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Archives of Disease in Childhood Jan 2020To explore social workers' and medical advisors' accounts of genetic testing in adoption.
OBJECTIVE
To explore social workers' and medical advisors' accounts of genetic testing in adoption.
METHODS
A qualitative study using semi-structured interviews to gather in-depth accounts of retrospective cases. Data were analysed thematically to identify professionals' knowledge and expectations.
RESULTS
Twenty professionals working in adoption services (including 8 medical advisors and 12 social workers) participated in this study. Social workers adopted an essentialist (single-gene) model to discuss genetic testing in relation to past cases. They assumed that testing was a generic procedure for detecting the presence or absence of a specific aetiology, the results of which were believed to be definitive and mutually exclusive. By contrast, medical advisors were circumspect and agnostic about the meaning of results, especially in relation to chromosomal microarray testing. Whereas social workers believed that genetic testing provided clarity in assessment and therefore assisted adoption, medical advisors emphasised the uncertainties of testing and the possibility that prospective adopters might be misled. Medical advisors also reported inappropriate requests to test children where there was a family history of a genetic condition, or to confirm or exclude a diagnosis of fetal alcohol spectrum disorder in children presenting with non-specific dysmorphic features.
CONCLUSION
Recent advances in genetic technologies are changing the ways in which professionals understand and tolerate uncertainty in adoption. Social workers and medical advisors have different understandings and expectations about the clinical utility of genetic testing. These findings have implications for social work training about genetic testing and enabling effective communication between professional groups.
Topics: Adoption; Communication; Female; Genetic Testing; Humans; Interviews as Topic; Male; Pediatricians; Retrospective Studies; Social Workers; Wales
PubMed: 31296598
DOI: 10.1136/archdischild-2019-316911 -
Preventing Chronic Disease Jun 2018In 2016, the US Department of Housing and Urban Development (HUD) issued a new rule requiring smoke-free policies in conventional public housing by July 2018 (HUD,...
PURPOSE AND OBJECTIVES
In 2016, the US Department of Housing and Urban Development (HUD) issued a new rule requiring smoke-free policies in conventional public housing by July 2018 (HUD, 2016). This process evaluation describes the policy development experiences of conventional and nonconventional public housing authorities (PHAs) in North Carolina and Georgia that had established smoke-free policies before the HUD rule.
INTERVENTION APPROACH
HUD began to issue guidance that encouraged smoke-free policies in public housing in 2009, and most early adopters were outside of the Southeast. Documenting the process early adopters in the Southeast used to develop their policies provides useful lessons for conventional PHAs and those with properties not covered by the rule.
EVALUATION METHODS
Semi-structured interviews were conducted with PHA representatives from 23 PHAs with some level of smoking restriction, along with residents from 14 of these PHAs, from January to August 2016.
RESULTS
Organizational leaders and board members were usually the primary players in making the decision to adopt a policy, with approval processes consistent with any type of policy adoption. Common reasons for establishing the policy included costs of turning a unit; health of children, nonsmokers, and staff; HUD guidance; and concerns or experience with fire caused by cigarettes. Levels of restriction were influenced by layout of the property, perceptions of compliance and enforcement challenges, concerns about smokers congregating, resident mobility, weather concerns, consistency with HUD guidance, and availability of funds for designated smoking areas. Resident input was obtained through general meetings, resident advisory boards or councils, surveys, and formal comment periods.
IMPLICATIONS FOR PUBLIC HEALTH
Understanding the process of policy development and adoption enables public health practitioners to be more effective partners in advising on the flexible components of the HUD smoke-free rule and accelerating the adoption of comprehensive policies within nonconventional PHAs.
Topics: Georgia; Humans; Interviews as Topic; North Carolina; Public Health; Public Housing; Smoke-Free Policy; Smoking; Tobacco Smoke Pollution; Urban Renewal
PubMed: 29935078
DOI: 10.5888/pcd15.170427 -
Frontiers in Sociology 2022In this article, I propose to take a closer look at the practices of kinning in the context of adoption in contemporary Poland. I am interested in the social production...
