possu?am alguma renda mensal e 62,6% recebiam bolsa fam?lia. Quanto as crian?as 39,4% estavam na faixa et?ria entre 13 a 24 meses. Nas a??es de promo??o e preven??o ? crian?a 64,2% fizeram a consulta at? o 7? dia de vida, 91,1% realizaram o teste do pezinho, 95,3% tinham a caderneta de sa?de, 98,9% tinham alguma vacina, 17,9% mama ou mamou no peito de 6 meses a 24 meses. Quanto ao v?nculo e continuidade do cuidado 86,8% das crian?as eram acompanhadas pelo mesmo profissional da equipe e 59,5% j? saiam com consulta subsequente marcada. Quantdo em situa??es agudas 42,4% das crian?as iam para unidade de sa?de e destas 64% eram atendidas. Conclui-se que as a??es que envolvem preven??o e promo??o ? sa?de da crian?a no RN, s?o avaliadas de forma positiva pelos usu?rios do servi?o e atendem as exig?ncias do MS, assim como o v?nculo e continuidade do cuidado. Sendo evidente fragilidades no acesso e acolhimento dos usu?rios, sinalizando a necessidade de adequa??o do servi?o a demanda das a??es de sa?de e planejamento das equipes para acolher a todos que procurarem a UBS
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Polgliane, Rúbia Bastos Soares. "Assistência pré-natal em Vitória - Espírito Santo: avaliação da concordância e da adequação do processo." Universidade Federal do Espírito Santo, 2013. http://repositorio.ufes.br/handle/10/5674.
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Previous issue date: 2013-04-10Introduction: Process evaluation of prenatal care is relevant in order to contribute to the actions of reducing rates of maternal and infant mortality. Objectives: To assess the agreement between the data recorded on the pregnant/´s card and the medical records of Primary Care on prenatal care in the National Health Sistem city of Vitória, Espírito Santo (ES), Brazil, to evaluate the adequacy of prenatal care in the county according to the criteria established by the Program for the Humanization of Prenatal and Birth (PHPN) and the World Health Organization (WHO) through the data recorded on the pregnant/´s cards. Methodology: Were interviewed 360 puerperae in three main public hospitals of the city of Vitória-ES, at delivery, from April 2010 to February 2011. Besides the interview, was made a full copy of the pregnant/´s card and the medical records. The information on prenatal care, their women, registered in the records of primary care were collected from January to June 2012. The data were processed and analyzed using SPSS version 18.0, PEPI version 4.0 and Microsoft Excel 2010. Statistical tests of Kappa, Kappa adjusted for prevalence and McNemar were applied to the verification of the consistency and trend of disagreement. Moreover, calculations of absolute and relative frequencies and confidence intervals were performed to analyze the adequacy of the process parameters of prenatal care. Results: The concordance between the records of pregnant/´s cards and medical records of primary care is mostly bad (Kappa<0,20). No puerpera had a process of prenatal care entirely appropriate to WHO criteria, while only 5% of the puerperae had prenatal care in consonance to PHPN. Conclusion: It is recommended that in studies evaluating or monitoring the pregnant card must be used as primary source. The adequacy of the process of prenatal care in the city far from that recommended by national and international criteria. Accordingly, strategies should be adopted to ensure the achievement of the minimum recommended procedures and to establish a pattern of systematic recording of information in the medical records of primary care
Introdução: A avaliação do processo da assistência pré-natal assume relevância no sentido de contribuir para com as ações de redução das taxas de morbimortalidade materna e infantil. Objetivos: Verificar a concordância entre os dados registrados no cartão da gestante e no prontuário da Atenção Básica sobre a assistência pré-natal no Sistema Único de Saúde (SUS) do município de Vitória, Espírito Santo (ES), Brasil; avaliar a adequação da assistência pré-natal no município segundo os critérios estabelecidos pelo Programa de Humanização do Pré-Natal e Nascimento (PHPN) e pela Organização Mundial de Saúde (OMS) por meio dos dados registrados nos cartões das gestantes. Metodologia: Entrevistou-se 360 puérperas nas três principais maternidades públicas