HIV-infected children benefit from Improved caregiver training

Main Category: HIV / AIDS
Also Included In: Pediatrics / Children's Health;  Caregivers / Homecare
Article Date: 19 Aug 2013 - 0:00 PDT Current ratings for:
HIV-infected children benefit from Improved caregiver training

Children born with HIV can live longer and richer lives if their caregivers receive training in ways to enhance the children's development, according to research led by Michigan State University.

The program also reduces depression in the caregivers which, in most cases, are the children's HIV-infected mothers, MSU researcher Michael Boivin and colleagues report in The Journal of Pediatrics.

An HIV diagnosis once all but guaranteed an African child would die within a few years, but more effective and widely available drugs have made it commonplace for children there to live with the disease into or beyond adolescence.

Still, with gravely ill caregivers - many of whom must also work long hours in the fields to provide food - these kids miss out on the affection and regular interaction that are crucial for their physical, social and cognitive development in early childhood, said Boivin, professor in the departments of Psychiatry and of Neurology and Ophthalmology.

"Better access to treatment has clinically stabilized these children and extended their lives, but their quality of life is still very much at risk," Boivin said. "The effects of the disease on their development and the compromised caregiving available to them compound the public health challenges already faced by African children in resource-poor settings."

Funded by the National Institutes of Health, the study involved a training program called Mediational Intervention for Sensitizing Caregivers, or MISC, which uses day-to-day interaction at home to enhance children's social skills, language and cognitive ability.

"MISC is about training mothers or other caregivers on ways they can be sensitive to their child's natural tendencies to learn, and to direct those tendencies in everyday life to enrich the child's development," said Boivin.

The study involved 120 preschool-aged children with HIV living in rural Uganda. Their primary caregivers were randomly assigned to receive childcare training through MISC or through an education program focused on improving children's health and nutrition.

After a year, the children whose caregivers received the MISC training showed significantly more developmental progress than the others, with particularly strong gains in memory and learning skills.

Somewhat surprisingly, there were significantly fewer deaths from diseases that take advantage of the patient's compromised immune system in the MISC group than among other children, suggesting the training may help pediatric HIV patients live longer.

Boivin said it could be that MISC-trained caregivers "became more attuned to their children's health needs and were more likely to seek medical help in a timely manner when the children are fighting an opportunistic illness."

Caregivers in the MISC group also were significantly less depressed six months into the study than those in the other group, perhaps because of the social support they received during MISC training.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Job training results in competitive employment for youth with autism

Main Category: Autism
Also Included In: Public Health
Article Date: 31 Jul 2013 - 0:00 PDT Current ratings for:
Job training results in competitive employment for youth with autism

A Virginia Commonwealth University study¹ shows intensive job training benefits youth with Autism Spectrum Disorders (ASD), one of the most challenging disabilities in the world where only 20 percent find employment. Published in the Journal of Autism and Developmental Disorders, the study demonstrates that nine months of intensive internship training, in conjunction with an engaged hospital, can lead to high levels of competitive employment in areas such as cardiac care, wellness, ambulatory surgery and pediatric intensive care units.

"This is the first study of its kind to demonstrate the skills and abilities youth with ASD have and the success they can experience at work," said Paul H. Wehman, Ph.D., principal investigator of the study and Professor of Physical Medicine and Rehabilitation and Director of the VCU Autism Center at the VCU School of Education. "Previous research in this area showed that youth with ASD were employed at lower rates than even their peers with other disabilities."

Traditionally, youth with autism between the ages of 18 and 22 remain unemployed after leaving school at rates of over 80 percent. But VCU researchers reported that those who completed a program called "Project SEARCH with Autism Supports" achieved employment at 87 percent. This study also showed that youth with ASD required less intense support as they became more competent at their work task.

VCU partnered on the study with Bon Secours Richmond Health System St. Mary's Hospital in Henrico County, Va., St. Francis Medical Center in Chesterfield County, Va.; Henrico County Public Schools; Chesterfield County Public Schools; and the Virginia Department for Aging and Rehabilitative Services (DARS).

"Bon Secours has participated in Project SEARCH since 2010 and each year we find the students add a tremendous value to our team of caregivers," said Michael Spine, Bon Secours Health System Senior Vice President of Business Development. "Project SEARCH graduates are permanent and important members of our staff, working throughout the hospitals in a variety of areas including labor and delivery, our cardiac units and wellness."

