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Anales de Pediatria (Barcelona, Spain :... May 2015
Topics: Adoption; Child; Humans; Internationality; Spain
PubMed: 25704273
DOI: 10.1016/j.anpedi.2015.01.007 -
Frontiers in Endocrinology 2023Neuro-biological variations in the timing of sexual maturation within a species are part of an evolved strategy that depend on internal and external environmental... (Review)
Review
Neuro-biological variations in the timing of sexual maturation within a species are part of an evolved strategy that depend on internal and external environmental conditions. An increased incidence of central precocious puberty (CPP) has been described in both adopted and "covid-19 pandemic" children. Until recently, it was hypothesised that the triggers for CPP in internationally adopted children were likely to be better nutrition, greater environmental stability, and improved psychological wellbeing. However, following data collected during and after the coronavirus (COVID-19) global pandemic, other possibilities must be considered. In a society with high levels of child wellbeing, the threat to life presented by an unknown and potentially serious disease and the stressful environment created by lockdowns and other public health measures could trigger earlier pubertal maturation as an evolutionary response to favour early reproduction. The main driver for increased rates of precocious and rapidly progressive puberty during the pandemic could have been the environment of "fear and stress" in schools and households. In many children, CPP may have been triggered by the psychological effects of living without normal social contact, using PPE, being near adults concerned about financial and other issues and the fear of getting ill. The features and time of progression of CPP in children during the pandemic are similar to those observed in adopted children. This review considers the mechanisms regulating puberty with a focus on neurobiological and evolutionary mechanisms, and analyses precocious puberty both during the pandemic and in internationally adopted children searching for common yet unconsidered factors in an attempt to identify the factors which may have acted as triggers. In particular, we focus on stress as a potential factor in the early activation of the hypothalamic-pituitary-gonadal axis and its correlation with rapid sexual maturation.
Topics: Child; Adult; Humans; Puberty, Precocious; COVID-19; Adoption; Pandemics; Communicable Disease Control
PubMed: 37201098
DOI: 10.3389/fendo.2023.1149417 -
Sensors (Basel, Switzerland) Sep 2022The study sought to: (1) evaluate agriculturalists' characteristics as adopters of IoT smart agriculture technologies, (2) evaluate traits fostering innovation adoption,...
The study sought to: (1) evaluate agriculturalists' characteristics as adopters of IoT smart agriculture technologies, (2) evaluate traits fostering innovation adoption, (3) evaluate the cycle of IoT smart agriculture adoption, and, lastly, (4) discern attributes and barriers of information communication. Researchers utilized a survey design to develop an instrument composed of eight adoption constructs and one personal characteristic construct and distributed it to agriculturalists at an agricultural exposition in Rio Grande do Sul. Three-hundred-forty-four ( = 344) agriculturalists responded to the data collection instrument. Adopter characteristics of agriculturalists were educated, higher consciousness of social status, larger understanding of technology use, and more likely identified as opinion leaders in communities. Innovation traits advantageous to IoT adoption regarding smart agriculture innovations were: (a) simplistic, (b) easily communicated to a targeted audience, (c) socially accepted, and (d) larger degrees of functionality. Smart agriculture innovation's elevated levels of observability and compatibility coupled with the innovation's low complexity were the diffusion elements predicting agriculturalists' adoption. Agriculturalists' beliefs in barriers to adopting IoT innovations were excessive complexity and minimal compatibility. Practitioners or change agents should promote IoT smart agriculture technologies to opinion leaders, reduce the innovation's complexity, and amplify educational opportunities for technologies. The existing sum of IoT smart agriculture adoption literature with stakeholders and actors is descriptive and limited, which constitutes this inquiry as unique.
Topics: Agriculture; Brazil
PubMed: 36146184
DOI: 10.3390/s22186833 -
PloS One 2021The capacity for reflective functioning (RF) or mentalizing of adoptive parents is hypothesized to play an important role in fostering socio-emotional development in...
The capacity for reflective functioning (RF) or mentalizing of adoptive parents is hypothesized to play an important role in fostering socio-emotional development in adopted children. This paper reports on the development and preliminary validation of the Adoption Expectations Interview (AEI), a semi-structured interview to assess RF in prospective adoptive parents. The AEI was developed based on the Pregnancy Interview, Parent Development Interview, and Working Model of the Child Interview, three interviews that have been used to assess RF in biological parents, to capture RF before child arrival in prospective adoptive parents. In a sample of 96 prospective adoptive parents, the Reflective Functioning Scale, as applied to the AEI (AEI-RFS) showed good reliability, with strong correlations between the different demand items, high internal consistency, and good to excellent inter-rater reliability. A principal component analysis yielded one component, suggesting that the items measured a unidimensional factor. Preliminary evidence for the construct validity of the AEI-RFS was demonstrated by significant associations between the AEI-RFS and well-validated measures of mentalizing, attachment dimensions, and interpersonal functioning.
