ABSTRACT
Objectives In this large scale, mixed methods evaluation, we determined the impact and context of early childhood home visiting on rates of child abuse-related injury. Methods Entropy-balanced and propensity score matched retrospective cohort analysis comparing children of Pennsylvania Nurse-Family Partnership (NFP), Parents As Teachers (PAT), and Early Head Start (EHS) enrollees and children of Pennsylvania Medicaid eligible women from 2008 to 2014. Abuse-related injury episodes were identified in medical assistance claims with ICD-9 codes. Weighted frequencies and logistic regression odds of injury within 24 months are presented. In-depth interviews with staff and clients (n = 150) from 11 programs were analyzed using a modified grounded theory approach. Results The odds of a healthcare encounter for early childhood abuse among clients were significantly greater than comparison children (NFP: 1.32, 95% CI [1.08, 1.62]; PAT: 4.11, 95% CI [1.60, 10.55]; EHS: 3.15, 95% CI [1.41, 7.06]). Qualitative data illustrated the circumstances of and program response to client issues related to child maltreatment, highlighting the role of non-client caregivers. All stakeholders described curricular content aimed at prevention (e.g. positive parenting) with little time dedicated to addressing current or past abuse. Clients who reported a lack of abuse-related content supposed their home visitor's assumption of an absence of risk in their home, but were supportive of the introduction of abuse-related content. Approach, acceptance, and available resources were mediators of successfully addressing abuse. Conclusions for Practice Home visiting aims to prevent child abuse among high-risk families. Adequate home visitor capacity to proactively assess abuse risk, deliver effective preventive curriculum with fidelity to caregivers, and access appropriate resources is necessary.
Subject(s)
Allied Health Personnel/psychology , Child Abuse/prevention & control , Family/psychology , Home Care Services/organization & administration , House Calls/statistics & numerical data , Parenting/psychology , Parents/education , Program Evaluation/methods , Adult , Child , Child, Preschool , Female , Humans , Male , Maternal Behavior , Pennsylvania , Qualitative Research , Retrospective Studies , Young AdultABSTRACT
The article "A Mixed Methods Evaluation of Early Childhood Abuse Prevention Within Evidence-Based Home Visiting Programs", written by M. Matone, K. Kellom, H. Griffis, W. Quarshie, J. Faerber, P. Gierlach, J. Whittaker, D. M. Rubin and P. F. Cronholm, was originally published electronically on the publisher's internet portal (currently SpringerLink) on 31 May 2018 without open access. With the author(s)' decision to opt for Open Choice the copyright of the article changed on 27 July 2018 to
ABSTRACT
The potential role of the kidney in renal serine synthesis was elucidated in rats following dietary serine as well as serine and glycine depletion for 6 weeks. Serine deficient diet caused a significant rise in blood serine and glycine values. In contrast, blood glycine concentration decreased significantly following serine and glycine depletion, whereas blood serine levels remained unchanged. Bilateral nephrectomy caused a significant decrease of blood serine values of control and serine deficient rats. Serine concentration, however, was not affected by bilateral nephrectomy following serine and glycine deficiency indicating kidney-independent serine synthesis under these conditions. There was a significant increase of blood lactate and pyruvate levels under serine and serine/glycine deficient diet compared with control animals, whereas blood ketone bodies fell. In contrast, 24 h after bilateral nephrectomy blood ketone bodies rose and blood lactate and pyruvate concentrations decreased significantly. 24 h after bilateral nephrectomy there was a marked rise in blood citrate values of female rats compared with male animals indicating sex dependency of kidney citrate metabolism in the rat.