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1.
Child Welfare ; 101(3): 209-234, 2023 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-38093717

RESUMO

The mission of child welfare is to ensure children's safety, permanency, and well-being. It is also charged with preserving and strengthening families and with avoiding the removal of children who can be kept at home safely. This paper addresses some of the challenges in meeting these concurrent goals in work with children prenatally exposed to alcohol and their families. Current child welfare practices are unlikely to identify prenatal alcohol exposure or children with fetal alcohol spectrum disorders (FASD). Yet if this exposure is identified when families come into contact with child welfare, a jurisdiction's laws and safety and risk assessment processes may lead to unnecessary removal of children from their homes, particularly for Black and American Indian/Alaska Native families. Drawing from research and discourse in the field, strategies are described that could help the child welfare system care for children who may be impacted by FASD while preserving their families. A crucial strategy is partnering with key child and family service providers to identify and respond to FASD.

2.
Child Welfare ; 101(2): 141-168, 2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38021378

RESUMO

This article presents findings from a mixed-methods study exploring child welfare agency practices addressing children with prenatal substance exposure and their families. Data sources include: (a) interviews with 159 professionals in child welfare; (b) surveys with 271 professionals in child welfare; and (c) a systematic review of state and local child welfare documents guiding processes in the five states in the study sample. Findings from descriptive statistics of survey data, grounded theory analysis of interviews, and content analysis of documents suggest practices center on infants identified by hospitals as affected by prenatal substance exposure. Without practice guidance and access to treatment services, the needs of older children whose prenatal exposure to substances, including alcohol and other types of legal and illegal substances, is not recognized at birth may be overlooked.

4.
J Card Surg ; 30(5): 431-2, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25728450

RESUMO

Aortic valve rupture has been previously reported in association with blunt chest trauma as well as spontaneously in the setting of abnormal valves. We present a case of a patient who required emergent aortic valve replacement following rupture of his aortic valve during an isometric muscle contraction.


Assuntos
Valva Aórtica/lesões , Contração Isométrica , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Ruptura/diagnóstico , Ruptura/cirurgia
5.
Eval Program Plann ; 97: 102231, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36709722

RESUMO

Three federally funded Child Welfare Capacity Building Centers provide services to build the organizational capacity of public child welfare agencies to help meet federal requirements, improve practice, and improve outcomes for children and families. The aim of this study was to explore capacity outcomes in five dimensions - resources, infrastructure, knowledge and skills, culture and climate, and engagement and partnership - achieved by child welfare jurisdictions who received Center services. Analyses describe the capacities targeted for improvement and the amount and type of services provided by Centers; assess the relationship between services and capacity increase; and explore whether that relationship differs depending on the jurisdiction's level of foundational capacity. Data collected through surveys and a service delivery tracking system reflect the perspectives of service recipients and service providers. Results reveal jurisdictions typically targeted capacity outcomes in the dimensions of knowledge and skills and infrastructure and received an average of 28 hours of direct services to support their capacity-building efforts. Dosage of service was positively associated with achievement of capacity outcomes, though no interaction was found between service dosage and foundational capacity in the effect on outcomes. Methodological lessons learned and implications for future evaluations of organizational capacity building efforts are offered.


Assuntos
Fortalecimento Institucional , Fonte de Informação , Criança , Humanos , Avaliação de Programas e Projetos de Saúde , Proteção da Criança , Serviços de Proteção Infantil
6.
J Public Child Welf ; 1(24)2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33897309

RESUMO

Many parents who interact with the child welfare system present with substance use issues, which means their children are at risk for prenatal exposure to alcohol and other drugs. Because child welfare agencies play an important role in identifying and providing services to mitigate negative impacts of prenatal exposures, we conducted a search for literature addressing child welfare information sources, policies, and practices related to this population. The search yielded 16 research/evaluation and 16 policy/practice papers, with most addressing exposures to both alcohol and other drugs. The literature most commonly reports that children identified as exposed are referred to child protection agencies during the newborn period. This practice may lead to underidentification, especially of children with prenatal exposure to alcohol. Research suggests that this population is at risk for poorer child welfare outcomes and that there are specific service needs for these children. This review indicates that there is an overall lack of research literature regarding identification of prenatally exposed children involved in the child welfare system that could best inform child welfare policies and practices. Studies investigating how the child welfare system identifies and cares for children with prenatal exposures are needed.

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