"Witnessing how these 'disabled students' are transformed into valued employees and colleagues during their Project SEARCH year is the best example of how our system can be successful when our collaboration is employed," said DARS Commissioner James A. Rothrock.kara

te "Getting a job is the central accomplishment in life for all 20-year-olds," said study co-investigator Carol M. Schall, Ph.D., Director of Technical Assistance for the VCU Autism Center for Excellence and Virginia Autism Resource Center. "For far too long, youth with ASD have been left out of that elated feeling that adults have when they get their first real employment. Through this study, we were able to demonstrate that youth with ASD can be successful employees."

Youth with autism were employed in jobs not typically considered for those with disabilities in a hospital setting. They worked 20 to 40 hours per week and were paid 24 percent more than the minimum wage.

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Competitive Employment for Youth with Autism Spectrum Disorders: Early Results from a Randomized Clinical Trial:

Paul H. Wehman, Carol M. Schall, Jennifer McDonough, John Kregel, Valerie Brooke, Alissa Molinelli, Whitney Ham, Carolyn W. Graham, J. Erin Riehle, Holly T. Collins, Weston Thiss

1. Wehman PH et al. (2013). Competitive employment for youth with Autism Spectrum Disorders: Early results from a randomized clinical trial. Journal of Autism and Developmental Disorders

2. The study was funded by the Disability and Rehabilitation Research Project (DRRP) grant #H133B080027 from the National Institute on Disability and Rehabilitation Research (NIDRR), and by the Virginia Department for Aging and Rehabilitative Services.

Abstract: For most youth with autism spectrum disorders (ASD), employment upon graduation from high school or college is elusive. Employment rates are reported in many studies to be very low despite many years of intensive special education services. This paper presented the preliminary results of a randomized clinical trial of Project SEARCH plus ASD Supports on the employment outcomes for youth with ASD between the ages of 18–21 years of age. This model provides very promising results in that the employment outcomes for youth in the treatment group were much higher in non-traditional jobs with higher than minimum wage incomes than for youth in the control condition. Specifically, 21 out of 24 (87.5 %) treatment group participants acquired employment while 1 of 16 (6.25 %) of control group participants acquired employment.

Springer

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Researchers urge review of health system-wide pediatric injury training, triaging and prevention efforts

Main Category: Pediatrics / Children's Health
Also Included In: Health Insurance / Medical Insurance;  Public Health
Article Date: 31 Jul 2013 - 0:00 PDT Current ratings for:
Researchers urge review of health system-wide pediatric injury training, triaging and prevention efforts

New research from The Center for Injury Research and Prevention at The Children's Hospital of Philadelphia (CHOP), signals that emergency and outpatient healthcare providers may need to prepare for higher demand for treatment among younger patients with mild and moderate injuries. As federal and state policies encouraging people to be covered by health insurance go into effect, researchers estimate the potential for more than 730,000 additional medically attended injuries annually, or a 6.1 percent increase if all currently uninsured children and young adults (ages 0-26) become insured. The estimates are based on 2008 injury data from the National Health Interview Survey. The study was published in this month's Clinical Pediatrics.

"In order to assist planning efforts by healthcare systems and policymakers, we aimed to examine the impact on trauma systems of increases in young people with health insurance" says Flaura Koplin Winston, MD, PhD, lead author and Scientific Director of the Center for Injury Research and Prevention at CHOP. "This study signals a need to prepare for potential large increases in demand for care of minor and moderate pediatric and young adult injuries in both emergency department and outpatient settings."

According to the study, a significant portion of the increase will come from currently uninsured young adults (18-26 year olds), who will now be able to remain on their parents insurance until age 26 or find affordable care through exchanges. Researchers found that the causes and nature of medically attended injuries differed between insured and uninsured young adults. The uninsured sought medical care for more serious injuries like fractures when compared to other types of injury. The insured sought medical care for a wider distribution of injuries-- with the most common being sprains and strains, as well as open wounds. Of interest, among children under age 18, 11 percent of medically attended injuries among insured kids were related to overexertion, but this injury mechanism did not cause uninsured children to seek care.

Winston and her colleagues based their estimates on recent injury care data and the assumption that those new to insurance would have a probability of medically attended injury that equals that of those who already have insurance. With these assumptions, they predict that each year as many as 510,553 additional children and young adults could be seen for injury treatment in outpatient settings, nearly 195,838 in Emergency Departments or admitted to hospital, with another 30,689 being attended to through phone- only encounters. Winston cautions that the actual health system utilization rates and sites of care may vary as newly insured people may access care differently from those who are already insured.