Topics: Adoption; Adult; Female; Humans; Male; Mentalization; Parents; Principal Component Analysis; Surveys and Questionnaires
PubMed: 33497406
DOI: 10.1371/journal.pone.0245852 -
Journal of Medical Internet Research Dec 2023Electronic health record (EHR) systems have been shown to be associated with improvements in care processes, quality of care, and patient outcomes. EHR also has a...
BACKGROUND
Electronic health record (EHR) systems have been shown to be associated with improvements in care processes, quality of care, and patient outcomes. EHR also has a crucial role in the delivery of substance use disorder (SUD) treatment and is considered important for addressing SUD crises, including the opioid epidemic. However, little is known about the adoption of EHR in SUD treatment programs or the organizational-level factors associated with the adoption of EHR in SUD treatment.
OBJECTIVE
We examined the adoption of EHR in SUD programs, with a focus on changes in adoption from 2014 to 2017, and identified organizational-level factors associated with EHR adoption.
METHODS
We used data from the 2014 and 2017 National Drug Abuse Treatment System Surveys. Our analysis included 1027 SUD programs (531 in 2014 and 496 in 2017). We used chi-square and Mann-Whitney U tests for categorical and continuous variables, respectively, to assess changes in EHR adoption, technology use, program, and client characteristics. We also investigated differences in characteristics and barriers to adoption by EHR adoption status (adopted EHR vs had not adopted or were planning to adopt EHR). We then conducted multivariate logistic regressions to examine internal and external factors associated with EHR adoption.
RESULTS
The adoption of EHR increased significantly from 57.6% (306/531) in 2014 to 69.2% (343/496) in 2017 (P<.001), showing that nearly one-third (153/496, 30.8%) of SUD programs had not yet adopted an EHR system by 2017. We identified a significant increase in technology use and ownership by a parent company (P=.01 and P<.001) and a decrease in the percentage of uninsured patients in 2017 (P<.001), compared to 2014. Our analysis further showed significant differences by adoption status for three major barriers to adoption: (1) start-up costs, (2) ongoing financial costs, and (3) privacy or security concerns (P<.001). Programs that used computerized scheduling (adjusted odds ratio [AOR] 3.02, 95% CI 2.23-4.09) and billing systems (AOR 2.29, 95% CI 1.62-3.25) were more likely to adopt EHR. Similarly, ownership type, such as private nonprofit (AOR 1.86, 95% CI 1.31-2.65) and public (AOR 2.14, 95% CI 1.27-3.67), or interest in participating in a patient-centered medical home (AOR 1.93, 95% CI 1.29-2.92), were associated with an increased likelihood to adopt EHR. Overall, SUD programs were more likely to adopt an EHR system in 2017 compared to 2014 (AOR 1.44, 95% CI 1.07-1.94).
CONCLUSIONS
Our findings highlighted that SUD programs may be on track to achieve widespread EHR adoption. However, there is a need for focused strategies, resources, and policies explicitly designed to systematically address barriers and tackle obstacles to expanding the adoption of EHR systems. These efforts must be holistic and address factors at multiple organizational levels.
Topics: Humans; Electronic Health Records; Cross-Sectional Studies; Surveys and Questionnaires; Odds Ratio; Substance-Related Disorders
PubMed: 38096006
DOI: 10.2196/45238 -
Danish Medical Journal Aug 2015Several studies have documented that international adoptees have an increased occurrence of health problems and contacts to the health-care system after arriving to...
INTRODUCTION
Several studies have documented that international adoptees have an increased occurrence of health problems and contacts to the health-care system after arriving to their new country of residence. This may be explained by pre-adoption adversities, especially for the period immediately after adoption. Our study aimed to the assess health-care utilisation of international adoptees in primary and secondary care for somatic and psychiatric diagnoses in a late post-adoption period. Is there an increased use of the health-care system in this period, even when increased morbidity in the group of international adoptees is taken into consideration?
