RESUMEN
The outbreak of novel coronavirus disease 2019 (COVID-19) has had a momentous impact on the field of otolaryngology due to the high number of aerosol-generating procedures involving the upper aerodigestive tract. These procedures bear significant risk to the provider and clinical environment due to the possibility of viral aerosolization. While significant attention has been appropriately paid to personal protective equipment during this pandemic, an understanding of industrial hygiene is also necessary for the safe delivery of health care to mitigate the risk of exposure to other patients and health care workers. We provide a review of air ventilation practices and their role in reducing pathogen spread. In addition, we share our experiences with effectively treating COVID-19-positive patients aboard the USNS Comfort through proper environment control measures.
Asunto(s)
COVID-19/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Control de Infecciones/métodos , Pandemias , Aisladores de Pacientes , COVID-19/transmisión , Personal de Salud , Humanos , Ciudad de Nueva York , Otolaringología , Equipo de Protección Personal , SARS-CoV-2 , Navíos , VentilaciónRESUMEN
Evidence-supported parenting interventions (ESPIs) have expanded into child welfare because a growing research base has demonstrated positive results among children with serious emotional and behavioral problems. Despite a clear federal policy emphasis on reunification, few randomized trials have tested ESPIs with biological families of children in foster care; even fewer studies have investigated the distal outcomes of ESPIs. The aim of the current study was to examine the effects of Parent Management Training, Oregon (PMTO) model on reunification. Children in foster care with emotional and behavioral problems were randomized to in-home PMTO (nâ¯=â¯461) or services as usual (SAU) (nâ¯=â¯457). Cox regression models tested whether children in the PMTO group achieved higher rates of reunification. We applied life tables data for integrals calculations to estimate days saved in foster care. Analyses were conducted as intent-to-treat (ITT), and per protocol analysis (PPA). ITT results showed reunification rates were 6.9% higher for the PMTO group (62.7%) than the SAU group (55.8%) with 151 days saved per typical child. PPA indicated that intervention completion strengthened effects as PMTO completers' reunification rates (69.5%) were 13.7% higher than the SAU group (55.8%), and were 15.3% higher than non-completers (54.2%). Days saved were also greater for completers as compared to the SAU group (299 days) and non-completers (358 days). Overall, findings suggest that an in-home parenting intervention positively affected reunification as delivered to biological parents of children and youth in foster care with serious emotional and behavioral problems. Implications and future considerations for research are discussed.
Asunto(s)
Niño Acogido/psicología , Emociones , Cuidados en el Hogar de Adopción/estadística & datos numéricos , Padres/educación , Problema de Conducta/psicología , Adolescente , Niño , Protección a la Infancia/psicología , Protección a la Infancia/estadística & datos numéricos , Preescolar , Femenino , Cuidados en el Hogar de Adopción/psicología , Humanos , Estudios Longitudinales , Masculino , Oregon , Relaciones Padres-Hijo , Responsabilidad Parental/psicología , Padres/psicología , Modelos de Riesgos ProporcionalesRESUMEN
Although parental substance abuse has been identified as a risk factor for poor foster care outcomes, current research on effective interventions is limited. A few studies have shown that parenting interventions improved parenting skills and family functioning and decreased time to reunification among children in foster care due to parental substance abuse. However, more research is needed to evaluate whether these interventions positively impact reentry rates. Using propensity score analyses to establish a matched comparison group, survival analyses evaluated the relationship between participation in a parenting intervention, the Strengthening Families Program (SFP), and reentry among a sample of 493 children previously reunified with their parents. The overall reentry rate was 20.9%. Analyses indicated that there was no difference in reentry rates between the SFP (23.7%) and comparison groups (18.6%). Significant predictors of reentry were child behavior problems, family poverty, and reunification between 15 and 18 months from removal.
Asunto(s)
Protección a la Infancia/psicología , Cuidados en el Hogar de Adopción/psicología , Relaciones Padres-Hijo , Responsabilidad Parental/psicología , Trastornos Relacionados con Sustancias/psicología , Adulto , Niño , Maltrato a los Niños/psicología , Femenino , Humanos , Masculino , Padres , Trastornos Relacionados con Sustancias/prevención & controlRESUMEN
Despite the presence of significant psychiatric comorbidity among children with autism spectrum disorders (ASDs), little research exists on those who receive community-based mental health services. This project examined one year (2004) of data from the database maintained by 26 community mental health centers (CMHCs) in the Midwestern US state of Kansas. Children with autism were compared to children with other ASDs - Asperger's disorder, Rett's disorder, and PDD-NOS. Children with autism predictably received more special education services than children with other ASDs, while the latter were more likely to have experienced prior psychiatric hospitalization. Children with ASDs other than autism were also significantly more likely to be diagnosed with attention deficit hyperactivity disorder, oppositional defiant disorder, depressive disorders, and bipolar disorder. In 2004, Kansas CMHCs served less than 15 percent of the children estimated to have an ASD. Implications of these findings are discussed.