In this article, I propose to take a closer look at the practices of kinning in the context of adoption in contemporary Poland. I am interested in the social production of this 'unfamiliar kind of kinship' and the positions of various actors involved in defining the "adoptable" children and the "families of excess" capable of adopting. My focus will be on the ways in which the psy-knowledge and practices are implied in these social processes of defining and delimiting the norm, the proper, and the ideal. This process can be called a progressing psychiatrization of kinning, this time developing on a specific terrain of adoption (i.e., the most desired state of exception from ideal family-nuclear, heteronormative, based around married, and non-divorced couple). I will consider both top-down and bottom-up processes within which the individuals, state institutions, and psy-knowledge interact. Thus, I propose to look at a sub-process of psychiatrization, which takes place in the specific ethnographic context at the intersection of family and social policies, medicalization and psychologization of familial relations, and troubled, disconnected biographies. Throughout the article, I discuss how the adoptive families become patient-consumers within the system of healthcare. It is despite the fact that when they enter the adoption network, they start to take part in the political process of solving the social problem. In fact, they become a part of the network, which enables privatization of the social problem and works toward individualizing the responsibility for solving it.
PubMed: 36189443
DOI: 10.3389/fsoc.2022.869593 -
Journal of Medical Internet Research Mar 2020Social media platforms are important tools for hospitals. These platforms offer many potential benefits in various areas of application for hospitals to connect and...
BACKGROUND
Social media platforms are important tools for hospitals. These platforms offer many potential benefits in various areas of application for hospitals to connect and interact with their stakeholders. However, hospitals differ immensely in their social media adoption. There are studies that provide initial findings on individual factors influencing social media adoption by hospitals, but there is no comprehensive and integrated model.
OBJECTIVE
This study aimed to develop a comprehensive model of social media adoption by hospitals in the context of the Swiss health care system and to test the model with empirical data from Switzerland.
METHODS
To develop our model, we applied the general technology-organization-environment framework of organizational technology adoption and adapted it to the specific context of social media adoption by hospitals in Switzerland. To test our model, we collected empirical data on all 283 hospitals in Switzerland and identified the accounts they operate on 7 different social media platforms (Facebook, Google+, Twitter, Instagram, LinkedIn, XING, and YouTube). We tested the hypotheses of our model by means of binary logistic regression (dependent variable: platform adoption) and negative binomial regression (dependent variable: number of different platforms adopted).
RESULTS
Our general model on social media adoption received broad support. Overall, hospitals in Switzerland are more likely to adopt social media if they have a higher share of patients with voluntary health insurance or have a higher patient volume. In contrast, they are less likely to operate their own social media accounts if they are associated with a hospital network. However, some hypotheses of our model received only partial support for specific social media platforms; for instance, hospitals in Switzerland are more likely to adopt XING if they provide an educational program and are more likely to adopt LinkedIn if they are located in regions with higher competition intensity.
CONCLUSIONS
Our study provides a comprehensive model of social media adoption by hospitals in Switzerland. This model shows, in detail, the factors that influence hospitals in Switzerland in their social media adoption. In addition, it provides a basic framework that might be helpful in systematically developing and testing comprehensive models of social media adoption by hospitals in other countries.
Topics: Cross-Sectional Studies; Delivery of Health Care; Hospitals; Humans; Social Media; Switzerland
PubMed: 32149718
DOI: 10.2196/16995 -
Journal of the American Geriatrics... Sep 2022Despite the effectiveness of innovations to improve the care of persons with dementia, there has been limited diffusion of these into widespread clinical practice. We... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Despite the effectiveness of innovations to improve the care of persons with dementia, there has been limited diffusion of these into widespread clinical practice. We aimed to identify common barriers and address them directly in the initial phase of dissemination of a successful dementia care program.
METHODS
Description of and early experience with a dissemination strategy of the UCLA Alzheimer's and Dementia Care Program to health care systems nationwide. We measured site-identified goals for the program and indicators of success, number of adopting sites, and participants in their programs.