do município de Vitória-ES, por ocasião do parto, no período de abril de 2010 a fevereiro de 2011. Além da entrevista, realizou-se cópia integral do cartão da gestante e do prontuário médico. As informações sobre a assistência pré-natal, das respectivas mulheres, registradas nos prontuários da atenção básica foram coletadas no período de janeiro a junho de 2012. Os dados foram processados e analisados nos programas SPSS versão 18.0, PEPI versão 4.0 e Microsoft Office Excel 2010. Testes estatísticos de Kappa, Kappa ajustado pela prevalência e McNemar foram aplicados para a verificação da concordância e da tendência de discordância. Além disso, cálculos das frequências absoluta e relativa e intervalos de confiança foram executados para analisar os parâmetros de adequação do processo da assistência pré-natal. Resultados: A concordância entre os registros dos cartões das gestantes e prontuários da atenção básica é, em sua maioria, ruim (Kappa<0,20). Nenhuma puérpera teve um processo de assistência pré-natal totalmente adequado segundo os critérios da OMS, enquanto apenas 5% das puérperas realizaram o pré-natal em consonância ao PHPN. Conclusão: Recomenda-se que em estudos de avaliação ou monitoramento o cartão da gestante deve ser utilizado como fonte prioritária. A adequação do processo da assistência pré-natal no município está distante do preconizado pelos critérios nacionais e internacionais. Nesse sentido, estratégias devem ser adotadas para garantir a realização dos procedimentos mínimos preconizados e para estabelecer um padrão sistematizado de registro das informações nos prontuários da atenção básica
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Souza, Sineide Santos de. "Avaliação dos atributos essenciais da Atenção Básica em Saúde da Criança: estudo de caso no Distrito de Saúde Norte da cidade de Manaus/AM." Universidade Federal do Amazonas - Fundação Oswaldo Cruz, 2016. http://tede.ufam.edu.br/handle/tede/5573.
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The Primary Health Care (APS) has been strengthened after the International Conference of Alma-Ata. Brazil has chosen the Family Health Strategy (FHS) to operationalize the PHC, as ordering the care model based on the principles of the Unified Health System (UHS). The APS has attributes which, being applied, favoring the quality of care, especially for children. This study aimed to evaluate the essential attributes of APS in health care for children offered by the FHS teams in the north of Manaus and identify the factors associated with essential score through the PCATool. This is an evaluative study and we used two instruments for data collection: a questionnaire on socioeconomic characteristics and the Primary Care Assessment Tool (PCATool) Brazil Child version. The study included 320 mothers of children under two years living and registered in the areas of coverage of the FHS teams. The analysis followed the recommendations of PCATool-Brazil Guide. As for the essential attributes of APS, showed satisfactory scores (≤ 6.6) only attributes Access - Use (6.7) and Coordination - Information System (8.7); the other attributes presented low scores: Access - Accessibility (5.0), Longitudinality (6.5), Coordination - Integration of Care (6.5), Comprehensiveness - Services Available (5.5) and Services (6.1). The Essential attribute score of APS was unsatisfactory (6.5) and shows that APS must move towards providing effective access and comprehensive care for children. The component degree of affiliation showed an average 6.7. Statistically significant between Essential score of APS and socioeconomic associations were identified, meaning that the outcome of Essential score can be attributed only to the health service offered. The α Cronbach presented value >0.75, reinforcing the validity of the instrument. The study revealed that the health care of children under two years in the FHS is not guided by APS and presents less effective, with problems related to access, difficulties in creating bond with the child/family, persistent fragmentation of care and coordination of care deficient. There is need for reorientation of health actions, in order to modify and improve the quality of care provided to the child population, which because of their vulnerability, makes up one of the priority areas in the country.