"Health care delivery systems across the US need to have sufficient numbers of general and pediatric healthcare providers who are trained in treating moderate trauma and injury and can staff urgent carecenters, health centers, primary care practices, call centers, and emergency departments," says Dr. Winston. "In keeping with the aims of the Affordable Care Act, the goal should be that all young patients who seek care for their injuries get the appropriate care at the right time and right place."

The study authors recommend several steps health care systems can take to manage the potential increase in patients and avoid both the expensive overuse of emergency services and the long-term effects on communities of inadequately treated injury:

Train medical students and residents with relevant course content on diagnosis and treatment of concussions, musculoskeletal injury, sports medicine and open wound care. Expand programs such as Poison Control Centers and call centers, and remote medical command for triage and treatment of non-life-threatening injuries. Prevent injuries to children by allocating federal and state resources to proven injury prevention strategies. They cost less than medical care needed to treat injuries. Implement the Centers for Disease Control and Prevention's National Action Plan for Childhood Injury Prevention. Develop or expand proven off-the-job injury prevention strategies. The cost of insuring this new population of youth, the majority of whom currently live with an employed head of household, may fall to employers.

"Injury is the leading health risk for children and young adults. Proven prevention strategies and appropriate acute care will reduce fatalities and the long-term consequences that injury can have on quality of life," says Dr. Winston.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Dr. Winston's co-authors include Mark R. Zonfrillo, MD, MSCE of CHOP, J Felipe Garcia-Espana, PhD of Coriell Institute for Medical Research, and Ted R. Miller, PhD of the Pacific Institute for Research and Evaluation. The study was supported by National Science Foundation Center for Child Injury Prevention Studies, Pennsylvania Department of Health, and the Health Resources and Administration's Children's Safety Network.

Children's Hospital of Philadelphia

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Pros and cons for Accredited Safety and health Training

If this involves safety and health training, among the issues that should be considered is whether or not you and alsoOror perhaps your employees require a certified or non-accredited training program. Associated with pension transfer things in existence, you will find pros and cons for each.

Course training content

Accredited safety and health courses like the NEBOSH Certificates (General, Construction, Fire and Environment), ConstructionSkills (SMSTS and SSSTS), IOSH (Controlling, Working, Pointing Securely) etc all have specific syllabuses which have to be adopted to be able to fulfill the assessment criteria. Which means that there might be large sections that are irrelevant for various people around the course as well as their particular job role, which can lead to associates becoming bored and "switching off". This is probably not an issue for that part that is not highly relevant to them, but when they don't "re-engage" when relevant details are being trained, they risk potentially missing crucial information. There's additionally a danger of annoying others around the course who need to know very well what has been trained.

Unlike accredited courses which, as pointed out above need to follow specific syllabuses, individuals that aren't accredited could be customized for an organisation's specific place of work hazards and dealing practices. Which means that the topic matter will probably be a lot more highly relevant to individuals attending. A non-accredited course may even incorporate the organisation's safety and health policy and emergency methods in to the trained subject material.

They might not be customized, bear in mind the status

The advantage of a certified safety and health training program is the fact that just the companies who've been pre-authorized by the relevant giving body are permitted to provide their particular courses. This enables for greater satisfaction (very important when parting with a lot of money!), as teaching standards happen to be evaluated as meeting a particular standard and pass rates are consistently good.

The truth that syllabuses are consistent and exams exactly the same across companies, this means that individuals who've acquired the qualification could be regarded as as getting an advanced of competency and safety and health understanding because they have passed the needed assessment, whereas a non-accredited qualification might have been granted to somebody after attending a training course that is way too simple and easy ,, more pertinently, doesn't supply the understanding essential for working securely or controlling others in the place of work. Simply because somebody includes a nice searching certificate does not necessarily mean they might perform their role towards the necessary requirement in the place of work if they don't have the sufficient understanding to choose it. Individuals having a genuine certificate from the recognised and well-respected giving body can be to others they have this understanding simply by showing the certificate.

However this status may come in a cost. For individuals undertaking accredited safety and health training, there's frequently a lot of course material and hefty books that are integrated into this course cost or need to be bought being an added extra, in addition to exam registration and official certification costs. There may also be lengthy waits to get exam results and certificates after finishing a certified course, which may be particularly frustrating for individuals who are required the qualification before beginning or using for jobs.

Conclusion

So to conclude, neither accredited or non-accredited training can be explained as "better", as it is viability will be based not just around the needs of the individual or company needing working out, but additionally on the standard from the training provider who's delivering this course.

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