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International Journal of Environmental... Dec 2022The World Health Organization (WHO) recently published guidelines on the implementation of a new Integrated Care for Older People (ICOPE) framework in 2017-2019. It is... (Review)
Review
The World Health Organization (WHO) recently published guidelines on the implementation of a new Integrated Care for Older People (ICOPE) framework in 2017-2019. It is an integrated care framework for the screening, assessment, and management of intrinsic capacity (IC) declines. We aimed to examine where the early adopters of ICOPE are across the world, how these study teams and sites plan to apply the framework or have applied it, and the lessons learnt for future adopters. We systematically searched electronic medical and social sciences databases and grey literature published between 31 October 2017 and 31 March 2022. Records were systematically selected using precise inclusion criteria. There were 18 ICOPE study teams and sites across the 29 selected records. Of the 18 study teams and sites, seven were in the development stage, seven conducted feasibility studies, and four have commenced implementation of interventions that applied the ICOPE framework. Future ICOPE adopters may need to make certain decisions. These include whether to adopt ICOPE in the community setting or other settings, whether to adopt only Step 1 on IC screening or additional ICOPE Steps, whether the ICOPE IC screening tool requires modifications, and whether to use digital health technology. We propose the key factors needed to make these decisions and future research needed.
Topics: Humans; Aged; Learning; Delivery of Health Care, Integrated; World Health Organization
PubMed: 36612480
DOI: 10.3390/ijerph20010154 -
Online Journal of Issues in Nursing Jan 2022Transracial/transcultural adoption is defined as a child of one race or ethnic group placed with parent(s) of a different race or ethnic group. An estimated 2 million...
Transracial/transcultural adoption is defined as a child of one race or ethnic group placed with parent(s) of a different race or ethnic group. An estimated 2 million children in the United States were identified as adopted in the 2010 census, and approximately one-fourth of these were transracial adoptions. Both a history of adoption and a strong ethnic or racial identity are specifically associated with health-related risk and protective factors for psychosocial, academic, and health behavior outcomes. A patient with a history of transracial adoption presents unique and important considerations for culturally responsive nursing care. This article begins with nursing practice considerations for transracially adoptive patients and provides an overview of epidemiology; relevant trauma informed nursing care;. laws and racial identity formation, and a mental model of health disparities to guide future directions. We synthesize information relevant to nursing care of individuals who are transracially adopted and racial/ethnic identity formation, including socialization and a merging model to conceptualize identities. The article also discusses principles of trauma informed care and health disparities and future improvements in the context of this population.
Topics: Child; Humans; Adoption; Censuses; Ethnicity; Nursing Care; Parents; Cultural Competency
PubMed: 36721853
DOI: No ID Found -
Child Abuse & Neglect Aug 2022Although a very heterogeneous group, adopted persons may present developmental and mental health problems of varying severity. Pre-placement adversity and trauma have...
BACKGROUND
Although a very heterogeneous group, adopted persons may present developmental and mental health problems of varying severity. Pre-placement adversity and trauma have often been linked to these problems. It has been also suggested that adoption itself is a psychological trauma, predisposing the individual to emotional difficulties.
OBJECTIVES
This article examines the links between early adversity, trauma, and adoption. We begin by defining trauma and then describe the way in which pre-placement adversity can undermine neurobehavioral and interpersonal functioning, increasing the risk for long-term psychological difficulties. Next, we examine children's recovery when placed in a stable adoptive home. Finally, we explore adoption as a lived experience, highlighting contextual and developmental factors that facilitate the person's positive or negative attributions about being adopted, leading to varying patterns of emotional adjustment.
CONCLUSIONS
Although pre-placement adversity increases adopted individuals' risk for maladjustment, the human brain and behavior are malleable, and placement in a nurturing adoptive home often facilitates recovery from early adversity, with significant heterogeneity in the extent of recovery within and across domains of functioning. While there is no evidence that early adoption is a trauma for the individual, ongoing negative life circumstances, attachment difficulties, and developmentally-mediated attributions about adoption can undermine the person's self-esteem, identity, relationships, and sense of well-being. Conclusions and suggestions for future research are offered.
Topics: Adoption; Child; Emotional Adjustment; Humans; Longitudinal Studies
PubMed: 34544593
DOI: 10.1016/j.chiabu.2021.105309 -
Journal of the American Academy of... Nov 2021A compelling piece of science in this month's issue is the work of Wood et al., which addresses a long-standing question about adoption in infancy-could the process of...
A compelling piece of science in this month's issue is the work of Wood et al., which addresses a long-standing question about adoption in infancy-could the process of adoption affect the later characteristics of adopted children? This question arises from studies showing that children adopted at birth have higher rates of behavioral problems on average later in life. Potential confounds of such studies are that adopted children may enter the adoption with pre-existing vulnerabilities related to the reason for adoption, which in turn could lead to behavioral differences. Scientists trying to minimize this confound previously have capitalized on the benefits of animal model approaches-randomization, controlled genetic background, controlled environmental factors, faster development, opportunities for close observation-showing that adoption at birth can affect rodent offspring long term. However, a nonhuman primate study comes closer to addressing this question specifically for our human, primate vulnerability.