A Atenção Primária à Saúde (APS) vem sendo fortalecida após a Conferência Internacional de Alma-Ata. O Brasil escolheu a Estratégia Saúde da Família (ESF) para operacionalizar a APS, como ordenadora do modelo assistencial, baseada nos princípios do Sistema Único de Saúde (SUS). A APS possui atributos, os quais, sendo aplicados, favorecem a qualidade da atenção, especialmente para crianças. Este estudo objetivou avaliar os atributos essenciais da APS na assistência à saúde da criança ofertada pelas equipes da ESF na zona Norte de Manaus e identificar os fatores associados ao escore essencial, por meio do PCATool. Trata-se de uma pesquisa avaliativa com a utilização de dois instrumentos para coleta de dados: um questionário características socioeconômicas e o Instrumento de Avaliação da Atenção Primária – PCATool Brasil versão Criança. Participaram do estudo 320 mães de crianças menores de dois anos residentes e cadastradas nas áreas de abrangência das equipes da ESF. A analise obedeceu às recomendações do Manual PCATool-Brasil. Quanto aos atributos essenciais da APS, apresentaram escores satisfatórios (≤ 6,6) apenas os atributos Acesso – Utilização (6,7) e Coordenação – Sistema de Informação (8,7); os demais atributos apresentaram baixos escores: Acesso – Acessibilidade (5,0), Longitudinalidade (6,5), Coordenação – Integração de Cuidados (6,5), Integralidade – Serviços Disponíveis (5,5) e Serviços Prestados (6,1). O escore do atributo Essencial da APS foi insatisfatório (6,5), o que evidencia que a APS precisa avançar no sentido de oferecer acesso efetivo e cuidado integral à criança. O componente grau de afiliação apresentou média 6,7. Não foram identificadas associações estatisticamente significativas entre escore Essencial da APS e condições socioeconômicas, significando que o resultado do escore Essencial pode ser atribuído somente ao serviço de saúde oferecido. O α de Cronbach apresentou valor > 0,75 e comprovou a validade do instrumento. O estudo revelou que a assistência à saúde da criança menor de dois anos na ESF não está orientada pela APS e se apresenta pouco efetiva, com problemas relacionados ao acesso, dificuldades na criação de vínculo com a criança/família, persistência da fragmentação do cuidado e coordenação da atenção deficiente. Há necessidade de reorientação das ações de saúde, com vista a modificar e melhorar a qualidade da atenção oferecida à população infantil, que devido à sua vulnerabilidade, compõe uma das áreas prioritárias no país.
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Menezes, Maria Alexsandra da Silva. "Estrutura hospitalar e processos de trabalho envolvidos na assistência neonatal no Brasil." Pós-Graduação em Ciências da Saúde, 2018. http://ri.ufs.br/jspui/handle/riufs/8549.
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Background: Despite the decrease and achieving the fourth target of the Millennium Development Goals, infant mortality is still high in Brazil. Neonatal mortality represents 60% of infant mortality. Almost one million neonatal deaths occur on the day of birth. Adequate hospital structure and high coverage of work processes in neonatal care, recommended by World Health Organization in the Essential Newborn Care program could reduce neonatal mortality. Objective: to assess hospital structure adequacy according newborns needs and to describe the coverage of Essential Newborn Care items in Brazilian neonatal care, next to childbirth. Methods: A cohort study was conducted between February 2011 and October 2012, in 266 public and private funding maternity hospitals of five major regions of Brazil including data of 23,894 postnatal women and their infants. We interviewed maternity hospitals managers and postnatal woman and we assay medical records of mothers and newborns. The proportions of newborns with high obstetric risk were analysed according to the presence of Neonatal Intensive Care Unit (NICU) and the level of adequacy of hospital structure. To analyse association between the categories, we used the chi-square test, considering p <0.05. Simple regression models were developed to estimate the strength of the associations between the dependent variable (non-access to each item of essential newborn care) and the hospital structure and maternal socio-demographics characteristics. In sequence, multiple regression models were developed with each dependent variable and the independent variables that proved significant in the first analysis. The odds ratios were adjusted, and 95% CI were estimated. Results: Only 10% of newborns with high obstetric risk were born in public maternity hospitals with NICU and with an adequate structure. In private sector, they were 8%. In public sector almost 50% of newborns with high obstetric risk were born in maternity hospital without NICU; that percentage rose to over 60% in the North, Northeast and non-capital cities. Antenatal corticosteroids were used in 41% of cases where this was indicated; this declined to 20% in the North and Mid-West and rose to 63.1% at private facilities. Early skin-to-skin contact occurred in 26.3% of births and in 39.7% of vaginal deliveries. 