RESULTS
From January 2019 to December 2021, 80 sites expressed interest in adopting the program, 14 (18%) sites adopted it, and 10 of these sites have begun caring for patients. Another 4 sites have implemented the program as part of a randomized clinical trial. To date, over 1690 persons living with dementia and their caregivers have received Alzheimer's and Dementia Care (ADC) care at 14 adopting sites. Key lessons from the early dissemination efforts include the importance of identifying a strong product champion at the adopting site, creating a business case for adoption, training of clinical staff and adapting the model to fit local cultures and workflow, as well as recognizing the likely long length of time needed for the decision to adopt and implementation process.
CONCLUSIONS
Despite many obstacles to dissemination, with local champions and technical assistance, successful innovations in dementia care can be implemented in diverse health systems. The ability to adopt sites to bring the program to full scale and achieve comparable outcomes to the original program remains to be determined.
Topics: Alzheimer Disease; Caregivers; Delivery of Health Care; Dementia; Humans
PubMed: 35678747
DOI: 10.1111/jgs.17900 -
Cancer Sep 2015To the authors' knowledge, little is known regarding the rate at which cancer survivors successfully adopt a child or about their experiences negotiating a costly, and...
BACKGROUND
To the authors' knowledge, little is known regarding the rate at which cancer survivors successfully adopt a child or about their experiences negotiating a costly, and perhaps discriminatory, process regarding the prospective parent's health history. The current study describes the results of a learning activity in which nurses contacted an adoption agency to learn more about the process for survivors with the goal of helping nurses provide patients with accurate information for making a well-informed decision regarding adoption.
METHODS
Training program participants identified an adoption agency (local, state, or international) and conducted an interview using a semistructured guide. After the interview, participants created a summary of responses to the questions. The authors examined responses to each question using qualitative content analysis.
RESULTS
A total of 77 participants (98% completion rate) across 15 states provided a summary. Responses were distributed across the following categories: adoption costs, steps required for survivors seeking adoption, challenges for survivors seeking adoption, birth parents' reservations, and planned institutional changes to increase adoption awareness. The majority of respondents reported improving their knowledge of adoption and cancer, increased challenges for survivors, and the need to educate patients concerning the realities of adoption policies. The need for a letter stating the survivor was 5 years cancer free was identified as a significant obstacle for survivors.
CONCLUSIONS
Nurses are charged with following practice guidelines that include recommendations for appropriate reproductive health referrals. Cancer survivors would benefit from a health care provider who can provide education and concrete information when patients are making a decision about fertility and adoption.
Topics: Adoption; Antineoplastic Agents, Alkylating; Education, Nursing; Female; Humans; Infertility; Male; Neoplasms; Nurses; Oncology Nursing; Survivors
PubMed: 26180029
DOI: 10.1002/cncr.29322 -
Frontiers in Psychology 2022Every emerging technology has its pros and cons; health-conscious users pay more importance to healthy and environment-friendly technologies. Based on the UTAUT2 model,...
Every emerging technology has its pros and cons; health-conscious users pay more importance to healthy and environment-friendly technologies. Based on the UTAUT2 model, we proposed a comprehensive novel model to study the factors influencing consumers' decision-making to adopt the technology. Compared to prior studies that focused on linear models to investigate consumers' technology adoption intentions and use behavior. This study used a Structural Equation Modeling-fuzzy set qualitative comparative analysis (SEM-QCA) approach to account for the complexity of customers' decision-making processes in adopting new technology. We collected valid responses from 830 consumers, analyzed them, and evaluated them using a deep learning SEM-QCA technique to capture symmetric and asymmetric relations between variables. We have extensively incorporated a health-consciousness attitude as a predictor and mediator to understand better the decision-making toward technology adoption, specifically 5G technology. All the factors tested in our model are statistically significant except the economic factors. Health-consciousness attitude (HCA) and behavioral intention (BI) found significant predictors and valid mediators in the process of 5G technology adoption. sQCA provided six configurations to achieve high 5G adoption. The findings have significant practical ramifications for telecom corporations, advertisers, government officials, and key policymakers. Additionally, the study added substantial theoretical literature to technology adoption, particularly the adoption of 5G technology.
PubMed: 35222212
DOI: 10.3389/fpsyg.2022.836194 -
Adoption Quarterly 2017Data from the 2011-2012 National Survey of Children's Health and the 2013 National Survey of Children in Nonparental Care were used to fit a multinomial logistic model...