Topics: Adoption; Animals; Macaca; Problem Behavior
PubMed: 34116168
DOI: 10.1016/j.jaac.2021.06.002 -
Science and Engineering Ethics Apr 2023This article introduces Designing for Care (D4C), a distinctive approach to project management and technological design informed by Care Ethics. We propose to...
This article introduces Designing for Care (D4C), a distinctive approach to project management and technological design informed by Care Ethics. We propose to conceptualize "care" as both the foundational value of D4C and as its guiding mid-level principle. As a value, care provides moral grounding. As a principle, it equips D4C with moral guidance to enact a caring process. The latter is made of a set of concrete, and often recursive, caring practices. One of the key assumption of D4C is a relational ontology of individual and group identities, which fosters the actualization of caring practices as essentially relational and (often) reciprocal. Moreover, D4C adopts the "ecological turn" in CE and stresses the ecological situatedness and impact of concrete projects, envisioning an extension of caring from intra-species to inter-species relations. We argue that care and caring can influence directly some of the phases and practices within the management of (energy) projects and the design of sociotechnical (energy) artefacts and systems. When issues related to "value change" emerge as problematic (e.g., values trade-offs, conflicts), the mid-level guiding principle of care helps evaluate and prioritize different values at stake within specific projects. Although there may be several actors and stakeholders involved in project management and technological design, here we will focus on the professionals in charge of imagining, designing, and carrying out these processes (i.e., project managers, designers, engineers). We suggest that adopting D4C would improve their ability to capture and assess stakeholders' values, critically reflect on and evaluate their own values, and judge which values prioritize. Although D4C may be adaptable to different fields and design contexts, we recommend its use especially within small and medium-scale (energy) projects. To show the benefits of adopting it, we envisage the application of D4C within the project management and the technological design of a community battery. The adoption of D4C can have multiple positive effects: transforming the mentality and practice of managing a project and designing technologies; enhancing caring relationships between managers, designers, and users as well as among users; achieving better communication, more inclusive participation, and more just decision-making. This is an initial attempt to articulate the structure and the procedural character of D4C. The application of D4C in a concrete project is needed to assess its actual impact, benefits, and limitations.
Topics: Engineering; Communication
PubMed: 37097387
DOI: 10.1007/s11948-023-00434-4 -
Heliyon Jan 2022The population aging and an increased life expectancy are widely recognized social changes. Technologies are believed to improve the elderly's daily lives and maintain... (Review)
Review
The population aging and an increased life expectancy are widely recognized social changes. Technologies are believed to improve the elderly's daily lives and maintain their health efficiently. Despite the advantage of adopting technologies, the elderly are slower to adopt new technologies compared to younger adults. This paper presents a Systematic Literature Review (SLR) to identify the different antecedents prevailing in the literature on elderly technology adoption. The SLR classifies and analyzes 26 relevant articles on elderly's technology adoption. Our findings revealed that quantitative approach and cross-sectional studies predominate in this field, building fundamentally upon the technology-driven theories. We identify seven categories of antecedents influencing elderly's use of technology, namely, technology, psychological, social, personal, cost, behavior, and environment antecedents. A conceptual framework for elderly's technology adoption and recommendations were presented. Particular attention is given to the need for in depth study for the antecedents, development of new measurement scales and investigation on the effectiveness of the proposed benefits after technology adoption.
PubMed: 35128090
DOI: 10.1016/j.heliyon.2022.e08765 -
Journal of Nutrition and Metabolism 2019In the past, only people diagnosed with celiac disease, approximately 1% of the population, avoided gluten consumption through all their meals. However, popular media... (Review)
Review
In the past, only people diagnosed with celiac disease, approximately 1% of the population, avoided gluten consumption through all their meals. However, popular media often now mistakenly present gluten-free foods as being a healthier choice, and more people have now concluded that gluten is a harmful part of the diet. A review of literature on gluten-free diets, gluten sensitivity, celiac disease, and attitudes toward gluten consumption was undertaken to examine the prevalence and consequences of adopting a gluten-free diet and to provide guidance to healthcare practitioners whose patients are now often adopting this diet without medical input. Aside from celiac disease, nonceliac gluten sensitivity (NCGS) occurs in those persons in which gluten ingestion leads to symptomatic manifestations in the absence of celiac disease or wheat allergy but who report a remission of certain symptoms after removing gluten from their diet. However, it was been shown that a large percentage of people who claim NCGS do not feel those manifestations under a double-blind challenge to gluten. Moreover, some parents, believing that ingesting gluten is detrimental for their health, adopt gluten-free diets for their children. A review of existing data shows that there are detrimental effects to going gluten free, including loss of the dietary fiber, deficiencies in dietary minerals and vitamins, and potential heavy metal exposure. Healthcare practitioners should query patients about their dietary choices, and in cases of questionable adoption of gluten-free diet, patients and parents are educated about the detriments of a gluten-free diet, and in cases where patients continue to insist on gluten-free foods, referrals to nutritional counseling are warranted in order to minimize potential harm.