59.1% of all newborns were breastfed in their first hour of birth. Inadequate (ORa 2.16; CI95% 1.17-4.01) and without NICU beds (ORa 3.93; CI95% 2.34-6.66) maternity hospitals were the factors most associated with non-use of antenatal corticosteroids. Caesarean section was most associated with the absence of early skin-to-skin contact (ORa 3.07; CI95% 3.37-4.90) and absence of breastfeeding in the first hour of birth (ORa 2.55; CI95% 2.21-2.96). Conclusions: A great number of newborns with high obstetric risk were born in inadequate maternity hospitals. The coverage of the Essential Newborn Care items in Brazil is low, and varies depending on the characteristics of both the mother and the health facility where the delivery occurs. We found association between absence of use of antenatal corticosteroid and inadequate structure. Caesarean section was found as a risk factor to absence of early skin-to-skin contact and breastfeeding in the first hour of birth.Introdução: A mortalidade infantil no Brasil, apesar de ter sido reduzida e alcançado a quarta meta dos Objetivos de Desenvolvimento do Milênio, ainda é elevada. O componente neonatal é responsável por 60% dessas mortes. Quase um milhão de mortes neonatais no mundo ocorrem no mesmo dia de nascimento. Estrutura hospitalar adequada e ampliação da cobertura dos processos de atendimento ao recém-nascido (RN), que são medidas preconizadas pela Organização Mundial de Saúde e estão agrupadas no programa Essential Newborn Care, poderiam reduzir a mortalidade neonatal. Objetivos: avaliar a adequação estrutural das maternidades brasileiras às necessidades do RN e a frequência de realização dos itens do Essential Newborn Care na assistência ao RN, no período próximo ao parto. Métodos: estudo transversal utilizando dados da pesquisa “Nascer no Brasil”, coorte sobre partos e nascimentos que ocorreram entre fevereiro de 2011 e outubro de 2012, em 266 maternidades públicas e privadas das cinco macrorregiões do Brasil, incluindo dados de 23.894 puérperas e seus RNs. Informações foram obtidas por meio de entrevista com o gestor, com as puérperas e através da análise dos prontuários. As proporções de RN em situação de alto risco foram analisadas conforme a presença de Unidade de Terapia Intensiva Neonatal (UTIN) e o grau de adequação da estrutura hospitalar, verificando a associação entre essas variáveis através do teste do qui-quadrado, considerado significativo se p<0,05. Para estimar a intensidade da associação entre a ausência de realização de algum item do Essential Newborn Care e características estruturais da unidade ou sócio-demográficas maternas foram realizados modelos de regressão simples. Em seguida, modelos de regressão múltipla foram desenvolvidos utilizando cada variável dependente e as variáveis independentes que foram significativas na regressão simples. Foram estimadas as razões de chance ajustadas (ORa) com os intervalos de confiança de 95% (IC95%). Resultados: Apenas 10% dos RNs em situação de alto risco nasceram em maternidades públicas com UTIN cuja estrutura foi classificada como adequada. No setor privado este percentual foi de 8%. No setor público, quase 50% da demanda de RN em situação de alto risco nasceu em maternidade sem UTIN, percentual que se elevou para mais de 60% nas Regiões Norte, Nordeste e cidades que não eram a capital. O corticoide antenatal foi utilizado em 41% dos casos indicados; reduzindo para 20% no Norte e Centro-Oeste e aumentando para 63,1% em estabelecimentos privados. O contato pele a pele precoce ocorreu em 26,3% dos partos e em 39,7% dos partos vaginais. O início do aleitamento materno na primeira hora de vida ocorreu para 59,1% dos neonatos. Unidades classificadas como inadequadas (ORa 2,16; IC95% 1,17-4,01) e sem UTIN (ORa 3,93; IC95% 2,34-6,66) estiveram mais associadas à não utilização do corticoide antenatal. A cesariana esteve mais associada à não realização do contato pele a pele precoce (ORa 3,07; IC95% 3,37-4,90) e do aleitamento materno na primeira hora de vida (ORa 2,55; IC95% 2,21-2,96). Conclusões: Proporção importante de RNs em situação de alto risco nasceram em unidades com estrutura inadequada para atender suas necessidades. As práticas descritas no Essential Newborn Care investigadas tiveram baixa cobertura em todo o país. Houve associação entre inadequação estrutural da maternidade e não uso de corticoide antenatal. A cesariana foi encontrada como fator de risco para ausência de contato pele a pele precoce e de aleitamento materno na primeira hora de vida.