Data from the 2011-2012 National Survey of Children's Health and the 2013 National Survey of Children in Nonparental Care were used to fit a multinomial logistic model comparing three groups to those who never considered adoption: those who ever considered, but are not currently planning adoption; those planning adoption; and those who adopted. Adoption may be more likely when the caregiver is a nonkin foster parent, a foster care agency was involved, and/or financial assistance is available. Those with plans to adopt but who have not adopted may face adoption barriers such as extreme poverty, lower education and being unmarried.
PubMed: 26949328
DOI: 10.1080/10926755.2016.1149534 -
International Journal of Environmental... Mar 2022People's lives, particularly farmers', have been affected by extreme weather conditions that have reduced the yield of numerous crops due to climate change....
People's lives, particularly farmers', have been affected by extreme weather conditions that have reduced the yield of numerous crops due to climate change. Climate-smart agriculture practices can reduce or eliminate greenhouse gas emissions and have the propensity to increase farm income and productivity. Therefore, the purpose of this study is to ascertain whether CSA practices impact farmers' income. This study includes all cocoa farmers in the selected districts in the Ashanti Region. The population includes those who live in the six cocoa production villages. The multistage sampling procedure was considered based on the dominants of literature. The study used an endogenous switching regression framework to examine the effects of the adoption of climate-smart agricultural practices (CSAPs) on farmers' income. While estimating treatment effects, telasso uses lasso techniques to select the appropriate variable sets. The results revealed that gender, farm experience, age, household size, and farm size do not significantly influence the adoption of irrigation and crop insurance. The study revealed a significant positive impact of access to credit on adopting irrigation and crop insurance. The adoption of climate-smart practices has a positive coefficient. This indicates that if all respondents in each region adopts these practices, their income would increase significantly. This study shows that adopting irrigation practices leads to an increase in household income of 8.6% and 11.1%, respectively, for cocoa farmers. Crop insurance has a positive coefficient and is statistically significant on household income, on-farm, and off-farm. This paper shows that climate-smart practices such as crop insurance can positively influence farmers' income in Ghana. We also conjecture that crop insurance is the most effective and efficient climate-smart practice among the various agricultural practices. The study suggests that access to credit and mass awareness should be compulsory modules coupled with the consistent training of farmers on new technologies for effective policy implementation. Expanding access to extension officers could enhance farmers' adaptive capacity and warrant the efficiency of implemented practices.
Topics: Agriculture; Cacao; Climate Change; Farmers; Farms; Ghana; Humans
PubMed: 35409488
DOI: 10.3390/ijerph19073804 -
Heliyon Aug 2022Using nationally representative survey data, we identify and examine the determinants of biogas technology adoption in Nepal. Because of its dependence on biomass...
Using nationally representative survey data, we identify and examine the determinants of biogas technology adoption in Nepal. Because of its dependence on biomass energy, the Government of Nepal has been promoting alternative sources of energy, particularly for rural households. Biogas has been identified and promoted as a viable alternative renewable energy source alongside many others. In addition to providing low-cost sustainable energy, biogas offers a wide range of additional benefits. Because of the many benefits of adopting biogas, the Government of Nepal has made expanding biogas technology a priority. Despite the policy priority and several benefits, the drivers and barriers to household-level biogas technology adoption have not been investigated at the national level. We use newly collected survey data to investigate the determinants and barriers to biogas adoption. We use probit models to quantify the marginal effect of these determinants on biogas adoption. Our analysis shows that income, land holdings and the number of livestock are key socioeconomic determinants of biogas adoption in Nepal. Our result suggests that households in the country's hilly region are less likely to adopt biogas indicating the difficulty of installing and operating biogas in mountain and hilly regions. The findings also indicate that lack of access to a bank and the number of biogas service providers are among the main obstacles to biogas adoption in Nepal. Our findings provide information that can make valuable contributions to the energy policy of developing countries for the sustainable development of alternative energies.
PubMed: 36033284
DOI: 10.1016/j.heliyon.2022.e10106