Italian international adoptees at home and at school: A multi-informant assessment of behavioral problems.

The aim of this study was to compare the reports of emotional and behavioral problems of adopted children on the part of mothers, fathers, and teachers, and to examine the agreement in the reports among the three informants. The approach employed was multi-informant, with a three-point sample composed of 75 Italian couples (all parents of international adoptees between 7 and 11 years of age) and one of the child's teachers. Parents reported higher levels of problems in their adopted children than teachers did. Moreover, the agreement between mother and father was higher than that between one parent and the teacher. The percentage of cases in which all three informants agreed on the classification of the child as being part of the clinical group turned out to be considerably lower than when only one informant was concerned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Migration and international health policies

Parity, age at first birth, age at menarche, and a family history of breast cancer have each been associated consistently with breast cancer risk. Whether this increase in risk is mediated, at least in part, through changes in endogenous hormone levels is unclear. We conducted a cross-sectional study of the relationships between these factors and plasma hormone levels in 216 healthy postmenopausal women in the Nurses' Health Study (United States). The hormones evaluated were estradiol, percent and total free estradiol, percent and total bioavailable estradiol, estrone, estrone sulfate, and prolactin. After controlling for age, body mass index (weight/height2), and alcohol use, we observed inverse associations between estrone sulfate and parity (r = -0.15, P = 0.03) and between percent bioavailable estradiol and age at first birth (r = -0.17, P = 0.02). Although women with a family history of breast cancer tended to have higher estrogen levels compared with women without such history, the differences were not statistically significant. Age at menarche was not related significantly to any of the hormones. These data provide some additional evidence that the inverse relationship observed between parity and breast cancer risk may be mediated, at least in part, through decreased estrogen levels. Our data do not support a substantial influence of either family history of breast cancer or age at menarche on postmenopausal estrogen or prolactin levels.     

Teaching Rwandan families to care for people with AIDS at home

AIDS causes disabling symptoms during its chronic and terminal phases. Families throughout the world, whether related to the patient by blood or affection, provide most of the personal care for him or her at home during these phases. Whether the family has access to advanced medical care or not, they can be taught simple comfort measures and nursing care skills that will improve the well-being of the patient. In Rwanda, a small country in east-central Africa, Red Cross volunteers were trained to teach these skills. The volunteers then returned to their villages to help local families. Six months later, 24 of these families were interviewed about the impact of the volunteers' visits. Families indicated they had benefited from being taught the caregiving skills. They also appreciated the emotional support attendant to the volunteers' visits. In summary, the training course enabled volunteers both to enhance family nursing care skills and to provide emotional support to families caring for people with AIDS at home. This training can also be used by volunteers to assist families caring for members ill with other endemic chronic infectious diseases.     

Help for home health strategies

Although home health care clearly isn't an industry for the weak-hearted, a sound strategic plan increases your chances for survival. These eight concepts can help nurse managers plan a multifaceted approach.     

Computerized documentation in home health

Computerized documentation in community health nursing is only now receiving the attention it deserves. The authors explain one agency's experience with adapting a computerized clinical documentation system to visiting nurses' needs and the nurses' responses to the process.     

Hospital care at home

Red cell aggregation has been studied by photometry in 47 children with insulin-dependent diabetes mellitus. The disease was associated with boosting of reversible red cell aggregation, which was most of all expressed during metabolic decompensation with ketoacidosis. When metabolic subcompensation was attained, this parameter did not completely normalize and still had to be corrected.     

Technology-dependent children at home

Many children cared for at home are dependent on medical technology. Stressors for the family caring for technology dependent children include: finances and adaptation to new roles. Good discharge planning is the key to successful adaptation by the family as discharge home is often delayed by financial wrangles between purchasers and providers.     

Social support in home health nurses

The decision of a home health nurse to remain employed at an agency is certainly influenced by a number of factors, one being how much support or encouragement that nurse is receiving from colleagues. The home health nurse does interact with peers at the office and over the telephone, but such an act as calling down the hall to another registered nurse to help with a client is not possible.     

Public health medicine training

Training in public health medicine uses a 'trainer-trainee' model for learning similar to that used in general practice. In order to examine the quality of training in the South Western region of the UK, a questionnaire was devised to assess both adequacy and importance of various factors for training. The results of the survey identified key areas for further discussion and were used as the basis of an interactive study day. One interesting finding was the difference in perceptions of trainers and trainees, possibly illustrating the differences between trainees' 'demands' and trainers' perceptions of trainees' 'needs'.     

Recent growth of Medicare home health

Medicare spending for home health services has grown at an unprecedented rate since regulations were revised in 1989. To address the implications of this striking growth, it is necessary to examine the causes. This paper finds that the most important source of growth has been in the number of home health visits received per beneficiary, not in the number of beneficiaries that have been added in response to redefined eligibility criteria. Policymakers should clarify the objectives of the Medicare home health benefit, in light of increased attention to long-term care financing and expanded services for older Americans.     

Social medicine and public health]

A case of Sipple's syndrome is reported, in which the full phenotype was expressed. The patient had the typical marfanoid habitus, with thickened lips and alae nasi, neuromas on lips and tongue, medullary carcinoma of the thyroid gland, phaeochromocytomas, and medullated corneal nerve fibres. The plasma calcitonin level was initially elevated, rose on calcium infusion before thyroidectomy, and was undetectably after thyroidectomy. The urinary catecholamine excretion was elevated. The plasma parathyroid hormone, adrenocorticotrophin and growth hormone levels and the serum calcium level were normal.     

The home health aide as a member of the home healthcare team

Individuals of all ages are discharged from acute-care facilities with a variety of medical and nursing diagnoses. Many of these individuals require home health aides services in addition to their skilled care. In the changing healthcare environment of the 1990s, home healthcare professionals are being challenged to provide effective, skilled care that is the most cost-effective and appropriate for patients. It is important that all professional home healthcare personnel work as a team with home health aides to accomplish these goals. The home health aide is an important member of the home care team.