PubMed: 31354988
DOI: 10.1155/2019/2438934 -
Frontiers in Public Health 2021Digital health has massive potential in health care but has been slow to evolve in comparison to other information-intensive industries, which have more readily taken... (Review)
Review
Digital health has massive potential in health care but has been slow to evolve in comparison to other information-intensive industries, which have more readily taken advantage of new technology. One of the key barriers has been the complex relationship between the perceived return on investment for the investor and the resulting value to patients and caregivers. Those actors who pay for technologies do not always see an appreciable return for themselves, while those actors who must apply the technology to generate value are not always incentivized to do so. This misalignment across health system payers and administrators, clinicians and patients must be better understood and addressed to help accelerate digital health. This paper will examine this challenge through the clinician experience, using empirical case examples from Canada to illustrate opportunities for change. While many factors may influence digital health adoption, this paper specifically aims to explore the shifts in the balance of the perceived value of implementing digital health tools, vs. the efforts required to adopt them. It will explore two contrasting case examples: clinical adoption of EMRs in Canada from 2009 to 2015, and clinical adoption of virtual care technologies during the COVID-19 pandemic from 2020 to 2021. In 2006, Canada lagged peer countries significantly in the adoption of electronic medical records (EMR) in community-based care. Financial support and cooperation of multiple levels of government and clinical stakeholders were required to address the misaligned incentives, which led to significant uptake by care providers. The rapid adoption of virtual care in Canada in response to the pandemic provides another relevant example of the importance of alignment among the factors of clinical workflows, clinical appropriateness, technology integration and payment models. Experts have highlighted the need for standardization, regulation, and clear policy to ensure sustainable, high quality virtual care that complements in-person care. In both cases, the costs and effort of adopting new technologies outweighed direct clinician value, requiring change initiatives to catalyze progress. This imbalance could be unique to these examples in Canada, and may not be globally generalizable to the adoption of all digital health tools. However, how change efforts can be tailored to adjust to a rapidly evolving health care workforce, spanning diverse jurisdictions and stakeholder groups will be critical to the sustainability of virtual care adoption. Furthermore, what key elements must be considered to guide change initiatives for successful implementation, designed to influence change while adding value for patients, clinicians and Canada's health care systems? Using insights from successful change initiatives past and present, this paper aims to answer these questions to enable a smoother transition to digital health innovations of the future.
Topics: COVID-19; Delivery of Health Care; Electronic Health Records; Humans; Pandemics; SARS-CoV-2
PubMed: 34712641
DOI: 10.3389/fpubh.2021.741424 -
Child Maltreatment May 2021Adoption and guardianship are meant to provide permanency to foster children when reunification is not a viable option. Unfortunately, sometimes adoption and...
Adoption and guardianship are meant to provide permanency to foster children when reunification is not a viable option. Unfortunately, sometimes adoption and guardianship placements dissolve resulting in children returning to care. Currently, there is limited research on the prevalence and predictors of adoption and guardianship dissolutions. This study investigated rates of guardianship and adoption dissolution using a complete entry cohort from a large state foster care system and the associations between child characteristics and risk factors with dissolution. Drawing on a complete entry cohort of foster children in Texas that exited to either adoption or guardianship placements, results demonstrated that over 2% of adoptive placements and 7% of guardianship placements were dissolved. Compared with White and Hispanic children, Black children had a higher risk of guardianship, but not adoption, dissolution. Older age was associated with a higher risk of adoption dissolution, and females had a higher risk of guardianship dissolution than males. Behavior problems, cognitive disability status, and mental health issues were all associated with a higher risk of dissolution. These findings have important implications for caseworkers and policymakers on permanency for children in adoptive or guardianship placements.
Topics: Adoption; Aged; Child; Child Welfare; Cohort Studies; Female; Foster Home Care; Humans; Male; Risk Factors
PubMed: 32909825
DOI: 10.1177/1077559520952171 -
The Urologic Clinics of North America May 2021The emergence of the COVID-19 pandemic and subsequent public health emergency (PHE) have propelled telemedicine several years into the future. With the rapid adoption of... (Review)
Review
The emergence of the COVID-19 pandemic and subsequent public health emergency (PHE) have propelled telemedicine several years into the future. With the rapid adoption of this technology came socioeconomic inequities as minority communities disproportionately have yet to adopt telemedicine. Telemedicine offers solutions to patient access issues that have plagued urology, helping address physician shortages in rural areas and expanding the reach of urologists. The Centers for Medicare & Medicaid Services have adopted changes to expand coverage for telemedicine services. The expectation is that telemedicine will continue to be a mainstay in the health care system with gradual expansion in utilization.
Topics: COVID-19; Centers for Medicare and Medicaid Services, U.S.; Diffusion of Innovation; Humans; SARS-CoV-2; Socioeconomic Factors; Telemedicine; United States; Urology
PubMed: 33795055
DOI: 10.1016/j.ucl.2021.01.006