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Salina, Alessandra. "O abrigo como fator de risco e proteção: indicadores e avaliação institucional." Universidade Federal de São Carlos, 2007. https://repositorio.ufscar.br/handle/ufscar/2964.
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Previous issue date: 2007-02-09Universidade Federal de Sao Carlos
Research indicates how foster care institutions problems may harm the development of children and adolescents in need for protection. Thus, a more efficient practice by professionals who work in these entities could contribute with the prevention of deficiencies, which institutionalized children may present. The present work focuses on the role of child protection services and has as general objective to investigate the strategies employed by such professionals, when evaluating foster care institutions, as well as under which quality indicators their assessment behavior is under control. Two studies were carried through in two interior cities of São Paulo estate, Brazil. Four child protection agents, a member of the Municipal Council for the Rights of the Children and the Adolescents, a member of the Social Assistance City Council, the Judiciary power s Social Worker, the town´s Judge, and the Coordinator of the town s single foster care institution participated of Study 1. Study 2 participants were: nine professionals responsible for the foster care evaluation (five Child Protection Agents, one member of the Municipal Council for the Rights of the Children and the Adolescents, the Youth and Child Judge and the city s Prosecutor; as well as five foster care institutions Coordinators). The data was collected by means of interviews, questionnaires and document analysis. Results indicated that the professionals who monitor foster care institutions, in both studies, use, predominantly, local visits to the entity as an evaluation strategy. However, these visits vary in frequency and format (some talk every two to six months with employees and children; while others only observe the functioning of the entity). Quality indicators described as guidelines for the assessment are also varied. The low frequency of reports regarding training aspects of foster care staff and the entity s concern for maintenance of the familiar bonds are of notice.
Pesquisas indicam como as dificuldades de instituições do tipo abrigo podem prejudicar o desenvolvimento de crianças e adolescentes que estão sob essa medida de proteção. Nesse sentido, uma prática mais eficiente dos profissionais que atuam nessas entidades, poderia contribuir com a prevenção de deficiências às quais os abrigados estão sujeitos. O presente trabalho foca o papel da rede de proteção à criança e ao adolescente e tem o objetivo geral de investigar as estratégias utilizadas por esses profissionais ao avaliarem os abrigos, bem como sob quais indicadores de qualidade o comportamento de avaliar dos mesmos está sob controle. Foram realizados dois estudos em duas cidades do centro-oeste do estado de São Paulo. Participaram do Estudo 1 quatro conselheiros tutelares, uma representante do Conselho Municipal dos Direitos das Crianças e dos Adolescentes, uma integrante do Conselho de Assistência Social do Município, a Assistente Social do poder judiciário, o juiz da cidade e a coordenadora do único abrigo do município. Os participantes do Estudo 2 foram nove profissionais responsáveis pela avaliação dos abrigos, sendo eles: os cinco Conselheiros Tutelares do Município, uma das integrantes do Conselho Municipal dos Direitos da Criança e do Adolescente, o Juiz da Vara da Infância e da Juventude e o promotor da cidade; e cinco coordenadores de abrigos. A coleta de dados foi realizada por meio de entrevistas, questionários e análise documental. Os resultados indicam que os profissionais que monitoram os abrigos, em ambos os estudos, utilizam predominantemente a visita à entidade como estratégia de avaliação. No entanto a mesma é conduzida de forma e freqüência variada (alguns conversam, bimestralmente ou semestralmente, com funcionários e abrigados; outros apenas observam o funcionamento da entidade). Os indicadores de qualidade descritos como orientadores da tarefa de avaliar, também são variados. Ressalta-se a baixa freqüência de citação de aspectos relacionados às práticas educativas dos monitores dos abrigos e cuidados da entidade para manutenção dos vínculos familiares.