METHODS
This was a Danish register-based cohort study examining health-care utilisation in a multivariable two-part model. The prevalence of selected outcomes and the quantity of use were assessed in a late (year three, four and five) post-adoption period. The cohort comprised internationally adopted children (n = 6,820), adopted between 1994 and 2005, and all non-adopted children (n = 492,374) who could be matched with the adopted children on sex, age, municipality and family constellation at the time of adoption.
RESULTS
International adoption increased the use of all services in primary care, while in secondary care only few areas showed an increased long-term morbidity.
CONCLUSION
International adoptees use medical services in primary care at a higher rate than non-adoptees some years after adoption. Excess use of services in secondary care is also present, but only exists in selected areas.
FUNDING
none.
TRIAL REGISTRATION
not relevant.
Topics: Adoption; Child, Preschool; Denmark; Emigration and Immigration; Female; Humans; Infant; Infant, Newborn; Male; Matched-Pair Analysis; Mental Disorders; Patient Acceptance of Health Care; Primary Health Care; Registries; Secondary Care
PubMed: 26239586
DOI: No ID Found -
Journal of Cancer Survivorship :... Feb 2017We compared adoption consideration between female young adult cancer survivors and women of the same age in the general US population, hypothesizing that cancer...
PURPOSE
We compared adoption consideration between female young adult cancer survivors and women of the same age in the general US population, hypothesizing that cancer survivors who desired children would report greater interest in adoption than an age-adjusted general population sample who desired children.
METHODS
After age-standardizing the cancer survivor cohort to match the age distribution of the 2006-2010 National Survey for Family Growth (NSFG), we estimated adoption consideration among women age 18-35 years who wanted a (another) child in the two cohorts overall and within age groups. We assessed characteristics and concerns related to adoption consideration among cancer survivors.
RESULTS
Among cancer survivors, 81.6 % (95 % CI 75.7-87.6) reported that they would consider adoption compared to 40.3 % (95 % CI 40.3-40.3) of women in the general population. While over 80 % of the cancer survivor sample reported that they would consider adoption, only 15 % of cancer survivors reported no concerns about adoption. The most common concerns were desire for a biological child (48 %), expense (45 %), adoption agency candidacy (41 %), and needing more information (39 %).
CONCLUSION
We observed a twofold higher interest in adoption when comparing the cancer survivor with the general population, suggesting that adoption is a consideration for many young women who have survived cancer.
IMPLICATIONS FOR CANCER SURVIVORS
Adoption is an important family-building option for those who want to have a child but are unable to or choose not to have a biological child. However, young adult survivors may need more support to understand and navigate this process.
Topics: Adolescent; Adoption; Adult; Cohort Studies; Female; Humans; Neoplasms; Survivors; Young Adult
PubMed: 27696249
DOI: 10.1007/s11764-016-0572-1 -
Current Opinion in Psychology Feb 2019Research with adoptive families offers novel insights into longstanding questions about the significance of attachment across the lifespan. We illustrate this by... (Review)
Review
Research with adoptive families offers novel insights into longstanding questions about the significance of attachment across the lifespan. We illustrate this by reviewing adoption research addressing two of attachment theory's central ideas. First, studies of children who were adopted after experiencing severe adversity offer powerful tests of the unique consequences of experiences in early attachment relationships. Although children who experience early maltreatment or institutionalization show remarkable recovery in the quality of their attachments after being placed with their adoptive families, experiencing pre-adoptive adversity also has long-lasting repercussions for these individuals' later attachment representations. Second, adoptive families allow for genetically-informed examinations of the intergenerational transmission process. Indeed, despite the lack of genetic relatedness, adoptive parents' attachment representations are associated with their children's attachment behaviors and representations across childhood and adolescence.
Topics: Adoption; Humans; Longevity; Object Attachment; Psychological Theory
PubMed: 29621692
DOI: 10.1016/j.copsyc.2018.03.011 -
BMC Health Services Research Sep 2023The digitalization studies in public hospitals in Türkiye started with the Health Transformation Program in 2003. As digitalization was accomplished, the policymakers...
BACKGROUND
The digitalization studies in public hospitals in Türkiye started with the Health Transformation Program in 2003. As digitalization was accomplished, the policymakers needed to measure hospitals' electronic health record (EHR) usage and adoptions. The ministry of health has been measuring the dissemination of meaningful usage and adoption of EHR since 2013 using Electronic Medical Record Adoption Model (EMRAM). The first published study about this analysis covered the surveys applied between 2013 and 2017. The results showed that 63.1% of all hospitals in Türkiye had at least basic EHR functions, and 36% had comprehensive EHR functions. Measuring the countrywide EHR adoption level is becoming popular in the world. This study aims to measure adoption levels of EHR in public hospitals in Türkiye, indicate the change to the previous study, and make a benchmark with other countries measuring national EHR adoption levels. The research question of this study is to reveal whether there has been a change in the adoption level of EHR in the three years since 2018 in Türkiye. Also, make a benchmark with other countries such as the US, Japan, and China in country-wide EHR adoption in 2021.
METHODS
In 2021, 717 public hospitals actively operating in Türkiye completed the EMRAM survey. The survey results, deals with five topics (General Stage Status, Information Technology Security, Electronic Health Record/Clinical Data Repository, Clinical Documentation, Closed-Loop Management), was reviewed by the authors. Survey data were compared according to hospital type (Specialty Hospitals, General Hospitals, Teaching and Research Hospitals) in terms of general stage status. The data obtained from the survey results were analyzed with QlikView Personal Edition. The availability and prevalence of medical information systems and EHR functions and their use were measured.
RESULTS
We found that 33.7% of public hospitals in Türkiye have only basic EHR functions, and 66.3% have extensive EHR functions, which yields that all hospitals (100%) have at least basic EHR functions. That means remarkable progress from the previous study covering 2013 and 2017. This level also indicates that Türkiye has slightly better adoption from the US (96%) and much better than China (85.3%) and Korea (58.1%).
CONCLUSIONS
Although there has been outstanding (50%) progress since 2017 in Turkish public hospitals, it seems there is still a long way to disseminate comprehensive EHR functions, such as closed-loop medication administration, clinical decision support systems, patient engagement, etc. Measuring the stage of EHR adoption at regular intervals and on analytical scales is an effective management tool for policymakers. The bottom-up adoption approach established for adopting and managing EHR functions in the US has also yielded successful results in Türkiye.
Topics: Humans; Electronic Health Records; Hospitals, Public; Benchmarking; China; Decision Support Systems, Clinical
PubMed: 37710253
DOI: 10.1186/s12913-023-09859-w -
Animals : An Open Access Journal From... Sep 2022Not all dog adoptions are successful. This two-year retrospective study used survival (i.e., time-to-event) analyses to investigate readmissions for dogs adopted from...
Not all dog adoptions are successful. This two-year retrospective study used survival (i.e., time-to-event) analyses to investigate readmissions for dogs adopted from RSPCA Queensland shelters between 1 January 2019 and 31 December 2020. A better understanding of temporal patterns and risk factors associated with readmission may help RSPCA Queensland shelters better target and tailor resources to improve retention by adopters. The failure function (the cumulative percentage of adoptions that were readmitted by day of the adoption period) increased rapidly during the first 14 days of the adoption period. Approximately two-thirds of all returns occurred in this period. This readmission rate may have been influenced by the RSPCA Queensland adoption-fee refund policy. The cumulative percentage of adoptions that were readmitted plateaued at just under 15%. Dog size, age, coat colour, breed, and spending time in foster before adoption were factors associated with the risk of readmission. Failure functions for a low and a high-risk adoption example demonstrated the large degree of difference in hazard of readmission between covariate patterns, with estimated percentages of adoptions being returned by 90 days for those examples being 2% and 17%, respectively. Spending time in foster care before adoption appears to be protective against readmission, presumably because it supports a successful transition to the new home environment. Behaviour support and training provided for dogs during foster care may contribute to improve their outcomes. These findings highlight the profile of the higher-risk dogs potentially providing shelters with an opportunity to examine where and how resources could be allocated to maximize outcomes for the overall cohort. Population attributable 90-day failure estimates were calculated for each of bodyweight and age at adoption, coat colour, spending time in foster care before adoption, and breed. This calculation shows the expected reduction in the cumulative percentage of dogs readmitted by day 90 if the hazards of readmission for higher risk categories were reduced to those of a lower risk category. Expected reductions for individual factors ranged from 1.8% to 3.6% with one additional estimate of 6.8%. Risk of readmission could be reduced through increased development of foster capacity and capability, targeted interventions, improved adopter-dog matching processes, and more effective targeting of support for higher risk dogs, such as older or larger dogs. Population impact analyses provide a macro view that could assist shelters in strategically assessing the return on investment for various strategies aiming to improve adoption outcomes and potentially reduce readmissions.
PubMed: 36230311
DOI: 10.3390/ani12192568